Financial Assistance Banner

Financial Assistance

Daiichi Sankyo Access Central offers financial assistance for eligible patients prescribed Injectafer. Call 1-866-4-DSI-NOW to learn how to help your patients access Injectafer.

fFinancial Assistance Tab

INJECTAFER Savings Program Tab Contnet

Copay savings may help reduce patients’ out-of-pocket costs*

For each course of treatment:

Doses are separated by at least 7 days. Note: The first dose of the second course may cost as little as $50.
  • Assistance of up to $500 per dose with a maximum benefit of up to $1000 per course of treatment (2 doses)
  • Enrollment is valid for 2 courses of treatment (4 doses) per 12-month period

Is your patient eligible?*

Has commercial insurance or pays for treatment with cash

AND

Is a resident of the USA and its territories, including Puerto Rico

 

Has Medicare, Medicaid, or other federal or state healthcare insurance

OR

Has private indemnity or HMO insurance that reimburses patients for the entire cost of prescription drugs

OR

Is Medicare-eligible and enrolled in an employer-sponsored health plan or medical or prescription drug benefit program for retirees

Register your office by calling Daiichi Sankyo Access Central (1-866-4-DSI-NOW)

  • Daiichi Sankyo Access Central will provide you with a login for injectafercopay.com
  • Registration only needs to be completed once

Before administering Injectafer, enroll your patient

  • Log in here (you can also enroll the patient at 1-866-4-DSI-NOW)
  • Enter required patient information
  • For each patient, you’ll receive a 16-digit code for a virtual debit card upon approval

After treatment, log in and submit EOB form

  • Log in here
  • Submit the Explanation of Benefits (EOB) form for the Injectafer treatment
  • There are 3 ways to send the EOB form:

    Upload here

    Best way to submit EOBs and manage all patients OR

    Fax to 1-888-257-4673

    OR

    Mail to

    Injectafer Savings Program
    100 Passaic Ave, Suite 245
    Fairfield, NJ 07004

  • It usually takes 2-3 days for EOB to be approved
  • Then, funds will be uploaded onto the virtual 16-digit debit card

*The Injectafer Savings Program is only available for adults 18 years or older who are commercially insured or cash-paying patients. Please see full Terms and Conditions.

Insurance out-of-pocket payment must be over $50. Other restrictions may apply.

When forms are uploaded to injectafercopay.com, the process may potentially be expedited. For patients who wish to directly submit their EOB form, please direct them to fax or mail the form to the Injectafer Savings Program.

The completion and submission of coverage- or reimbursement-related documentation is the responsibility of the patient and healthcare provider. Daiichi Sankyo, Inc., makes no representation or guarantee concerning coverage or reimbursement for any service or item. A completed form includes signatures from both the physician and the patient. Before submitting, please ensure all required information is provided.