Sign in

To submit a medical co-pay claim you will need:

  • Explanation of Benefits (EOB) form for insured patients
  • Specific information regarding the patient, prescriber, date of therapy administration, etc.

Please note: You may only submit a claim if the patient is commercially insured and is not participating in Medicare Part D, VA, TriCare, CHAMPUS, Medicaid, or any other similar federal or state program. Your information will be shared with Novartis Pharmaceuticals Corporation and used in accordance with its Privacy Policy. Please click here to view the NPC Privacy Policy.

10/20 ONC-1236778