What is Catalyst Pathways®?
Catalyst Pathways is a single source of support for patients, families, and physicians. It offers one-on-one support throughout your treatment journey and a dedicated team of specialists that can help you manage your unique challenges. Catalyst Pathways includes financial assistance programs to help all eligible patients with their out-of-pocket costs Costs for medical care that aren’t covered by insurance and must be paid by the individual. and additional programs to assist those patients who are uninsured. The Catalyst Pathways team is available to meet with you in person and over the phone to answer any questions you have.
How do I enroll in Catalyst Pathways?
Why does my physician need to fill out the Enrollment Form?
Your Enrollment Form must include a valid prescription from a licensed healthcare provider.
How long will it take to receive my medicine after my physician sends in my Enrollment Form?
Approximately 2-3 weeks from when you and your physician fully complete an Enrollment Form. Please start as soon as possible!
How much time will it take for my insurance company to make a decision on coverage for my medicine?
Each insurance company and plan is different. Your Catalyst Pathways team will help you move your prescription through the insuranceA policy that covers all or a portion of a person’s medical expenses and/or medication. process as quickly as possible. During that time, we can offer free medication through our “Bridge” Medicine program to reduce a potential lapse in therapy due to insurance coverage delays.
How much will I have to pay?
For patients with commercial insurance, Catalyst Pathways lowers out-of-pocket costs to $0/month. For government-funded insurance, the co-paymentThe fixed amount patients pay for a covered healthcare service. A person’s co-payment amount depends on their insurance plan. depends on the type of insurance you have. For patients who are having trouble paying their out-of-pocket costs, Catalyst Pathways can direct them to nonprofit foundations that help patients pay for their medicine.
Will most commercial plans cover my medicine? What about Medicaid and Medicare?
We anticipate that most commercial and government insurers (Medicare and Medicaid) will cover your medicine through 2024 and beyond.
What if I don’t have insurance coverage or my insurance doesn’t approve my medicine for coverage?
Catalyst Pathways has generous eligibility requirements for free, long-term Patient Assistance Program (PAP) medicine, which can be explained by your Patient Access Liaison (PAL). Contact a Care Coordinator at 1-833-422-8259 to get an application.
Is there financial assistance available to cover the cost of my medicine?
Through our free patient support program, Catalyst Pathways, Catalyst has put into place several programs to address out-of-pocket costs and decrease that burden for all eligible patients.
Will I pick up my medicine at my pharmacy?
No, your medicine will come from AnovoRx Specialty Pharmacy, our rare-disease-experienced specialty pharmacy A pharmacy that delivers specialty medications directly to patients through the mail. that will deliver medicine overnight, directly to your location. They will call you prior to shipping your medicine to ensure that all information provided is correct and that someone will be home to accept the delivery the next day. All patients should take their medicine as directed by their physician.
How do I pay my copay for my medicine?
AnovoRx Specialty Pharmacy will collect your payment via credit/debit card.
Will the specialty pharmacy provide additional medication to accommodate extended travel if my insurance company approves and pays for it?
Yes. If your insurance company will allow for and reimburse additional medication, Catalyst’s primary specialty pharmacy, AnovoRx Specialty Pharmacy, will provide it. It is best to notify AnovoRx Specialty Pharmacy in plenty of time so that they can work with your insurance company to get coverage for the additional medicine needed. They can be reached 24 hours a day at 1-844-288-5007.
Will Catalyst’s primary specialty pharmacy, AnovoRx Specialty Pharmacy, provide a 90-day supply if my insurance company approves and pays for a 90-day supply?
If your insurance company will approve and reimburse the cost of additional medicine, then yes. It is best to notify AnovoRx Specialty Pharmacy well ahead of time so that they can work with your insurance company to get coverage for the additional medicine needed.