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EYLEA® (aflibercept) Injection Co-Pay Card

Help Eligible Patients Pay Only $5 of Their Co-Pay for EYLEA With the EYLEA Co-Pay Card*

No income eligibility requirement

Eligible patients who have commercial insurance not funded through a government healthcare program may qualify for the Co-Pay Card Program.

Who's Eligible?

  • Must have commercial or private insurance that covers EYLEA for an
    approved indication
  • Co-pay for EYLEA must exceed $5 per purchase/treatment
    • Must be a resident of the United States or its territories or possessions

Program Benefits

The program
covers*
  • Up to $10,000 in assistance per year toward product-specific co-pay, co-insurance, and insurance deductibles for EYLEA treatments
The patient is
responsible for
  • The first $5 of each treatment's co-pay
  • Any additional co-pay costs that exceed the program assistance limit

* Not a debit card program. This program is not valid for prescriptions covered by or submitted for reimbursement under Medicaid, Medicare, VA DOD, TRICARE, or similar federal or state programs. The program does not cover or provide support for supplies, procedures, or any physician-related service associated with EYLEA. General, non–product-specific co-pay, co-insurance, or insurance deductibles are not covered. This program is not valid where prohibited by law, taxed, or restricted. EYLEA4U® reserves the right to rescind, revoke, terminate, or amend this offer, eligibility, and terms of use at any time without notice. Additional program conditions apply.

How it works: a patient example

EYLEA Co-Pay Card Enrollment Options

To learn more about the EYLEA Co-Pay Card, call
EYLEA4U at 1-855-EYLEA4U (1-855-395-3248), Option 4,
Monday–Friday 9 AM to 8 PM Eastern Time.
IMPORTANT SAFETY INFORMATION
+
  • EYLEA® (aflibercept) Injection is contraindicated in patients with ocular or periocular infections, active intraocular inflammation, or known hypersensitivity to aflibercept or to any of the excipients in EYLEA.
  • Intravitreal injections, including those with EYLEA, have been associated with endophthalmitis and retinal detachments. Proper aseptic injection technique must always be used when administering EYLEA. Patients should be instructed to report any symptoms suggestive of endophthalmitis or retinal detachment without delay and should be managed appropriately. Intraocular inflammation has been reported with the use of EYLEA.
  • Acute increases in intraocular pressure have been seen within 60 minutes of intravitreal injection, including with EYLEA. Sustained increases in intraocular pressure have also been reported after repeated intravitreal dosing with VEGF inhibitors. Intraocular pressure and the perfusion of the optic nerve head should be monitored and managed appropriately.
  • There is a potential risk of arterial thromboembolic events (ATEs) following intravitreal use of VEGF inhibitors, including EYLEA. ATEs are defined as nonfatal stroke, nonfatal myocardial infarction, or vascular death (including deaths of unknown cause). The incidence of reported thromboembolic events in wet AMD studies during the first year was 1.8% (32 out of 1824) in the combined group of patients treated with EYLEA. The incidence in the DME studies from baseline to week 52 was 3.3% (19 out of 578) in the combined group of patients treated with EYLEA compared with 2.8% (8 out of 287) in the control group; from baseline to week 100, the incidence was 6.4% (37 out of 578) in the combined group of patients treated with EYLEA compared with 4.2% (12 out of 287) in the control group. There were no reported thromboembolic events in the patients treated with EYLEA in the first six months of the RVO studies.
  • Serious adverse reactions related to the injection procedure have occurred in <0.1% of intravitreal injections with EYLEA including endophthalmitis and retinal detachment.
  • The most common adverse reactions (≥5%) reported in patients receiving EYLEA were conjunctival hemorrhage, eye pain, cataract, vitreous floaters, intraocular pressure increased, and vitreous detachment.
IMPORTANT PRESCRIBING INFORMATION

EYLEA® (aflibercept) Injection is indicated for the treatment of patients with

  • Neovascular (Wet) Age-related Macular Degeneration (AMD): The recommended dose is 2 mg administered by intravitreal injection every 4 weeks (monthly) for the first 12 weeks (3 months), followed by 2 mg once every 8 weeks (2 months). Although EYLEA may be dosed as frequently as 2 mg every 4 weeks (monthly), additional efficacy was not demonstrated in most patients when EYLEA was dosed every 4 weeks compared to every 8 weeks. Some patients may need every 4 week (monthly) dosing after the first 12 weeks (3 months).
  • Macular Edema following Retinal Vein Occlusion (RVO): The recommended dose is 2 mg administered by intravitreal injection every 4 weeks (monthly).
  • Diabetic Macular Edema (DME) and Diabetic Retinopathy (DR) in Patients with DME: The recommended dose is 2 mg administered by intravitreal injection every 4 weeks (monthly) for the first 5 injections, followed by 2 mg once every 8 weeks (2 months). Although EYLEA may be dosed as frequently as 2 mg every 4 weeks (monthly), additional efficacy was not demonstrated in most patients when EYLEA was dosed every 4 weeks compared to every 8 weeks. Some patients may need every 4 week (monthly) dosing after the first 20 weeks (5 months).

Please see the full Prescribing Information for EYLEA.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

The information provided in this site is intended only for healthcare professionals in the United States. The products discussed herein may have different product labeling in different countries.

With the EYLEA® (aflibercept) Injection Co-Pay Card

For example, if your patient had an out-of-pocket cost of $1,500 for EYLEA (25% co-insurance and $1,000 deductible)

  • The patient would be responsible for the first $5
  • The EYLEA Co-Pay Card would cover the remaining balance of $1,495 if your patient has not exceeded the $10,000 per-year limit. Any cost above the limit would be the patient's responsibility

The EYLEA4U® e-Portal

Call 1-855-EYLEA4U (1-855-395-3248), Monday–Friday 9 AM–8 PM Eastern Time.
Getting In Touch

EYLEA and EYLEA4U are registered trademarks of Regeneron Pharmaceuticals, Inc.

777 Old Saw Mill River Road, Tarrytown, NY 10591
US-LEA-1260

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