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Commercial insurance

  • $5 Copay Assistance Program
  • Bridge Program

Myfembree Copay Assistance Program

PAY AS LITTLE AS $5 per month*

The Myfembree Copay Assistance Program can provide financial assistance to eligible prescribed patients with commercial insurance when they get their prescription from their retail pharmacy during the cost-sharing portion of their insurance benefit. Additional terms and conditions apply and can be found below.

*With a $2000 annual limit.

The Myfembree Copay Assistance Program (“Program”) is for eligible patients with commercial prescription insurance for Myfembree. With this Program, eligible patients will pay as little as $5 per monthly Myfembree prescription or $15 if they received a 90-day prescription; subject to a maximum of $2,000 per calendar year. After the annual maximum of $2,000 for Myfembree is reached, patient will be responsible for the remaining monthly out-of-pocket costs. Patient must enroll in the Program by visiting www.Myfembree.com or by calling 1-833-MYFEMBREE (833-693-3627). Card must be activated before use. This Program may not be redeemed more than once every 21 days. The Program is not valid for patients whose prescription claims are reimbursed, in whole or in part, by any state or federal government program, including, but not limited to, Medicaid, Medicare, Medigap, Department of Defense (DoD), Veterans Affairs (VA), TRICARE, Puerto Rico Government Insurance, or any state patient or pharmaceutical assistance program. Offer is not valid for cash-paying patients. Patient must be a resident of the U.S., Puerto Rico, or U.S. Territories. This Program is void where prohibited by state law and on the date an AB rated generic equivalent for Myfembree becomes available. Certain rules and restrictions apply. This card is not insurance. This offer cannot be combined with any other coupon, free trial, discount, prescription savings card, or other offer. This offer is not conditioned on any past or future purchase, including refills. Patient and participating pharmacists agree not to seek reimbursement for all, or any part of the benefit received by the patient through this Program. Patient and participating pharmacists agree to report the receipt of Program benefits to any insurer or other third party who pays for or reimburses any part of the prescription filled using the Card, as may be required by such insurer or third party. Myovant Sciences reserves the right to revoke, rescind, or amend this offer without notice. The Myfembree Copay Assistance Program is good through December 31, 2022.

Myfembree Bridge Program

Receive a free supply of Myfembree for up to 4 months per calendar year

The Myfembree Bridge Program can help provide eligible prescribed patients access to Myfembree by providing a free temporary supply in cases of interrupted or delayed coverage. Free medication supply is fulfilled by TC Script, a noncommercial dispensing pharmacy. Additional terms and conditions apply and can be found below.

The Myfembree Bridge Program (“Program”) provides Myfembree at no cost for a limited period to eligible patients with commercial insurance who have been prescribed Myfembree for an FDA-approved indication, and whose insurance coverage is delayed or who experience a temporary lapse in coverage. Commercially insured patients are eligible for up to 4 months of free product. This Program is not valid for patients whose prescription claims are reimbursed, in whole or in part, by any state or federal government program, including, but not limited to, Medicaid, Medicare, Medigap, Department of Defense (DoD), Veterans Affairs (VA), TRICARE, Puerto Rico Government insurance, or any state patient or pharmaceutical assistance program. Patients and prescribers must complete the Myfembree Support Program enrollment form, and prescribers must provide a Myfembree Bridge prescription. Patients will receive their drug supply each month for up to 4 months or until they receive insurance coverage approval, whichever occurs earlier. Patients must be residents of the United States or US Territories. Program is not available to patients who are uninsured or where prohibited by law such as Massachusetts and Minnesota. Patients may be asked to reverify insurance coverage status during the course of the Program. Patients and participating prescribers agree not to seek reimbursement for all, or any part of the benefit received by the patient through this Program. No purchase necessary. Program is not health insurance, nor is participation a guarantee of insurance coverage. Other limitations may apply. Myovant Sciences reserves the right to rescind, revoke, or amend the Program and discontinue support at any time without notice.

Enrolling in the Myfembree® Support Program

Call to speak to dedicated support staff who will guide you through the enrollment process.

1-833-MYFEMBREE (1-833-693-3627), 8 AM–8 PM ET, Monday–Friday.

Please see your prescribing doctor or call the Myfembree® Support Program for enrollment assistance. Once you are enrolled, the support program team can provide specific information to help you understand your insurance benefits and coverage for Myfembree.

USE

Myfembree (relugolix, estradiol, and norethindrone acetate) is used to control heavy menstrual bleeding due to uterine fibroids in premenopausal women ≥18 years of age. It should not be taken for more than 24 months.

IMPORTANT SAFETY INFORMATION

Boxed Warning: Cardiovascular conditions: Myfembree may increase your chances of heart attack, stroke, or blood clots, especially if you are >35 years old, smoke, and have uncontrolled high blood pressure. Stop taking Myfembree and call your healthcare provider (HCP) or go to the nearest emergency room right away if you have: leg pain or swelling that won’t go away; sudden shortness of breath; double vision, bulging of the eyes, sudden partial or complete blindness; pain or pressure in your chest, arm, or jaw; sudden, severe headache unlike your usual headaches; weakness or numbness in an arm or leg, or trouble speaking.

IMPORTANT SAFETY INFORMATION

Boxed Warning: Cardiovascular conditions: Myfembree may increase your chances of heart attack, stroke, or blood clots, especially if you are >35 years old, smoke, and have uncontrolled high blood pressure. Stop taking Myfembree and call your healthcare provider (HCP) or go to the nearest emergency room right away if you have: leg pain or swelling that won’t go away; sudden shortness of breath; double vision, bulging of the eyes, sudden partial or complete blindness; pain or pressure in your chest, arm, or jaw; sudden, severe headache unlike your usual headaches; weakness or numbness in an arm or leg, or trouble speaking.

USE

Myfembree (relugolix, estradiol, and norethindrone acetate) is used to control heavy menstrual bleeding due to uterine fibroids in premenopausal women ≥18 years of age. It should not be taken for more than 24 months.

USE

Myfembree (relugolix, estradiol, and norethindrone acetate) is used to control heavy menstrual bleeding due to uterine fibroids in premenopausal women ≥18 years of age. It should not be taken for more than 24 months.

IMPORTANT SAFETY INFORMATION

Boxed Warning: Cardiovascular conditions: Myfembree may increase your chances of heart attack, stroke, or blood clots, especially if you are >35 years old, smoke, and have uncontrolled high blood pressure. Stop taking Myfembree and call your healthcare provider (HCP) or go to the nearest emergency room right away if you have: leg pain or swelling that won’t go away; sudden shortness of breath; double vision, bulging of the eyes, sudden partial or complete blindness; pain or pressure in your chest, arm, or jaw; sudden, severe headache unlike your usual headaches; weakness or numbness in an arm or leg, or trouble speaking.

Do not take Myfembree if you:

  • have or have had blood clots in your legs, lungs, or eyes; a stroke or heart attack; a problem that makes your blood clot more than normal; blood circulation disorders; certain heart valve or rhythm problems that can cause blood clots to form in the heart; high blood pressure not well controlled by medicine; diabetes with kidney, eye, nerve, or blood vessel damage; certain kinds of severe migraine headaches with aura, numbness, weakness or changes in vision or migraine headaches if you are >35 years old; breast cancer or any cancer that is sensitive to female hormones; osteoporosis; undiagnosed vaginal bleeding; liver problems;
  • smoke and are >35 years old;
  • have had a serious allergic reaction (e.g., swelling of your face, lips, mouth or tongue, trouble breathing, skin rashes, redness) or swelling or an allergic reaction to relugolix, estradiol, norethindrone or any of the ingredients in Myfembree.

Bone Loss (Decreased Bone Mineral Density [BMD]): While taking Myfembree, your estrogen levels may be low, which can lead to BMD loss. If this happens, your BMD may improve after you stop Myfembree, but complete recovery may not occur. It is unknown if these BMD changes could increase your risk for broken bones as you age. For this reason,you should not take Myfembree for more than 24 months. Your HCP may order an X-ray test called a DXA scan to check your BMD when you start Myfembree and periodically after.

Suicidal thoughts and behavior and worsening of mood. Call your HCP or get emergency medical help right away if you have any of these symptoms, especially if they are new, worse, or bother you: thoughts about suicide or dying, attempts to commit suicide, new or worse depression or anxiety, other unusual changes in behavior or mood. Pay attention to any changes, especially sudden changes in your mood, behaviors, thoughts, or feelings.

Abnormal liver tests. Call your HCP right away if you have any of these signs and symptoms of liver problems: jaundice, dark amber-colored urine, feeling tired, nausea and vomiting, generalized swelling, right upper stomach area pain, bruising easily.

High blood pressure. See your HCP to check your blood pressure regularly.

Effects on Pregnancy: Do not take Myfembree if you are trying to become or are pregnant. It may increase the risk of early pregnancy loss.If you think you are pregnant, stop taking Myfembree right away and call your HCP. Myfembree can cause decreased or no menstrual bleeding, making it hard to know if you are pregnant. Watch for other signs of pregnancy like breast tenderness, weight gain, and nausea. Myfembree does not prevent pregnancy. You will need to use effective non-hormonal methods of birth control (e.g., condoms, spermicide) during and for 1 week after stopping Myfembree. Do not take hormonal birth control such as birth control pills, because they may increase side effects and Myfembree may not work as well.

Uterine fibroid prolapse or expulsion. Fibroids can come out completely or partially through the vagina. Call your HCP right away if you have increased bleeding from the vagina, which can be serious, or cramping.

Severe allergic reactions. Myfembree may cause swelling of your face, lips, mouth or tongue, trouble breathing, skin rashes, and redness.

The most common side effects are hot flushes, increased sweating, night sweats, abnormal vaginal bleeding (bleeding that lasts too long, is too much, or is unexpected), hair loss or thinning, decreased interest in sex.

These are not all the possible side effects of Myfembree. Call your doctor for medical advice about side effects.

Tell your HCP about all your prescription and over-the-counter medicines, vitamins, and herbal supplements. If you take oral P-gp inhibitors, take Myfembree first and wait at least 6 hours before taking the P-gp inhibitor. Ask your HCP if you are not sure if you are taking this type of medicine.

Tell your HCP if you are breastfeeding. Myfembree may pass into your breast milk.

Please see full Prescribing Information, including BOXED WARNINGand Patient Information

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The information provided on myfembreehcp.com is intended only for healthcare professionals in the United States.
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