A significant majority of PA requests for ARCALYST have been approved*†
Eligible, commercially insured patients pay as little as $0 per month for ARCALYST treatment with the copay assistance program*
†From approval in March 2021 to September 2024. | *Based on final coverage approval.
Payer Coverage Decision Example
This is an example of common payer coverage decision making; however, each payer may differ in the determination of coverage for ARCALYST. Please refer to specific payer policies on ARCALYST access requirements.
Prior Authorization (PA) Best Practices
Prevent delays with ARCALYST initiation
The information needed for the ARCALYST Enrollment Form is similar to the information needed for the PA documentation. Filling out both forms and submitting at the same time may help to:
- Potentially accelerate the time for a patient to gain access and initiate ARCALYST
- Save you and your staff time since the patient’s file is already available when your office is filling out the Enrollment Form
Prior authorization helpful hint
In the PA form, as allowed, include previous medications used to treat recurrent pericarditis such as NSAIDs, colchicine, and/or steroids.
Payer Access Resources
Supporting your practice in navigating access for your patients
The Kiniksa OneConnect™ program is designed to support you throughout the access process in order to help your patients initiate their treatment quickly. In addition to benefits verification and providing Prior Authorization and Appeals support, your dedicated Patient Access Lead can identify financial assistance programs to help make access to treatment more affordable for eligible patients.
