PROLASTIN DIRECT® insurance resource hub for PROLASTIN®-C LIQUID (alpha1-proteinase inhibitor [human])

Navigating health insurance and financial questions can feel overwhelming, especially when you’re also managing alpha-1. This PROLASTIN DIRECT Insurance Resource Hub is here to help you make sense of the basics, prepare for important conversations, and find support when you need it.

Whether you’re just getting started or moving through a new insurance step, you’ll find clear information and helpful resources throughout this hub.

Helping you understand health insurance and coverage

Here are some basic, need-to-know facts about health insurance. Keep these 3 points in mind:

  • Insurance plans do not automatically cover treatment. In many cases, your prescribing doctor will need to provide a medically supported reason for the therapy being recommended.
  • Coverage can vary widely by insurance plan, treatment, and even provider.
  • Many treatments for alpha-1 require an additional approval process, which can take extra time.

Find more information by downloading the resource below.

How Insurance Works

Here’s an example of how starting on PROLASTIN-C LIQUID typically works

Start by confirming your own insurance and benefit details. For information about Medicare and Medicaid, see below.

Your doctor prescribes your treatment and gathers the information needed for insurance review.

Your doctor then submits a prior authorization request to your health plan—a common requirement for those with alpha-1.

Your insurance reviews the request and makes a coverage decision based on your plan and the information provided. If approved, your treatment can begin. If not approved, speak to your doctor.

Request assistance from a PAL

Patient Access Liaisons (PALs) are reimbursement and coverage specialists who can help patients with a PROLASTIN-C LIQUID script understand options and provide general education about insurance coverage, reimbursement, and access matters related to PROLASTIN‑C LIQUID.

Only patients with a prescription for PROLASTIN-C LIQUID may speak with a PAL. Tap the button below to request assistance from a PAL.

Connect With a PAL

How Medicare and Medicaid may affect coverage

Many people in the US know that Medicare and Medicaid are government-provided healthcare programs but may not be familiar with how they differ. Understanding the program(s) for which you qualify can help set expectations around authorization, costs, and timing.

Let’s go over some differences.

Medicare

Medicare is a federal healthcare program.

Medicaid is managed by individual states following federal guidelines.

Medicaid

Medicare eligibility is based on age (65+) or disability, and income doesn’t affect eligibility.

Medicaid eligibility is income-based, and requirements vary from state to state.

Dual eligibility

Some individuals qualify for both programs. For example, a person who is 65 or older may qualify for Medicare, and their income level may also make them eligible for Medicaid.

Coverage rules and costs will differ depending on which program, or combination of programs, an individual has.

For more information, download the guide below

Medicare vs Medicaid

Prior authorization: what it is and why it’s important

At times, your health plan may ask you and your doctor for additional information before approving coverage for a prescribed treatment. This is a normal part of the insurance process, especially for specialty therapies like PROLASTIN-C LIQUID.

What you need to know:

Ongoing treatment may require periodic reviews to maintain coverage. PROLASTIN DIRECT may offer guidance on navigating this insurance process, if needed. In these situations, being an active advocate for one’s own care can make a meaningful difference.

Authorization helps your insurance provider understand the medical need for this treatment.

Approval can take time, and follow-ups are common. It’s important not to get discouraged if delays happen.

Learn More About Authorization

Find options to help with your copay

The PROLASTIN DIRECT Assist Program may help with your copay.* Patients receiving PROLASTIN-C LIQUID who have commercial insurance may qualify for a $0 copay through the PROLASTIN DIRECT Assist Program. The program may also help with the cost of the deductible and can provide up to $10,000 per calendar year in financial assistance for eligible patients.

For any questions, please contact PROLASTIN DIRECT at 1-833-PHONEA1 (746-6321) or your infusion provider to inquire about assistance.

*Patient may not be enrolled in Medicare, Medigap, Medicaid, VA, DOD, Tricare, or any other state or federally-funded program

Support from PROLASTIN DIRECT

If receiving PROLASTIN-C LIQUID through Accredo specialty pharmacy, PROLASTIN DIRECT can help with:

  • Insurance verification
  • Pharmacy services, supplies, and delivery to your home or infusion center
  • Access to expert nurses and pharmacists

Call 1-833-PHONEA1 (746-6321) for more information. If you are not receiving PROLASTIN-C LIQUID through Accredo specialty pharmacy, please call your infusion provider.

Find Support Now

Sign up for more information

Are you looking for additional advice about alpha-1? Click the button to receive tips on living with alpha-1, as well as important updates about PROLASTIN-C LIQUID.

Sign Up Now

Important Safety Information

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PROLASTIN®-C LIQUID is an alpha1-proteinase inhibitor (human) (alpha1-PI) indicated for chronic augmentation and maintenance therapy in adults with clinical evidence of emphysema due to severe hereditary deficiency of alpha1-PI (alpha1-antitrypsin deficiency).

Limitations of Use

  • The effect of augmentation therapy with any alpha1-PI, including PROLASTIN-C LIQUID, on pulmonary exacerbations and on the progression of emphysema in alpha1-PI deficiency has not been conclusively demonstrated in randomized, controlled clinical trials
  • Clinical data demonstrating the long-term effects of chronic augmentation or maintenance therapy with PROLASTIN-C LIQUID are not available
  • PROLASTIN-C LIQUID is not indicated as therapy for lung disease in patients in whom severe alpha1-PI deficiency has not been established

PROLASTIN-C LIQUID is contraindicated in immunoglobulin A (IgA)-deficient patients with antibodies against IgA or patients with a history of anaphylaxis or other severe systemic reaction to alpha1-PI products.

Hypersensitivity reactions, including anaphylaxis, may occur. Monitor vital signs and observe the patient carefully throughout the infusion. If hypersensitivity symptoms occur, promptly stop PROLASTIN-C LIQUID infusion and begin appropriate therapy.

Because PROLASTIN-C LIQUID is made from human plasma, it may carry a risk of transmitting infectious agents, eg, viruses, the variant Creutzfeldt-Jakob disease (vCJD) agent, and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent. This also applies to unknown or emerging viruses and other pathogens.

The most common adverse reactions during PROLASTIN-C LIQUID clinical trials in >5% of subjects were diarrhea and fatigue, each of which occurred in 2 subjects (6%).

Please see full Prescribing Information for PROLASTIN-C LIQUID.

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

PROLASTIN®-C LIQUID is an alpha1-proteinase inhibitor (human) (alpha1-PI) indicated for chronic augmentation and maintenance therapy in adults with clinical evidence of emphysema due to severe hereditary deficiency of alpha1-PI (alpha1-antitrypsin deficiency).

Limitations of Use

  • The effect of augmentation therapy with any alpha1-PI, including PROLASTIN-C LIQUID, on pulmonary exacerbations and on the progression of emphysema in alpha1-PI deficiency has not been conclusively demonstrated in randomized, controlled clinical trials
  • Clinical data demonstrating the long-term effects of chronic augmentation or maintenance therapy with PROLASTIN-C LIQUID are not available
  • PROLASTIN-C LIQUID is not indicated as therapy for lung disease in patients in whom severe alpha1-PI deficiency has not been established

PROLASTIN-C LIQUID is contraindicated in immunoglobulin A (IgA)-deficient patients with antibodies against IgA or patients with a history of anaphylaxis or other severe systemic reaction to alpha1-PI products.

Hypersensitivity reactions, including anaphylaxis, may occur. Monitor vital signs and observe the patient carefully throughout the infusion. If hypersensitivity symptoms occur, promptly stop PROLASTIN-C LIQUID infusion and begin appropriate therapy.

Because PROLASTIN-C LIQUID is made from human plasma, it may carry a risk of transmitting infectious agents, eg, viruses, the variant Creutzfeldt-Jakob disease (vCJD) agent, and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent. This also applies to unknown or emerging viruses and other pathogens.

The most common adverse reactions during PROLASTIN-C LIQUID clinical trials in >5% of subjects were diarrhea and fatigue, each of which occurred in 2 subjects (6%).

Please see full Prescribing Information for PROLASTIN-C LIQUID.

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

Important Safety Information

PROLASTIN®-C LIQUID is an alpha1-proteinase inhibitor (human) (alpha1-PI) indicated for chronic augmentation and maintenance therapy in adults with clinical evidence of emphysema due to severe hereditary deficiency of alpha1-PI (alpha1-antitrypsin deficiency).

Limitations of Use

  • The effect of augmentation therapy with any alpha1-PI, including PROLASTIN-C LIQUID, on pulmonary exacerbations and on the progression of emphysema in alpha1-PI deficiency has not been conclusively demonstrated in randomized, controlled clinical trials
  • Clinical data demonstrating the long-term effects of chronic augmentation or maintenance therapy with PROLASTIN-C LIQUID are not available
  • PROLASTIN-C LIQUID is not indicated as therapy for lung disease in patients in whom severe alpha1-PI deficiency has not been established

PROLASTIN-C LIQUID is contraindicated in immunoglobulin A (IgA)-deficient patients with antibodies against IgA or patients with a history of anaphylaxis or other severe systemic reaction to alpha1-PI products.

Hypersensitivity reactions, including anaphylaxis, may occur. Monitor vital signs and observe the patient carefully throughout the infusion. If hypersensitivity symptoms occur, promptly stop PROLASTIN-C LIQUID infusion and begin appropriate therapy.

Because PROLASTIN-C LIQUID is made from human plasma, it may carry a risk of transmitting infectious agents, eg, viruses, the variant Creutzfeldt-Jakob disease (vCJD) agent, and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent. This also applies to unknown or emerging viruses and other pathogens.

The most common adverse reactions during PROLASTIN-C LIQUID clinical trials in >5% of subjects were diarrhea and fatigue, each of which occurred in 2 subjects (6%).

Please see full Prescribing Information for PROLASTIN-C LIQUID.

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