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Copay Program Help Desk

For inquiries about the Copay Savings Program

1-877-858-5452

Applicable Forms

Programs for Patients:
Synagis® (palivizumab) Copay Savings Program

The Synagis Copay Savings Program assists qualified commercially insured Synagis (palivizumab) patients with their Synagis copays. Eligible patients may have access to a virtual debit account funded with up to $2,000 to assist with Synagis out-of-pocket costs. Patients are responsible for the first $30 of each Synagis dose.

Synagis Copay Savings Program Support Process

Synagis Copay Savings Program Support Process

Who is Eligible?

Must meet all criteria

  • Patients that have been prescribed Synagis (palivizumab) for use that is consistent with the product label.
  • Patients with a copay/coinsurance greater than $30.
  • Patients not covered in any way by Medicaid, TRICARE, or any other healthcare plan funded by a government entity.
  • Patients currently not receiving copay assistance for Synagis from another charitable organization.

How the Program Works

  • You may be contacted by a pharmacy, home care clinic, or prescriber’s office informing you that you have an out-of-pocket cost (copay or coinsurance) for the Synagis dose.
  • If you are told that the copay or coinsurance is more than $30, and you meet the other program eligibility requirements, you should ask to be enrolled in the Synagis Copay Savings Program. Your pharmacy, home care clinic, or prescriber’s office can help you do this online, or by calling the Help Desk at 1-877-858-5452.
  • If you meet the program’s eligibility criteria, a Synagis Copay Savings Program virtual debit account number will be created for you.
  • You must pay the first $30 of the Synagis copay (per dose), and your pharmacy, home care clinic, or prescriber’s office will use the Synagis Copay Savings Program account number to cover the balance, up to $2,000 per season.

View Eligibility Requirements and Terms and Conditions

Important Safety Information for Synagis®

What is Synagis (palivizumab)?

Synagis is a prescription medication that is used to help prevent a serious lung disease caused by respiratory syncytial virus (RSV) in children at high risk for severe lung disease from RSV.

Who should not receive Synagis?

Children should not receive Synagis if they have ever had a severe allergic reaction to it. Signs and symptoms of a severe allergic reaction could include itchy rash; swelling of the face; difficulty swallowing; difficulty breathing; bluish color of the skin; muscle weakness or floppiness; a drop in blood pressure; and/or unresponsiveness. If your child has any of these signs or symptoms of a severe allergic reaction after getting Synagis, be sure to tell your child’s healthcare provider or get medical help right away.

How is Synagis given?

Synagis is given as a shot, usually in the thigh muscle, each month during the RSV season. Your child should receive their first Synagis shot before the RSV season starts, to help protect them before RSV becomes active. When RSV is most active, your child will need to receive Synagis shots every 28-30 days to help protect them from severe RSV disease for about a month. Your child should continue to receive monthly shots of Synagis until the end of RSV season. Your child may still get severe RSV disease after receiving Synagis. If your child has an RSV infection, they should continue to get their monthly shots throughout the RSV season to help prevent severe disease from new RSV infections.

The effectiveness of Synagis shots given less than monthly throughout the RSV season has not been established.

What are the side effects of Synagis?

Possible, serious side effects include severe allergic reaction, which may occur after any dose of Synagis. Such reactions may be life-threatening or cause death. Unusual bruising and/or groups of tiny red spots on the skin have also been reported.

Common side effects of Synagis include fever and rash. Other possible side effects include skin reactions around the area where the shot was given (like redness, swelling, warmth, or discomfort).

Please see accompanying full product information, including patient information.