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Patient Support
starts here

Welcome to KaryForward®, a patient support program by Karyopharm Therapeutics® Inc. dedicated to providing assistance and resources to patients and their caregivers for XPOVIO® (selinexor), including insurance coverage, financial assistance, and resources and support.

To get started, complete the KaryForward Enrollment Form or call KaryForward at 1-877-KARY4WD 1-877-KARY4WD (1-877-527-9493),
Monday-Friday, 8 AM to 8 PM ET.

Patient Support
starts here

Welcome to KaryForward®, a patient support program by Karyopharm Therapeutics® Inc. dedicated to providing assistance and resources to patients and their caregivers for XPOVIO® (selinexor), including insurance coverage, financial assistance, and resources and support.

To get started, complete the KaryForward Enrollment Form or call KaryForward at 1-877-KARY4WD 1-877-KARY4WD (1-877-527-9493),
Monday-Friday, 8 AM to 8 PM ET.

KaryForward® patient with a healthcare professional KaryForward® patient with a healthcare professional

Enroll your patients in KaryForward today

To apply for KaryForward, you and your patients will need to complete and sign the KaryForward Enrollment Form. This form can be completed online or downloaded and faxed to 1-833-589-1603.

Enroll Now—Two Options Available:

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ENROLL ONLINE
Enroll your patient today using the DocuSign enrollment link
If patient or caregiver does not have email access, or the ability to provide electronic signature, please utilize PDF version to enroll by fax.
OR
OR horizontal
Icon of paper with signature
ENROLL BY FAX
There are two ways to complete the PDF form:
1. Print it out and manually write in the information,
or
2. Type the information directly into the fields on the PDF. Save the file and print it out.
Both pages of the completed form are submitted via fax.
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Icon of tablet with signature
KARYFORWARD PATIENT CONSENT FORMS
Have your patient select and sign the KaryForward Patient e-Consent Form below. Alternatively, patients may download the following printable KaryForward Patient Consent Forms to be completed and submitted via fax by their healthcare provider.

Translation services are available. Please call KaryForward for assistance with other languages.

Insurance
coverage

Get assistance navigating the insurance process, including benefits investigations, claims assistance, prior authorizations, and appeals.

To get started, complete the KaryForward Enrollment Form or call KaryForward at 1‑877‑KARY4WD1‑877‑KARY4WD (1‑877‑527‑9493),
Monday-Friday, 8 AM to 8 PM ET.

Insurance verification
Includes benefits, deductibles, and copay or coinsurance. Full benefit verification is specific to the patient’s insurance plan

Prior authorization assistance
Includes identifying plan-specific requirements and providing information about the process

Billing and coding assistance
Includes providing information on XPOVIO and the respective regimen. Reimbursement Specialists are available to assist with complex reimbursement questions

Claims management and appeals assistance
Includes providing information about the appeals process if a denial is received

QuickStart Program
This program enables you to initiate XPOVIO according to prescribing information for your
patients who experience a delay in insurance coverage.

Patients may be eligible for this program if circumstances exist, including but not limited to patient safety, when:

  • There is an inability to verify insurance coverage within 5 business days
  • You determine the patient needs urgent access to XPOVIO

Bridge Program
This program enables you to provide eligible patients an emergency supply of XPOVIO at no cost.

Patients may be eligible for this program if:

  • There is an unexpected disruption in therapy exceeding 5 business days
  • It is determined to be medically necessary for the patient to continue therapy without interruption
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Financial
assistance*

Gain access to programs that can help your eligible patients with the cost of XPOVIO.

XPOVIO® Copay Program
If eligible, your patients may be able to:

OR

  • KaryForward can work with you and your office to help find alternative sources of copay coverage for your patients

Coverage Benefits

  • Eligible patients with commercial insurance pay as little as $5 per month, with a maximum of $8,000 per 30-day prescription and up to a maximum total of $25,000 per calendar year
  • The program is valid through 12/31 of each calendar year
  • Offer is limited to one card per person

Patient Assistance Program

Patients who are uninsured or underinsured may be eligible to receive XPOVIO at no cost.

If patients do not meet the eligibility criteria below and still need assistance, KaryForward may be able to help identify alternative sources of financial support.

Eligibility Requirements:

In order to be eligible for the program, patients must:

  • Be a resident of the United States or its territories and be under the care of a licensed healthcare professional authorized to prescribe, dispense, and administer medicine in the U.S.
  • Be uninsured or underinsured or lack coverage for the XPOVIO prescription

To get started, complete the KaryForward Enrollment Form or call KaryForward at 1‑877‑KARY4WD1‑877‑KARY4WD (1‑877‑527‑9493),
Monday-Friday, 8 AM to 8 PM ET.

*All programs and support are subject to eligibility requirements.

Dose Exchange Program

Karyopharm cares about helping patients stay on therapy. The Dose Exchange Program provides support for necessary dose adjustments that may occur mid-cycle. Please see the Dose Exchange Form below for more details, terms and conditions, and to enroll your appropriate patients.

Eligibility Criteria:

  • Patient has a valid prescription for XPOVIO®
  • Must have remaining tablets from a current prescription
  • Prescribing HCP must have decided to reduce the patient's dose of XPOVIO
  • 18 years of age or older
  • U.S. or U.S. Territory residency

There are two ways to complete the PDF Form:

1.
Print it out and manually write in the information,

OR

2.
Type the information directly into the fields
on the PDF. Save the file and print it out.

Both pages of the completed form are submitted via fax.

DOSE EXCHANGE FORM

Click below to access a PDF of the Dose Exchange
Program Overview:

DOSE EXCHANGE
PROGRAM OVERVIEW

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Support & resources

Nurse Case managers do not assist patients in making decisions regarding their treatment nor do they provide care.

Nurse Case Managers can:

  • Explain prescription instructions
  • Provide psychosocial support and additional non-clinical education regarding XPOVIO
  • Highlight what to expect when taking XPOVIO and the importance of speaking with healthcare professionals about the patient’s treatment journey
  • Provide referrals to additional third-party support, such as transportation assistance

Click below to learn more about the nurses on the KaryForward team and see an overview of the support options available for you and your patients:

We are proud to serve a diverse group of patients. Share these resources with your patients and caregivers, so they can learn more about the KaryForward Patient Support Program. Resources are available in English, Spanish, and Chinese.

To get started, complete the KaryForward Enrollment Form or call KaryForward at 1‑877‑KARY4WD1‑877‑KARY4WD (1‑877‑527‑9493),
Monday-Friday, 8 AM to 8 PM ET.


HCP Resources

Benefits Verification and Enrollment Resources

Utilize these tools to help your patients start and stay on treatment:

Patient with her Nurse Case Manager Patient with her Nurse Case Manager Patient with her Nurse Case Manager

Helpful
Organizations

If a patient or caregiver is in need of assistance or guidance, the organizations listed below may be able to help.

Cancer Support Resources

American Cancer Society

www.cancer.org

1-800-227-2345 1-800-227-2345

CancerCare

www.cancercare.org

1-800-813-HOPE (4673) 1-800-813-HOPE (4673)

Cancer Hope Network

www.cancerhopenetwork.org

1-877-HOPENET (467-3638) 1-877-HOPENET (467-3638)

Cancer Support Community

www.cancersupportcommunity.org

1-888-793-9355 1-888-793-9355

Friend for Life Cancer Support Network

www.friend4life.org

1-866-374-3634 1-866-374-3634

International Myeloma Foundation

www.myeloma.org

1-800-452-CURE (2873) 1-800-452-CURE (2873)

Leukemia & Lymphoma Society

www.lls.org

1-800-955-4572 1-800-955-4572

Lymphoma Coalition

www.lymphomacoalition.org

Lymphoma Research Foundation

www.lymphoma.org

1-800-500-9976 1-800-500-9976

Multiple Myeloma Research Foundation

www.themmrf.org

1-866-603-MMCT (6628) 1-866-603-MMCT (6628)

Myeloma Crowd

www.myelomacrowd.org

Caregiver Support Resources

Caregiver Action Network

www.caregiveraction.org

1-202-454-3970 1-202-454-3970

Family Caregiver Alliance

www.caregiver.org

1-800-445-8106 1-800-445-8106

Friends’ Health Connection

www.friendshealthconnection.org

To maintain the independence of these organizations, Karyopharm Therapeutics® Inc. does not endorse or recommend any of the advocacy groups or services on this list and is not responsible for the content of these sites or services. Be sure to remind your patients and their caregivers that they should speak with you before making any changes to their treatment plan.

KaryForward® support worker

Can't find what you need?
We're here to help.

Call us at 1-877-KARY4WD
(1-877-527-9493),

1-877-KARY4WD

(1-877-527-9493),

Monday-Friday, 8 AM to 8 PM ET.

8 AM to 8 PM ET.

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