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Navigating coverage for treatment with GAMIFANT® (emapalumab-lzsg)

Obtaining approval for your patient’s treatment may require your institution to complete several steps, including conducting a thorough benefits investigation to determine if a prior authorization or medical exception is needed. Our Gamifant Patient Services team is available to help explain these processes at 833-597-6530.

Coverage resources

Sobi has developed a library of resources to help you and your institution navigate the insurance approval process for Gamifant.

Gamifant Start Form

Overview of Gamifant

Gamifant Product Fact Sheet

A high-level overview, including relevant product codes


Gamifant Clinical Overview

Information about studies with Gamifant


Access and Reimbursement

Tips for Completing a Benefits Investigation

A guide to review the process


Understanding Your Patient's Medical and Pharmacy Benefits

Information about different types of coverage


Guide to Prior Authorization Submission

Details about the process and submission of documentation to gain approval


Summary of Relevant Codes for Gamifant

A consolidated checklist


Requesting a Medical Exception for Gamifant

Guidance for submission and appealing denial of coverage


Sample Letter of Medical Necessity

Sample Letter

A downloadable template that can be tailored to your patient and submitted to health insurance plans to request approval for Gamifant


Pharmacy and Office Resources

Provider Contact Sheet

A customizable PDF to track communications with insurance companies and ensure timely follow-up


It is the provider's responsibility to determine the appropriate healthcare setting and to submit true and correct claims for those products and services rendered. Providers should contact third-party payers for specific information on their coding, coverage, and payment policies.