MySMA Support is a service from Genentech that can help provide information about Evrysdi.

Genentech is the company that makes Evrysdi. We believe every person should get the Genentech medicine their doctor prescribed and we offer programs to help make this happen.

A PAL is the local, main point of contact from Genentech who supports people taking Evrysdi. PALs are here to answer questions about Evrysdi and refer you to helpful resources. PALs can also help you understand your insurance and financial support options.

A PAL is not a part of your medical team and is not a substitute for your health care provider. PALs do not provide medical advice. Your health care provider should always be your main resource for any questions about your health and medical care.

Connect with your local PAL by:

• Visiting www.Evrysdi.com/PAL
• Calling (833) 387-9734 (Monday–Friday, 9 a.m. to 8 p.m. ET)

There may be options to help you get the Genentech medicine your doctor has prescribed. Your PAL can refer you to financial assistance options.

Only a specialty pharmacy* can prepare and ship Evrysdi to you. Evrysdi is not available at retail pharmacies.

A specialty pharmacy prepares and ships Evrysdi directly to you each month. Although the SP is not a part of Genentech, it is an important part of the MySMA Support team.

*Specialty pharmacies are not part of Genentech and maintain independence in their operations and in their role as a health care provider.

You might not be able to get Evrysdi right away. First, your doctor’s office or specialty pharmacy will have to check to make sure your health insurance plan covers your medicine. This is called an “insurance benefits investigation.” They also might have to send some more information before your plan covers your medicine. This is called a “prior authorization.”

Your PAL will take the time to explain the results of the insurance benefits investigation to you and let you know if you need a prior authorization. Approval times can vary.

To help ensure this process goes as smoothly as possibly, be sure to answer and return all calls from your doctor's office, your PAL and the specialty pharmacy.

The Evrysdi Start Form is used to enroll people who have been prescribed Evrysdi into MySMA Support.

1. You fill out Page 4 of the Evrysdi Start Form.
2. Your doctor fills out the rest of the form.
   
3. Your doctor sends the form to MySMA Support.

By signing Page 4, you allow MySMA Support to talk about your health information with your doctor and health insurance plan.

You can also submit your section of the form online.

By signing Page 4, you allow MySMA Support to talk about your health information with your doctor and health insurance plan.

This permission is needed for MySMA Support to begin working with you.

You do not need to do anything else, but your doctor does. He or she needs to fill out the rest of the Evrysdi Start Form. The other sections of this form tell us your doctor wants to treat you with Evrysdi. Make sure your doctor has sent us the completed Evrysdi Start Form so you get help from us.

If your health insurance plan will not cover Evrysdi, you and your doctor's office can file an appeal. Contact your doctor to ask if you should file an appeal.

We provide general resources to help you and your doctor file an appeal.

EVRYSDI Access Solutions cannot complete or submit an appeal for you.

We provide general resources to help you and your doctor file an appeal. You or your doctor’s office has to file the appeal directly with your health insurance plan. Genentech cannot complete or submit an appeal for you or your doctor's office.

EVRYSDI Access Solutions cannot complete or submit an appeal for you.

Each health insurance plan is different. Some plans work more quickly than others. The process may even take several months if you have to appeal multiple times.

Check with your health insurance plan to find out its process.

EVRYSDI Access Solutions cannot complete or submit an appeal for you.

If your insurance changes while you’re taking Evrysdi, call us. Your PAL can walk you through your new coverage.

The Genentech Patient Foundation gives free Genentech medicine to people who don’t have health insurance coverage or who have financial concerns and meet certain eligibility criteria.