Empliciti (elotuzumab)
Patient Assistance Program Guide — Bristol Myers Squibb Patient Assistance Foundation
Do You Qualify?
Income
Up to $75,300 for a single person
Insurance
Must be uninsured or have insurance that does not cover the drug; Medicare Part D patients may qualify if they meet specific financial criteria and have been denied a Low Income Subsidy.
Residency
U.S. resident or resident of U.S. territories
Income Limits (500% FPL)
Calculated at 500% of FPL which is the standard threshold for BMS oncology products.
Based on 2025 HHS Federal Poverty Level guidelines.
# How to Get Empliciti (Elotuzumab) Through the Bristol Myers Squibb Patient Assistance Foundation
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Who Qualifies for the Bristol Myers Squibb Patient Assistance Foundation?
If you need Empliciti (elotuzumab) and cannot afford it, you may be able to get it at no cost through the Bristol Myers Squibb Patient Assistance Foundation. This program is designed for patients who meet income and insurance requirements. For a single-person household, your annual income must be at or below $75,300 to qualify. On the insurance side, you generally must be uninsured or have insurance that does not cover Empliciti. Some Medicare Part D patients may also qualify under specific conditions. If you meet these criteria, this program could provide your medication free of charge, shipped directly to your prescriber's office.
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About Empliciti (Elotuzumab)
Empliciti (elotuzumab) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat multiple myeloma, a type of blood cancer that affects plasma cells in the bone marrow. It belongs to a drug class called SLAMF7-directed cytolytic antibodies and is typically used in combination with other medications. Empliciti is administered by intravenous (IV) infusion, meaning it is given in a clinical setting rather than taken at home as a pill. As a specialty biologic drug, Empliciti carries a very high list price, often placing it out of reach for patients without comprehensive insurance coverage. The Bristol Myers Squibb Patient Assistance Foundation exists specifically to help bridge that gap.
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Income Eligibility: Full Breakdown
The Bristol Myers Squibb Patient Assistance Foundation uses 500% of the Federal Poverty Level (FPL) as its income threshold for Empliciti and other oncology products. Here is how that breaks down by household size:
| Household Size | Maximum Annual Income |
|---|---|
| 1 person | $75,300 |
| 2 persons | $102,200 |
| 3 persons | $129,100 |
| 4 persons | $156,000 |
Your income is typically verified using your most recent federal tax return, W-2 forms, or 1099 forms. If your tax documents are not yet available, three months of recent pay stubs may be accepted in some cases.
If your income is above these limits, you may not qualify for this particular program. However, you should still explore the alternatives listed later in this guide, including manufacturer savings cards and state pharmaceutical assistance programs, which use different eligibility criteria.
Household size is generally defined as the number of people living in your home whose finances are considered together when filing taxes. If your situation is unusual — for example, you support dependents not listed on your return — it may be worth calling the program directly to discuss your specific circumstances.
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Insurance Requirements Explained
Your insurance status plays a major role in whether you qualify. Here is a straightforward breakdown:
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Step-by-Step: How to Apply
Follow these steps to apply for free Empliciti through the Bristol Myers Squibb Patient Assistance Foundation:
1. Gather your documents before you start. You will need: a completed and signed application form (both the patient section and the prescriber section), proof of income (most recent tax return, W-2, or 1099), and your current prescription information.
2. Choose your application method. You can apply online, by phone, or by fax.
- Online: Visit https://www.bmsaccesssupport.bmscustomerconnect.com/patient/patient-assistance-foundation to complete the application digitally.
- By phone: Call (800) 736-0003 to apply with assistance from a program representative.
- By fax: Send your completed application and supporting documents to (800) 736-1611.
3. Have your prescriber complete their section. The application requires a signature and information from the doctor who prescribed Empliciti. Coordinate with your oncology office before submitting.
4. Submit your income documentation along with the completed application. Make sure documents are legible and complete to avoid delays.
5. Wait for a decision. Processing typically takes 2 to 3 business days after all required documents are received.
6. Confirm approval with your prescriber's office. Bristol Myers Squibb will notify the prescriber. Follow up with your oncology office to confirm they have received approval before your next scheduled infusion.
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What to Expect: Timeline and Delivery
Once your completed application and all supporting documents are submitted, a decision is typically made within 2 to 3 business days. You will not need to pick up Empliciti at a pharmacy. Approved medication is shipped directly to your prescriber's office — the clinic or infusion center where you receive treatment. You do not need to do anything special at the time of delivery; your care team will handle the medication when it arrives.
Keep in mind that approval is not permanent. The Bristol Myers Squibb Patient Assistance Foundation requires annual reauthorization. As your renewal date approaches, your prescriber's office will typically help initiate the process, but it is a good idea to track your approval date and follow up proactively to avoid a gap in your treatment.
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Alternatives If You Don't Qualify
If you do not meet the eligibility criteria for this program, here are other options worth exploring:
1. Biosimilars: There are currently no FDA-approved biosimilar alternatives to Empliciti (elotuzumab). This option is not available at this time.
2. Manufacturer savings card (for insured patients): If you have private insurance that covers Empliciti, you may qualify for a savings card through the manufacturer. Visit https://www.empliciti.com/savings-support to learn more and see if you are eligible for cost-sharing assistance.
3. State Pharmaceutical Assistance Programs (SPAPs): Many states run their own programs to help residents afford expensive medications, particularly for Medicare beneficiaries. Eligibility and benefits vary by state. Contact your state's department of health or aging to ask about available programs.
4. NeedyMeds.org: This free, independent database at www.NeedyMeds.org lists patient assistance programs, disease-specific funds, and other resources. It is a useful tool if you are exploring multiple options at once.
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*This guide is for informational purposes only and does not constitute medical or legal advice. Eligibility determinations are made solely by Bristol Myers Squibb. Program terms may change — verify current requirements at [https://www.bms.com/patient-and-caregiver-support/patient-assistance-foundation.html](https://www.bms.com/patient-and-caregiver-support/patient-assistance-foundation.html) before applying.*
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Documents You'll Need
If You Don't Qualify for the Assistance Program
Manufacturer Savings Card (for insured patients)
Bristol Myers Squibb offers a savings card that may reduce your out-of-pocket cost if you have commercial insurance. Ask your prescriber or pharmacist for current savings card details.
Common Questions
Once Bristol Myers Squibb receives your completed application and all required documents, a decision is typically made within 2 to 3 business days. Missing documents are the most common cause of delays, so make sure your income proof and the prescriber section of the application are fully completed before submitting.
Yes. The Bristol Myers Squibb Patient Assistance Foundation requires annual reauthorization. You will need to submit updated information, including current proof of income, each year to continue receiving Empliciti at no cost. Work with your prescriber's office to start the renewal process before your current approval expires.
You may qualify. Medicare Part D patients who have been denied a Low Income Subsidy (also called Extra Help) and meet the program's income requirements may be eligible for the Bristol Myers Squibb Patient Assistance Foundation. You will need documentation of your LIS denial to include with your application. Call (800) 736-0003 to discuss your specific situation.
Approved medication is shipped directly to your prescriber's office or infusion center — not to your home. Your care team will receive the shipment and have it ready for your scheduled infusion appointment. You do not need to arrange pickup or coordinate delivery yourself.
The income limits are set at 500% of the Federal Poverty Level, and eligibility decisions are made by Bristol Myers Squibb. If your income is close to the threshold, it is still worth applying or calling (800) 736-0003 to ask. If you do not qualify, the savings card program at https://www.empliciti.com/savings-support or state pharmaceutical assistance programs may offer other forms of help.
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