Symdeko (tezacaftor/ivacaftor)

Do You Qualify?

Income Limits (500% FPL)

Calculated at 500% FPL; program often evaluates eligibility on a case-by-case basis considering high cost of therapy.

Based on 2025 HHS Federal Poverty Level guidelines.

# Vertex GPS: Guidance & Patient Support — A Patient Guide to Getting Symdeko at Low or No Cost

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Who Qualifies for the Vertex GPS: Guidance & Patient Support?

If you have been prescribed Symdeko (tezacaftor/ivacaftor) for cystic fibrosis and are struggling to afford it, you may be able to get it free or at a reduced cost through the Vertex GPS: Guidance & Patient Support program. This is Vertex's official patient assistance program for Symdeko and other Vertex medicines.

To qualify for free medication, you generally need to earn below $75,300 per year if you live alone. Larger households may qualify at higher income levels. On the insurance side, you typically need to be uninsured, underinsured, or facing a gap in your current coverage. Patients with commercial insurance who do not qualify for free medication may still be able to lower their out-of-pocket costs through a separate savings card option.

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About Symdeko (tezacaftor/ivacaftor)

Symdeko is a prescription medicine used to treat cystic fibrosis (CF), a serious genetic condition that affects the lungs and other organs. It belongs to a drug class called CFTR modulators — specifically, it combines a corrector (tezacaftor) and a potentiator (ivacaftor) that work together to target the underlying protein defect caused by certain CF gene mutations. Symdeko is FDA-approved for patients aged six and older who have specific mutations.

Without insurance or assistance, Symdeko can cost well over $300,000 per year, placing it far out of reach for most patients and families. Patient assistance programs like Vertex GPS exist specifically to help close that gap.

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Income Eligibility: Full Breakdown

Vertex GPS uses income guidelines set at approximately 500% of the Federal Poverty Level (FPL). The table below shows the maximum annual income allowed based on household size:

| Household Size | Maximum Annual Income |

|---|---|

| 1 person | $75,300 |

| 2 persons | $102,200 |

| 3 persons | $129,100 |

| 4 persons | $156,000 |

If your household has more than four people, the income limit typically continues to rise. Contact the program directly to confirm the threshold for your household size.

Income is usually verified using your most recent federal tax return, a W-2, or three months of recent pay stubs. If your income situation has changed significantly from last year — for example, due to job loss or reduced hours — you may be able to document your current income using recent pay stubs instead.

If your income is above these limits, do not assume you are automatically disqualified. Because Symdeko is an exceptionally high-cost therapy, Vertex often reviews applications on a case-by-case basis. It is worth applying or calling the program at (844) 247-4477 to discuss your specific situation before giving up.

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Insurance Requirements Explained

Your insurance status plays a major role in how the program helps you. Here is how different situations are typically handled:

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Step-by-Step: How to Apply

Follow these steps to apply for the Vertex GPS: Guidance & Patient Support program:

1. Gather your documents. You will need a completed enrollment form, proof of income (your most recent tax return, W-2, or three months of pay stubs), and a valid prescription from your licensed healthcare provider.

2. Choose your application method. You can apply in more than one way:

- Online: Visit https://www.vertexgps.com/ to start your application directly on the program's website.

- By phone: Call (844) 247-4477 to speak with a program representative who can walk you through the process.

- By fax: Submit your completed enrollment form and supporting documents to (844) 220-0044.

3. Complete the enrollment form. This form collects your personal information, household size, income details, insurance status, and prescriber information. Your doctor or their office staff may need to sign a portion of the form.

4. Submit your documents. Send all required paperwork through your chosen method — online upload, phone-assisted submission, or fax.

5. Wait for your review. Vertex GPS typically completes its review within two business days of receiving a complete application.

6. Receive your approval notice. If approved, you will be notified of your eligibility and next steps for receiving your medication.

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What to Expect: Timeline and Delivery

Once you submit a complete application, Vertex GPS typically reviews it within two business days. You will receive confirmation of your approval status — either by phone or in writing, depending on your preferred contact method.

If approved, Symdeko is shipped directly to your home address. You do not need to pick it up at a pharmacy. Make sure your address on the application is current and that someone will be available to receive temperature-sensitive shipments if applicable.

Your enrollment in the program is not permanent. Reauthorization is required once per year. Before your approval period ends, you will need to resubmit updated income documentation and a current prescription to continue receiving your medication without interruption.

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Alternatives If You Don't Qualify

If you do not qualify for the Vertex GPS patient assistance program, you still have options:

1. Biosimilars: There are currently no FDA-approved biosimilar alternatives to Symdeko. This means you cannot substitute a lower-cost generic or biosimilar at this time.

2. Manufacturer savings card: If you have commercial insurance, you may be eligible for the Vertex GPS copay assistance savings card, which can reduce your out-of-pocket costs at the pharmacy. Apply at https://www.vertexgps.com/copay-assistance.

3. State Pharmaceutical Assistance Programs (SPAPs): Many states offer programs that help residents afford high-cost medications. Eligibility and benefits vary by state. Contact your state's department of health or aging to find out what programs may be available to you.

4. NeedyMeds.org: This free, independent database at https://www.needymeds.org lists thousands of assistance programs by drug name, condition, or zip code. It is a useful starting point if you need to explore additional options.

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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 Vertex. Program terms may change — verify current requirements at [https://www.vertex.com/en-us/support/assistance-programs](https://www.vertex.com/en-us/support/assistance-programs) before applying.*

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