Neffy rep: Christian @ 978-995-3911 (5/2026)

Neffy Coverage as of 10/2025- 

**Non-formulary:** 
CVS Caremark PBM,
OptumRX PBM,
BCBS OUT OF STATE (IL, OH, TX, etc),
HPHC,
Aetna,
Cigna,
MassHealth, 
Wellcare,
Silverscripts
 

**Formulary:**
Express Scripts PBM 


**Copay Info:**

-For the forseeable future, copay for neffy with a PA approval or on insurance formulary will be $0 for up to 3 two packs. (Per rep Josh 10/22/25)

-Non-formulary/ with PA denial can pay $199 OOP through ProModRx or BlinkRx for one. 

**ICD-10 codes for PA's:**

F40.298- Other specified phobia (fear of needles)

F40.231- Trypanophobia (severe fear of needles)

Y65.4- Failure to inject or perform procedure

Y63.6- Underdosing and non-administration of necessary drug (e.g. the patient can't inject and/or will not carry an epinephrine auto injector, considered a therapeutic failure)

Z91.128- Patient's intentional underdosing of medication for unspecified reason

Z91.148- Patient's other noncompliance with medication regimen for other reasons (e.g. physical limitations, device bulkiness and handling challenges, etc)

Z91.120-  Patient's intentional underdosing of medication due to financial hardship