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