EYLEA4U® can help your patients with the referral process

EYLEA4U® logo.
EYLEA4U® logo.

EYLEA4U e-Portal: Your one-stop, online destination for reimbursement and patient support

The EYLEA4U e-Portal is an efficient, secure, and convenient tool for enrolling and managing patients in our support programs. The portal is available online for instant access to patient case status updates.

  • Requires registration and e-signature setup.

EYLEA4U Enrollment Form

Use the EYLEA4U Enrollment Form to request the specific support your patients need, including copay assistance.

Independent charitable foundations

Patients who need help paying for their EYLEA out-of-pocket costs can apply for assistance through independent charitable foundations, including the following*:

*Regeneron does not influence or control the operations of independent charitable foundations and cannot guarantee assistance will be provided.

Get help from EYLEA4U

During referral to an independent charitable foundation, a Reimbursement Specialist:

  • Verifies coverage and determines patient out-of-pocket costs for EYLEA
  • Contacts patient to discuss the referral process and independent charitable foundations with available funding for approved indications
    • Provides information to assist patient with applying to the foundation chosen by the patient
    • Follows up until outcome is determined
  • Communicates with physician's office throughout the referral process
EYLEA4U® contact information.

To get started with a referral, visit the EYLEA4U e-Portal or call EYLEA4U at 1-855-EYLEA4U (1-855-395-3248), Option 4, Monday–Friday 9 AM–8 PM Eastern Time.

Product support for EYLEA® (aflibercept) Injection.
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See More Important Safety Information and Indications
  • CONTRAINDICATIONS: EYLEA is contraindicated in patients with ocular or periocular infections, active intraocular inflammation, or known hypersensitivity to aflibercept or to any of the excipients in EYLEA.
Important Safety Information INDICATIONS

EYLEA® (aflibercept) Injection 2 mg (0.05 mL) is indicated for the treatment of patients with Neovascular (Wet) Age-related Macular Degeneration (AMD), Macular Edema following Retinal Vein Occlusion (RVO), Diabetic Macular Edema (DME), and Diabetic Retinopathy (DR).

Please see the full Prescribing Information for EYLEA.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

The information provided in this site is intended only for healthcare professionals in the United States. The products discussed herein may have different product labeling in different countries.