Polivy (polatuzumab vedotin-piiq) Patient Assistance Program
Don’t let the high cost of brand CD79b-targeted antibody-drug conjugate disrupt your diffuse large B-cell lymphoma treatment. We help eligible patients access Polivy (polatuzumab vedotin-piiq intravenous infusion) for as little as $69.95 per month through the manufacturer’s Patient Assistance Program.
- Clear & Transparent Pricing
- Paperwork & Doctor-Coordination
- Comprehensive Support: From Application to Entire Journey
- Annual Re-certification And Refills Management
- Medicare Part D Patients Accepted
Key Takeaways:
- Polivy (polatuzumab vedotin-piiq) is FDA-approved for previously untreated DLBCL or high-grade B-cell lymphoma in combination with rituximab + cyclophosphamide + doxorubicin + prednisone (Pola-R-CHP per POLARIX trial), and for relapsed or refractory DLBCL after at least two prior therapies in combination with bendamustine and rituximab (Pola-BR per GO29365). Antibody-drug conjugate targeting CD79b — anti-CD79b antibody linked to MMAE microtubule disruptor.
- Without assistance, Polivy costs commonly run approximately $11,000–$15,000 per dose (every 3 weeks for 6 cycles in first-line; weekly during induction in R/R setting).
- Through AffordMyPrescriptions, qualifying patients can access Polivy for a flat $69.95 per month.
- Other DLBCL therapies: standard R-CHOP first-line (rituximab biosimilars now widely available — Truxima, Ruxience, Riabni — much cheaper rituximab component; cyclophosphamide, doxorubicin, vincristine, prednisone all generic — historical $5,000/cycle backbone), CAR-T cell therapy for relapsed/refractory (axicabtagene/Yescarta, lisocabtagene/Breyanzi, tisagenlecleucel/Kymriah), bispecific antibodies (Columvi, Epkinly), other ADCs (loncastuximab tesirine/Zynlonta — CD19 ADC), tafasitamab (Monjuvi) + lenalidomide (Revlimid generic), selinexor (Xpovio). Autologous SCT for chemosensitive relapsed disease.
What is Polivy Prescription Assistance Program?
The Polivy Patient Assistance Program is a manufacturer-sponsored initiative that helps eligible patients access Polivy (used for previously untreated DLBCL with Pola-R-CHP or relapsed/refractory DLBCL with bendamustine and rituximab) at little or no cost when they meet specific income, insurance, and clinical criteria. The program is free to apply for, but the enrollment process involves detailed applications, hematology/oncology coordination, supporting documentation, and ongoing renewal — which can be overwhelming when you are managing aggressive lymphoma.
At AffordMyPrescriptions, our Patient Advocates handle the entire Polivy PAP enrollment for a flat $69.95 per month. We complete the application, coordinate with your oncologist for required medical documentation, follow up with the manufacturer’s program until approval, manage your infusion cycles, and handle annual re-certification — so you never face a gap in your Polivy ADC therapy.
AffordMyPrescriptions eliminates that burden. For a flat $69.95 per month, our Patient Advocates handle every step of your Polivy enrollment — from the initial application through ongoing refills and annual re-enrollment — so you never face a gap in your diffuse large B-cell lymphoma treatment.
Pharmacy Price Comparison
- Without assistance, Polivy costs thousands of dollars per dose at oncology centers. Discount cards and pharmacy coupons offer minimal relief at this price point, but a Patient Assistance Program can make this targeted lymphoma therapy accessible if you qualify. The table below compares typical pricing across major settings to what you'd pay with our Polivy advocacy service:
| PHARMACY | PRICE (30-DAY) WITH BEST COUPONS | YOU SAVE W/ US |
|---|---|---|
| CAR-T cell therapy (alt R/R) | ~$425,000 total | Alt cellular therapy R/R |
| Hospital oncology | ~$14,500/dose | Save substantially |
| Community oncology | ~$13,000/dose | Save substantially |
| Specialty pharmacy | ~$12,000/dose | Save substantially |
| 340B-eligible institution | ~$11,000/dose | Save substantially |
| Rituxan biosimilars + CHP/BR | ~$3,500/cycle | Generic backbone alt |
*Retail prices are estimates based on public data and vary by pharmacy. Coupon prices from GoodRx and SingleCare as of April 2026. AffordMyPrescriptions Advocacy Service bypasses pharmacy pricing entirely by using the manufacturer’s assistance program to secure your Polivy — independent of dosage or retail price.
Our Pricing:
$69.95 Per month
1 Medications
$79.95 Per Month
2 Medications
$89.95 Per Month
3 Medications
$99.95 Per Month
4+ Medications
Why choose us For Your Polivy Prescription Program?
The Polivy Patient Assistance Program is free to apply and provides medication at no cost if approved. But the process involves detailed applications, prescriber coordination, documentation, and ongoing management — applications that are commonly delayed or denied when paperwork is incomplete. Our $69.95 per month covers full advocacy: applications, doctor coordination, documentation, refill management, and re-enrollment — so you focus on your health, not paperwork. Pola-R-CHP is now FDA-approved first-line for DLBCL after POLARIX trial — replacing vincristine with Polivy in the R-CHOP backbone for IPI 2-5 patients.
Enroll
Complete a simple eligibility form so our team can determine if you may qualify for Polivy assistance.
We Advocate
Our specialists gather documentation, complete applications, and coordinate with your prescriber and the assistance program.
Receive Medication
Once approved, your Polivy is delivered through the assistance program while we manage refills and annual renewals.
Discount Coupons vs. Patient Assistance Programs
Many patients try discount cards first. Here’s why the Patient Assistance Program through AffordMyPrescriptions is the better long-term solution for Polivy:
Limitations of Coupons
Prices fluctuate — savings aren’t guaranteed month-to-month
Copay accumulators may prevent savings from counting toward your deductible
Coupon cards expire and require constant renewal
Still $11,000–$15,000/dose per month even with the best discount
Cannot be used with Medicare, Medicaid, or government insurance
Advantages of PAP Through Us
Fixed $69.95/month — never changes regardless of retail price
- No expiration — continuous access as long as you qualify
Medication supplied directly through the assistance program
We manage all paperwork, refills, and annual renewals
Medicare Part D patients accepted
If denied, we explore alternative savings paths on your behalf
DO YOU QUALIFY?
Eligibility is generally determined by annual household income and insurance status. Most programs follow guidelines that include limits of up to $40,000 for individuals, $60,000 for couples, and $100,000 for larger families. Because requirements vary by program and household, we encourage you to contact AffordMyPrescriptions directly so we can review your specific situation and determine if you qualify for Polivy assistance.
- You Are A U.S. Citizen Or Legal Resident
- You Have A Valid Polivy Prescription From A Licensed U.S. Healthcare Provider
- You Are Uninsured, Underinsured, Or A Medicare Part D Beneficiary
- You Have Recently Experienced A Change In Financial Circumstances That Affects Your Ability To Pay
Understanding Polivy:
Polivy is a CD79b-targeted antibody-drug conjugate combining anti-CD79b antibody with the MMAE microtubule-disrupting payload via a cleavable linker. CD79b is part of the B-cell receptor complex, broadly expressed on B-cell malignancies. The POLARIX trial established Polivy + rituximab + CHP (cyclophosphamide, doxorubicin, prednisone — vincristine replaced by Polivy) as first-line standard for IPI 2-5 DLBCL with improved PFS vs R-CHOP. Pola-BR established in R/R DLBCL per GO29365.
How It Works:
Diffuse large B-cell lymphoma (DLBCL) is the most common aggressive non-Hodgkin lymphoma. CD79b is part of the B-cell receptor signaling complex, broadly expressed on B-cell malignancies including DLBCL and provides a tumor-selective targeting opportunity. Anti-CD79b antibody binds CD79b on B-cell lymphoma cells — the ADC is internalized, the cleavable linker releases the MMAE (monomethyl auristatin E) payload — MMAE binds tubulin and disrupts microtubule polymerization, causing cell cycle arrest and apoptosis. The tumor-selective delivery improves the therapeutic index compared with systemic chemotherapy. POLARIX established improved PFS in first-line DLBCL with IPI 2-5; GO29365 established benefit in relapsed/refractory DLBCL with bendamustine and rituximab.
Form and Use:
Polivy IV infusion. First-line DLBCL (Pola-R-CHP per POLARIX): 1.8 mg/kg every 3 weeks for 6 cycles, combined with rituximab + cyclophosphamide + doxorubicin + prednisone. Relapsed/refractory DLBCL (Pola-BR per GO29365): 1.8 mg/kg every 3 weeks for 6 cycles, combined with bendamustine + rituximab. Premedication with antihistamine and antipyretic for infusion reactions. Periodic CBC, CMP, neurologic assessment for peripheral neuropathy.
Generic Availability:
No biosimilar/generic Polivy. Component generics for combination regimens: rituximab biosimilars (Truxima, Ruxience, Riabni — substantially cheaper than brand Rituxan), cyclophosphamide generic, doxorubicin generic, prednisone generic, bendamustine generic. Other DLBCL therapies: standard R-CHOP first-line (rituximab biosimilars + generic chemotherapy backbone — historical alternative for IPI 0-1 or fit patients per POLARIX subgroup analysis). Relapsed/refractory DLBCL: CAR-T cell therapy (axicabtagene ciloleucel/Yescarta, lisocabtagene maraleucel/Breyanzi, tisagenlecleucel/Kymriah — one-time cellular therapy at specialized centers, ~$425,000+ cost, intensive logistics), bispecific antibodies (Columvi/glofitamab, Epkinly/epcoritamab), other antibody-drug conjugates (loncastuximab tesirine/Zynlonta — CD19 ADC), tafasitamab (Monjuvi) + lenalidomide (Revlimid — generic now), selinexor (Xpovio), autologous SCT for transplant-eligible chemosensitive disease. Allogeneic SCT for select cases. NCCN B-cell lymphoma guidelines guide selection.
Warnings:
Peripheral neuropathy (sensory more than motor — common and sometimes severe; monitor; dose-modify; some neuropathy may be permanent), infusion-related reactions, myelosuppression (cytopenias including neutropenia, anemia, thrombocytopenia — monitor CBC; consider G-CSF; manage infections aggressively), serious infections (bacterial, viral, fungal — including hepatitis B reactivation; screen HBV; consider antiviral prophylaxis), tumor lysis syndrome (high disease burden — hydration, allopurinol), progressive multifocal leukoencephalopathy (PML — rare but reported with anti-B-cell therapies; evaluate any new neurologic symptoms), hepatotoxicity (monitor LFTs), embryo-fetal toxicity. Other: nausea/diarrhea, fatigue, anorexia, pyrexia. Live vaccines avoided. Drug interactions: strong CYP3A4 inhibitors increase MMAE exposure — caution.
FAQ (Frequently Asked Questions)
How much does Polivy cost without insurance?
$11,000–$15,000 per dose. Six-cycle Pola-R-CHP course can cost $80,000–$120,000 for Polivy alone (plus chemotherapy and rituximab biosimilar backbone). Specialty pharmacy and Patient Assistance Programs are essential.
Is Polivy considered chemotherapy?
Polivy is an antibody-drug conjugate — it delivers a chemotherapy payload (MMAE microtubule disruptor) selectively to CD79b-expressing B-cell tumor cells. Different from systemic chemotherapy in that the cytotoxic agent is targeted via the anti-CD79b antibody, improving the therapeutic window. Combined with traditional chemotherapy in Pola-R-CHP and Pola-BR regimens.
What is Pola-R-CHP and how does it differ from standard R-CHOP?
Standard R-CHOP first-line DLBCL therapy uses rituximab + cyclophosphamide + doxorubicin + vincristine + prednisone. Pola-R-CHP (per POLARIX trial) replaces vincristine with Polivy — providing better PFS in IPI 2-5 DLBCL. Pola-R-CHP is now FDA-approved first-line for previously untreated DLBCL with IPI 2-5.
Why does Polivy cause peripheral neuropathy?
MMAE (monomethyl auristatin E) is a microtubule-disrupting agent — affects nerve cell microtubules, causing sensory peripheral neuropathy (and motor in some cases). Monitor symptoms; dose-modify for grade 2+ neuropathy. Some neuropathy may be permanent. Vincristine (replaced by Polivy in Pola-R-CHP) also causes neuropathy — Polivy substitution doesn’t eliminate this class concern.
Why is hepatitis B screening considered before Polivy?
B-cell-depleting therapy and immunomodulatory treatment can reactivate hepatitis B in patients with prior exposure. Screen HBsAg, anti-HBc, anti-HBs before initiation. Antiviral prophylaxis (entecavir, tenofovir) appropriate if HBV exposure history.
Take Control of Your Medication Costs
Targeted ADC therapy for DLBCL should not be derailed by cost. Pola-R-CHP is now first-line standard for IPI 2-5 DLBCL per POLARIX. Our Polivy advocacy team is ready to verify your eligibility, complete the manufacturer application on your behalf, and manage your prescription through approval, delivery, and renewal — for a flat $69.95 per month. If we cannot help you access Polivy through a Patient Assistance Program, you are not charged.
Submit Enrollment Form
Start free by filling out a simple online form.
Receive Welcome Call
Our specialist will contact you for a quick welcome call.
We Manage The Process
Our team handles everything, so you can focus on your health.