How do I submit the application? The completed application can be submitted by fax (800-784-9950), mail (XHANCE Patient Assistance, 2325 Heritage Center Drive, Furlong, PA 18925), email ([email protected] programs, or other support programs • to investigate my health insurance coverage for DUPIXENT injection • to obtain prior authorization for coverage • to assist with appeals of denied claims for coverage • for the operation and administration of the DUPIXENT MyWay Program • to refer me to, or to determine my eligibility. We are here to help. 30 Section: Prescription Drugs Effective Date: January 1, 2022 Subsection: Topical Products Original Policy Date: April 7, 2017 Subject: Dupixent Page: 4 of 11 2. DUPIXENT is a form of medicine called a biologic that targets Type 2 inflammation, an underlying cause of nasal polyps. With our help, you could get your Dupixent prescription for a flat fee of $49 per month. Dupixent MyWay is a program that provides support and resources to people prescribed Dupixent (dupilumab) to help them get the most out of their treatment. In order to be eligible for the program, you must meet the following requirements: facilitate the filling of my patient’s prescription; to assess, if applicable, my patient’s eligibility for patient assistance and other support programs; and to otherwise administer DUPIXENT MyWay for the patient. such as copay assistance. Each time you fill your DUPIXENT prescription, please ensure your. Helminth infections (5 cases of enterobiasis and 1 case of ascariasis) were reported in pediatric patients 6 to 11 years old in the pediatric asthma development program. 1-844-DUPIXENT 1-844-387-4936. Uninsured patients can apply to the manufacturer’s patient assistance program, the Dupixent MyWay program. 2 pens of 300mg/2ml. consent to receive text messages by or on behalf of the Program. This program may provide a Bridge Program for eligible patients who experience a delay, temporary loss, or change in coverage. The Dupixent development program has shown significant clinical benefit and a decrease in type 2 inflammation in Phase 3 trials, establishing that IL-4 and IL-13 are key and central drivers of the. Helminth infections (5 cases of enterobiasis and 1 case of ascariasis) were reported in pediatric patients 6 to 11 years old in the pediatric asthma development program. Patients prescribed Praluent® may have access to the following program services: product administration training, treatment reminders, reimbursement navigation, copay assistance and a toll-free call center. This program is not valid where prohibited by law, taxed or restricted. I, _____, certify that the information provided for this reimbursement request is accurate to the best of my knowledge, and the product-specific copay, co-insurance, or deductible expenses requested for reimbursement were actually. facilitate the filling of my patient’s prescription; to assess, if applicable, my patient’s eligibility for patient assistance and other support programs; and to otherwise administer DUPIXENT MyWay for the patient. Box 5697, Louisville, KY 40255 Monday – Friday Phone: 1-855-297-5904 Fax: 1-855-297-5905 8:30 AM – 6:00 PM ET Page 2 of 5medications on this list, whether made by you, your plan or a manufacturer’s copay assistance program, will not count toward your plan deductible. Here’s an NBC News article about it. These diseases include approved indications for. DUPIXENT® (dupilumab) therapy (“My Information”). coverage assistance programs, patient assistance programs, or other support programs • to investigate my health insurance coverage for DUPIXENT inection • to obtain prior authorization for coverage • to assist with appeals of denied claims for coverage • for the operation and administration of the DUPIXENT MyWay Programfacilitate the filling of my patient’s prescription; to assess, if applicable, my patient’s eligibility for patient assistance and other support programs; and to otherwise administer DUPIXENT MyWay for the patient. Sanofi Patient Connection ® can provide certain Sanofi prescription medications at no cost if you meet program eligibility requirements. ago. The variable copay program applies to a select list of 200 drugs — representing more than 90% of the copay assistance available today — when dispensed through Optum Specialty Pharmacy. Dupixent is one shot self administered every two weeks, and delivered to my door through the specialty Pharm. For families/households with more than 8 persons, add $5,140 for each. BI Cares Patient Assistance Program - Specialty Program P. FWIW I pay my copay out of pocket and then submit the receipt to the Dupixent MyWay Reimbursement Program through the mail. Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. Red tape, paperwork, and communication gaps hijack the time that providers. Prior Authorization of Dupixent (dupilumab) – Pharmacy Services BY Sally A. Saveonsp-supported specialty medications. or U. These diseases include approved indications for. DUPIXENT® (dupilumab) offers webinars where you can learn from medical professionals and people who live with eosinophilic esophagitis (EoE). Co-pay support is available for people who have commercial insurance to help cover the cost of DUPIXENT. PhRMA’s Medicine Assistance Tool (MAT) – Partnership for Prescription Assistance. facilitate the filling of my patient’s prescription; to assess, if applicable, my patient’s eligibility for patient assistance and other support programs; and to otherwise administer DUPIXENT MyWay for the patient. Serious side effects can occur. I also understand that no free product may be submitted for reimbursement to any payer, including Medicare and Medicaid; and no free product may be sold, traded, or distributed for sale. DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older with uncontrolled, moderate-to-severe. Alliance partners program Become an advocate Support PAN. I also understand that no free product may be submitted for reimbursement to any payer, including Medicare and Medicaid; and no free product may be sold, traded, or distributed for sale. To qualify for the GSK Patient Assistance Program, you must: Live in one of the 50 states, District of Columbia, Puerto Rico or U. Copay amounts after applying copay assistance may depend on the patient’s insurance. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. The Mission of the Nevada Check Up program is to provide low-cost, comprehensive health care coverage to low. You may be eligible for the DUPIXENT MyWay Copay Card if you:. DUPIXENT can cause allergic reactions that can sometimes be severe. Do not heat the syringe. Enrollment Form FOR DERMATOLOGISTS Complete the entire form and submit pages 1-2 to ®DUPIXENT MyWay via fax at 1-844-387-9370 or Document Drop at (code: 8443879370) For assistance, call 1-844-DUPIXEN(T) (1-844-387-4936) Option 1, Monday–Friday, 8 am. S. g. herbypablo • 23 hr. Select a tab below to get you to helpful information depending on where you are in your treatment journey. HELPLINE (800) 503-6897; CONTACT US; ABOUT US; EN ESPANOL. Have commercial insurance, including health insurance. I also understand that no free product may be submitted for reimbursement to any payer, including Medicare and Medicaid; and no free product may be sold, traded, or distributed for sale. In 2022, we assisted nearly 200,000 people. Injection site reactions and eye conditions are the most common side effects reported and, unlike several other biologics, the risk of infection is low. 1-844-DUPIXENT (1-844-387-4936) Topicort (desoximetasone spray 0. Those who may qualify must be at least 18 years of age or older, a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam or the USVI, and demonstrate a financial. Program has an annual maximum of $13,000. The Dupixent development program has shown significant clinical benefit and a decrease in type 2 inflammation in Phase 3 trials, establishing that IL-4 and IL-13 are key and central drivers of the. designated, DUPIXENT MyWay is authorized to transmit this prescription to a network pharmacy it selects or to the pharmacy otherwise indicated. S. Surgery may remove your nasal polyps, but it may not treat an underlying cause of inflammation—allowing them to grow back. Create your signature and click Ok. You must have an annual household income of ≤400% of the. Patient Assistance Program Center: Search Database. Prurigo Nodularis: The most common adverse reactions (incidence ≥2%) are nasopharyngitis, conjunctivitis, herpes infection, dizziness, myalgia, and diarrhea. Compare monoclonal antibodies. We consider each application according to: the drug that is needed. They’ll help you: Track the status of PAP applications. g. Through the Patient Assistance Program, qualified patients who are uninsured or whose insurance does not cover DUPIXENT could receive DUPIXENT at no cost. If patients become infected while receiving treatment with DUPIXENT and do not respond to anti-helminth treatment, discontinue treatment with DUPIXENT until the infection resolves. morbid asthma receiving DUPIXENT in the CRSwNP development program. In those situations, the Program may change its terms in order to enable patients to realize the full benefits of the assistance available under the Program. I know my Co. Especially tell your healthcare provider if you. ” but i don’t know if having insurance with a copay accumulator is the same thing as insurance not. In order to be eligible for the program, you must meet the following requirements:understand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. There are. chart notes, laboratory values) and use of claims history documenting the following: 1. , Quick Start, Copay Card, and Patient Assistance Program) Nursing Support (e. In those situations, the Program may change its terms in order to enable patients to realize the full benefits of the assistance available under the Program. We work directly with your healthcare provider and will handle the full enrollment process on your behalf. Program has an annual maximum of $13,000. This program may provide a Bridge Program for eligible patients who experience a delay, temporary loss, or change in coverage. I have definitely heard that before from multiple sources. Even when using the Copay Card, that would cover only cover 4 months worth, and would not go towards my deductible, totaling about. Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. Fax: 1-908-809-6249. chart notes, laboratory values) and. The Dupixent development program has shown significant clinical benefit and a decrease in type 2 inflammation in Phase 3 trials, establishing that IL-4 and IL-13 are key and central drivers of the type 2 inflammation that plays a major role in multiple related and often. The program is intended to help patients afford DUPIXENT. Dupixent is used to treat certain chronic inflammatory conditions, such as asthma and atopic dermatitis. How we help. Enrollment Form FOR DERMATOLOGISTS Complete the entire form and submit pages 1-2 to ®DUPIXENT MyWay via fax at 1-844-387-9370 or Document Drop at (code: 8443879370) For assistance, call 1-844-DUPIXEN(T) (1-844-387-4936) Option 1,. Patient assistance options are available for eligible patients with commercial insurance, public insurance or no insurance. This copay card may be for you if you. DUPIXENT® is a prescription medicine used as an add-on maintenance treatment for uncontrolled moderate-to-severe eosinophilic or oral steroid dependent asthma in people aged 6 years and older. Patient and Co-pay Assistance: DUPIXENT MyWay helps eligible patients get access to. , One-on-One Nurse Education, and Supplemental Injection Training) Please click “Continue. Get a Quick Start. Each time you fill your DUPIXENT prescription, please ensure your. The Dupixent development program has shown significant clinical benefit and a decrease in type 2 inflammation in Phase 3 trials, establishing that IL-4 and IL-13 are key and central drivers of the type 2 inflammation that plays a major role in multiple related and often co-morbid diseases. Asthma: DUPIXENT is indicated as an add-on maintenance treatment of adult and pediatric patients aged 6 years and older with moderate-to-severe asthma characterized. by McKesson's Portal! RxCrossroads is pleased to provide you with fast, reliable assistance in obtaining medication copay saving offerings. Drug copay assistance programs have long been controversial. hm well on the dupixent website it says “If your health plan did not accept the copay card or if you paid the copay because you were not enrolled in this program, we may be able to reimburse you for certain out-of-pocket costs in accordance with program terms. Information regarding eligibility is available on line at or by calling toll free at 1-800-992-0900. I tell them I’ve. Within 24 hours, one of our patient advocates will call you for a brief interview. The most common side effects include: DUPIXENT MyWay. Only a doctor or nurse practitioner can apply for coverage through the Exceptional Access Program. DUPIXENT has been FDA approved for use in adults with uncontrolled moderate-to-severe eczema since 2017. Patients will need to meet the eligibility criteria, including household income, to qualify. Dupixent® should be given by or under the supervision of an adult in children 12 years of age and older. Pricing Principles;. Find DUPIXENT® (dupilumab) injection videos and instructions for the pre-filled syringe (200 mg or 300 mg) with needle shield for ages 6 months & older. Need additional guidance with the enrollment process? Contact your field access specialist or call DUPIXENT MyWay. TRICARE, or other federal or state programs including any state pharmaceutical assistance programs. Patient is responsible for any out-of-pocket amounts that exceed the program limit. Medicine Assistance Tool;. At a time when the cost of specialty medications accounts for over 50 percent of pharmacy spend, it’s never been more urgent to find a solution to this growing problem. S. This form (and attachments) contains protected health. How possessed an annual upper of $13,000. Eligibility Requirements. 1-Member cost share payments for these medications, whether made by you, your plan or a manufacturer copayment assistance program, do not count towa rds the plan’s out of pocket. The program is intended to help patients afford DUPIXENT. By way of background: Dupixent was approved by the Food and Drug Administration in May 2017. You can email or print the enrollment forms below. Provide proper training to patients and/or caregivers on the preparation and administration of DUPIXENT prior to use according to the “Instructions for. One-on-one nursing support, when needed, to provide disease and DUPIXENT education. Agency: Ministry of Health. LONG-LASTING CLEARER SKIN AT 16 and 52 Weeks 22% taking. Dupixent is contraindicated for breast feeding. In those situations, the program may change its terms. DUPIXENT® (dupilumab) therapy (“My Information”). The Dupixent development program has shown significant clinical benefit and a decrease in type 2 inflammation in Phase 3 trials, establishing that IL-4 and IL-13 are key and central drivers of the type 2 inflammation that plays a major role in multiple related and often. Patients will need to meet the eligibility criteria, including household income, to qualify. Please click on the link to see if you may qualify. Patients may be eligible for the Quick Start Program if they: • Have a valid DUPIXENT prescription for an FDA-approved indicationThe Division of Welfare and Supportive Services (DWSS) determines eligibility for the Medicaid program. With Optum Rx. Is the patient currently receiving Dupixent through samples or a manufacturer’s patient assistance program? DUPIXENT® (dupilumab) therapy (“My Information”). Sanofi is committed to providing patients with support programs. Dupixent MyWay Copay Program is available to residents of the United States or Puerto Rico who have commercial insurance, covering up to $13,000 of copay costs per year. Enrollment Form FOR DERMATOLOGISTS Complete the entire form and submit pages 1-2 to ®DUPIXENT MyWay via fax at 1-844-387-9370 or Document Drop at (code: 8443879370) For assistance, call 1-844-DUPIXEN(T) (1-844-387-4936) Option 1, Monday–Friday, 8 am. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. These diseases include approved indications forTell your healthcare provider about any new or worsening joint symptoms. DUPIXENT (dupilumab) Prescriber Information Patient Information . I certify that I have obtained my patient’s written authorization in accordance with applicablecoverage assistance programs, patient assistance programs, or other support programs • to investigate my health insurance coverage for DUPIXENT inection • to otain prior authoriation for coverage • to assist with appeals of denied claims for coverage • for the operation an aministration of the DUPIXENT MyWay Programconsent to receive text messages by or on behalf of the Program. Manufacturers have generous assistance programs that often exceed what most non-profit foundations can offer, particularly for commercially insured patients. Patient Assistance Foundations; Pricing Principles. We believe that no patient should go without life changing medications because they cannot afford them. LEARN HOW WE CAN HELP DUPIXENT MyWay ENROLLMENT FORMS; English Enrollment Form: Spanish Enrollment Form. DUPIXENT 200 mg injections at different injection sites. , Quick Start, Copay Card, and Patient Assistance Program) Nursing Support (e. DUPIXENT MyWay TM will help eligible patients who are uninsured, lack coverage, or need assistance with their out-of-pocket costs. Through the Patient Assistance Program, qualified patients who are uninsured or whose insurance does not cover DUPIXENT could receive DUPIXENT at no cost. understand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. DUPIXENT MyWay offers a range of support, including: Coverage Support (e. You can rely on Simplefill to connect you with programs and organizations that offer the prescription assistance you need. understand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. 2 cartons. The DUPIXENT MyWay nurse connects patients to a variety of helpful resources, including one-on-one nursing support, financial assistance for eligible patients, and helpful refill and injection reminders. Co-payment assistance, and patient assistance programs are available for eligible. O. Learn how to inject DUPIXENT® (dupilumab), a biologic subcutaneous injectable prescription medicine for eosinophilic esophagitis (EoE) in patients 12 years and older who weigh at least 88lb (40kg). With of DUPIXENT MyWay Copay Card, right, commercially insured patients might pay as little as $0* copay per fill of DUPIXENT. A program called Dupixent MyWay provides a manufacturer coupon copay card. Food and Drug Administration (FDA) has approved Dupixent ® (dupilumab) 300 mg weekly to treat patients with eosinophilic esophagitis (EoE) aged 12 years and older, weighing at least 40 kg. DUPIXENT: your first choice to adequately control this chronic, systemic disease. g. Patient Savings Center - beta. Dupixent is an injection that is usually given under the skin every other week for the treatment of asthma, eczema, and some other inflammatory conditions. or U. Sanofi and Regeneron announce FDA approval of Dupixent (dupilumab), the first targeted biologic therapy for adults with moderate-to-severe atopic. 2 cartons. Enrollment Form FOR DERMATOLOGISTS Complete the entire form and submit pages 1-2 to ®DUPIXENT MyWay via fax at 1-844-387-9370 or Document Drop at (code: 8443879370) For assistance, call 1-844-DUPIXEN(T) (1-844-387-4936) Option 1, Monday–Friday, 8 am. Get your personalized discussion guide to help yourself have a productive conversation with your doctor & see if DUPIXENT® (dupilumab) for uncontrolled moderate-to-severe atopic dermatitis is right for you. Contact the program for details: Re-application: New application yearly : Additional Information: Co-payment assistance, and patient assistance programs are available for eligible patients. , One-on-One Nurse Education, and Supplemental Injection Training)3. Call 855-204-2410 if you need assistance. Providers rendering services in the MA managed care delivery system. The DUPIXENT MyWay team can research each patient’s situation and determine eligibility. INJECTION SUPPORT. Check the liquid in the prefilled pen or syringe. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. DUPIXENT MyWay is a patient support program that can help enable access to DUPIXENT through benefits verification and assistance navigating the insurance process. , One-on-One Nurse Education, and Supplemental Injection Training) Please click “Continue. This program may provide a Bridge Program for eligible patients who experience a delay, temporary loss, or change in coverage. With our help, you could get your Dupixent prescription for a flat fee of $49 per month. assistance programs, or other support programs • to investigate my health insurance coverage for DUPIXENT injection • to obtain prior authorization for coverage • to assist with appeals of denied claims for coverage • for the operation and administration of the DUPIXENT MyWay Program • to refer me to, or to determine my eligibility. To help, we have remained committed to developing patient support services and programs that provide assistance, including: Helping patients navigate the complexities of their insurance plans (both private and public) Researching alternative forms of funding and reimbursement. Prior Authorization of Dupixent (dupilumab) – Pharmacy Services BY Sally A. Kozak, Deputy Secretary Office of Medical Assistance Programs IMPORTANT REMINDER: All providers must revalidate the Medical Assistance (MA) enrollment of each service location every 5 years. This program may provide a Bridge Program for eligible patients who experience a delay, temporary loss, or change in coverage. Enrollment Form FOR DERMATOLOGISTS Complete the entire form and submit pages 1-2 to ®DUPIXENT MyWay via fax at 1-844-387-9370 or Document Drop at (code: 8443879370) For assistance, call 1-844-DUPIXEN(T) (1-844-387-4936) Option 1,. Healthcare professionals should be alert to vasculitic rash, worsening pulmonary symptoms, cardiac complications, and/or neuropathy presenting in patients with eosinophilia. 2 pens of 300mg/2ml. You can be eligible for and DUPIXENT MyWay Copay Card if you:. Please see Important Safety. Biologic Drug: Biologic drugs are made from living cells and are often expensive. The DUPIXENT pre-filled syringe is for use in adult and pediatric patients aged 6 months and older. Now that the copay assistance has capped out, I'm 100% OOP until I hit my $3500 deductible, at which time they will pay 80% of $2848. I also understand that no free product may be submitted for reimbursement to any payer, including Medicare and Medicaid; and no free product may be sold, traded, or distributed for sale. The manufacturer can provide additional information and enrollment forms. Sanofi (DUPIXENT®) 844‑387‑4936 (option 1). Please see Important Safety Information and Patient Information on. That’s why myAbbVie Assist provides free AbbVie medicine to qualifying patients. I understand the disclosure to the Alliance will be for the purposes of enrolling me in, and providing certain services through the “DUPIXENT MyWay Program,” including: • to determine if I am eligible to participate in DUPIXENT MyWay coverage assistance programs, patient assistance DUPIXENT MyWay is a patient support program designed to help you get access to. Dupilumab in children aged 6 months to younger than 6 years with uncontrolled atopic dermatitis: a randomised, double-blind, placebo-controlled, phase 3 trial. Patient Assistance Connection Financial Eligibility(for uninsured or functionally uninsured patients) Determine the maximum household income requirement to be considered for Patient Assistance Connection by selecting your household size and then viewing the 400% column. That’s why we offer patient assistance programs that provide free AbbVie medicines to qualifying patients. Ask the prescriber about patient assistance. DUPIXENT MyWay. ICD-10-CM Diagnosis Codes Select at least 1 primary and 1 secondary ICD-10-CM code. Program has an annual maximum of $13,000. It also offers financial assistance for eligible patients, one-on-one nursing support, and more. Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. 4. The program is intended to help patients afford DUPIXENT. Dupixent changed my life completely. The Dupixent development program has shown significant clinical benefit and a decrease in type 2 inflammation in Phase 3 trials, establishing that IL-4 and IL-13 are key and central drivers of the type 2 inflammation that plays a major role in multiple related and often co-morbid diseases. Kozak, Deputy Secretary Office of Medical Assistance Programs IMPORTANT REMINDER: All providers must revalidate the Medical Assistance (MA) enrollment of each service location every 5 years. Providers rendering services to MA beneficiaries in the managed care delivery system should A program called Dupixent MyWay provides a manufacturer coupon copay card. Pair the right financial assistance with the patient’s needs at the point of prescribing and fulfillment. DUPIXENT MyWay is a patient support program that can help enable access to DUPIXENT and offers financial assistance for eligible patients, one-on-one nursing support, and more. Need additional guidance with the enrollment process? Call DUPIXENT MyWay at 1-844-387-4936 Monday through Friday, 8 am to 9 pm Eastern Time. We believe that people who need our medicines should be able to get them. LEARN MORE. It also offers financial assistance for eligible patients, one-on-one nursing support, and more. DUPIXENT MyWay® is a patient support program that can help enable access to. Learn how DUPIXENT® (dupilumab), the first FDA-approved weekly injectable biologic treatment for eosinophilic esophagitis (EoE) in patients 12 years and older who weigh at least 88lb (40kg) targets a source of inflammation, which contributes to EoE. Needs-Based/Patient Assistance Program (PAP): This type is offered by a manufacturer sponsor or independent non-profit to help patients who meet specific financial eligibility criteria. Data from DUPIXENT ® clinical trials have shown that IL-4 and IL-13 are key drivers of the type 2 inflammation that plays a major role in asthma, atopic. MS One to One™ (AUBAGIO ® and LEMTRADA ®): 1-855-671-2663. Is Dupixent being prescribed by or in consultation with an allergist/immunologist or a pulmonologist? Yes No 19. Copayment Assistance Organizations. The program. Patients will need to meet the eligibility criteria, including household income, to qualify. Fast forward to now, I’m on my third dermatologist (new job=new insurance) and it’s finally safe for me to take Dupixent. Stop using DUPIXENT and tell your healthcare provider or get emergency help right away if you get any of the following signs or symptoms: breathing problems or wheezing, swelling of the face, lips, mouth, tongue or throat, fainting, dizziness, feeling lightheaded, fast pulse. All our information is free and updated regularly. *. Serious side effects can occur. facilitate the filling of my patient’s prescription; to assess, if applicable, my patient’s eligibility for patient assistance and other support programs; and to otherwise administer DUPIXENT MyWay for the patient. Please be aware that not all Sanofi products are covered under the Sanofi Patient Assistance program. 2022;400 (10356):908-919. Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. Complete the At Home Program Application form with the assistance of a physician. coverage assistance programs, patient assistance programs, or other support programs • to investigate my health insurance coverage for DUPIXENT inection • to obtain prior authorization for coverage • to assist with appeals of denied claims for coverage • for the operation and administration of the DUPIXENT MyWay ProgramAt NiceRx, we help eligible individuals to enroll in the Dupixent patient assistance program. 5. Simplefill closely monitors any changes to the eligibility of these patient assistance programs. The Dupixent development program has shown significant clinical benefit and a decrease in type 2 inflammation in Phase 3 trials, establishing that IL-4 and IL-13 are key and central drivers of the type 2 inflammation that plays a major role in multiple related and often co-morbid diseases. For additional information or if you have questions, contact your Field Representative or call DUPIXENT MyWay at 1-844-DUPIXEN(T) (1-844-387-4936) Option 1, Monday–Friday, 8 am –9 pm Eastern time. , One-on-One Nurse Education, and Supplemental Injection Training) AbbVie Patient Assistance Program. Automate the review and validation of. I understand the disclosure to the Alliance will be for the purposes of enrolling me in, and providing certain services through the “DUPIXENT MyWay Program,” including: • to determine if I am eligible to participate in DUPIXENT MyWay coverage assistance programs, patient assistance Medicaid, or any other state or federal programs unless you choose not to use your government-sponsored program. I'm fortunate enough to have really good insurance but my friend isn't and he gets his dupixent through the no insurance program at low/no costThe $0 Copay Card reduces monthly copays to $0 for insured patients, and the Amgen Patient Assistance Program can help provide no-cost medication for patients who qualify. Find videos and downloadable instructions for the two injection administration options available for DUPIXENT® (dupilumab), pre-filled syringe (200 mg or 300 mg) with needle shield for ages 6 months & older, or pre-filled pen (200 mg or 300 mg) for ages 2+ years. NeedyMeds NeedyMeds has free information on medication and. Lancet. SYNVISC ® OnTRACK: 1-800-796-7991. 5. g. Once enrolled, the DUPIXENT MyWay support program can help enable access to. It may be covered by your Medicare or insurance plan. Caring. Paller AS, Simpson EL, Siegfried EC, et al. chevron_right. Sign up to connect with a DUPIXENT MyWay® mentor to help patients with Nasal Polyps through their DUPIXENT. Those who may qualify must be at least 18 years of age or older, a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI, and. Our Patient Assistance Programs are intended for people that live in the United States, have limited or no health insurance coverage and demonstrate qualifying financial need. You can connect with DUPIXENT MyWay Nurse Educators by phone to receive supplemental injection training, help scheduling deliveries and prescription refills, or help navigating financial support options, such as copay assistance. DUPIXENT® (dupilumab) is a prescription medicine FDA-approved to treat five conditions. DUPIXENT MyWay®. , February 26, 2022. facilitate the filling of my patient’s prescription; to assess, if applicable, my patient’s eligibility for patient assistance and other support programs; and to otherwise administer DUPIXENT MyWay for the patient. Learn more about DUPIXENT® (dupilumab), is the first FDA-approved biologic to treat eosinophilic esophagitis (EoE) in patients 12 years and older who weigh at least 88lb (40kg). Learn how DUPIXENT® (dupilumab) works as the first and only FDA-approved treatment for prurigo nodularis (PN) in adults aged 18 years and older. Box 64811 St. Dupixent MyWay Enrollment Form: Asthma 10/10/23 Dupixent. Enrolled patients receive: One-on-one support from our DUPIXENT MyWay support team; Help understanding insurance coverage; Financial assistance (for eligible patients only) Help. The. How to apply. Financial and insurance assistance:. Identify eligible patients, complete and verify enrollment, facilitate product recovery and uncover hidden revenue with the help of McKesson RxO’s PAP Recovery team. , Quick Start, Copay Card, and Patient Assistance Program) Nursing Support (e. You may be eligible for the DUPIXENT MyWay Copay Card if you:DUPIXENT MyWay Copay Card if you:For general information about our products and programs in the U. The DUPIXENT MyWay Copay Card Program includes the Copay Card, the Debit Card, and any direct patient rebate, and has a combined annual maximum benefit of $13,000 per patient per calendar year. The Dupixent MyWay program may help reduce its cost. Once enrolled, you can receive: One-on-one nursing support when needed for DUPIXENT; Insurance benefit investigation support; Opportunities for financial assistance provided to eligible patients;Dupixent (dupilumab) is a prescription drug that comes as an injection. 1-844-DUPIXENT 1-844-387-4936. understand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. Please note that you will receive a confirmation fax after sending the form. Assistance may be available for patients who do not have insurance. facilitate the filling of my patient’s prescription; to assess, if applicable, my patient’s eligibility for patient assistance and other support programs; and to otherwise administer DUPIXENT MyWay for the patient. Teva Pharmaceuticals (QVAR ®) Teva Cares Foundation Teva Savings Card for QVAR® Redihaler™ 877-237-4881 DUPIXENT® (dupilumab) therapy (“My Information”). Eligible patients will receive their cards by email. Maybe try that while waiting for the Dupixent. Rare Together. Serious side effects can occur. This site provides important information to health care providers about the Connecticut Medical Assistance Program. Is the request for a continuation of therapy with Dupixent? Yes No If No, skip to #23 20. You earn extra money, and NeedyMeds earns funding. coverage assistance programs, patient assistance programs, or other support programs • to investigate my health insurance coverage for DUPIXENT inection • to otain prior authoriation for coverage • to assist with appeals of denied claims for coverage • for the operation an aministration of the DUPIXENT MyWay ProgramPatient Rebate Portal. With this approval, Dupixent becomes the first and only medicine specifically indicated to. In addition, you cannot use this card with any health insurance program, but you can use it in place of your insurance if the Customer Care card offers a better price. DUPIXENT MyWay is a patient support program designed to help you get access to DUPIXENT and stay on track while providing helpful tools and resources. It is free to apply, and those who qualify will receive their medicine for free — no co-pays or shipping costs. 1-914-354-9001. DUPIXENT® (dupilumab) is a. As a reminder, with all of these folks helping to get you off to good start with DUPIXENT, you may receive phone calls from your. Choose My Signature. Dupixent Patient Assistance Programs. The maximum annual patient benefit under the DUPIXENT MyWay® Copay Card Program is $13,000. coverage assistance programs, patient assistance programs, or other support programs • to investigate my health insurance coverage for DUPIXENT inection • to otain prior authoriation for coverage • to assist with appeals of denied claims for coverage • for the operation an aministration of the DUPIXENT MyWay ProgramDUPIXENT® (dupilumab) therapy (“My Information”). , clear or. It may be covered by your Medicare or insurance plan. I also understand that no free product may be submitted for reimbursement to any payer, including Medicare and Medicaid; and no free product may be sold, traded, or distributed for sale. Any savings provided by the program may vary depending on patients' out-of-pocket costs. The upper arm can also be used if a caregiver administers the injection. These programs and tips can help make your prescription more affordable. Please see Important Safety Information and Prescribing Information and Patient. Compare monoclonal antibodies. I certify that I have obtained my patient’s written authorization in accordance with applicableconsent to receive text messages by or on behalf of the Program. Is the request for a continuation of therapy with Dupixent? Yes No If No, skip to #23 20. You’ll need to become a Simplefill member for us to find you the prescription assistance you need to pay for your Dupixent. S. DUPIXENT can be used with or without topical corticosteroids. The DUPIXENT MyWay patient support program is here to help you at every step of your DUPIXENT treatment journey. Patients will need to meet the eligibility criteria, including household income, to qualify. programs, or other support programs • to investigate my health insurance coverage for DUPIXENT injection • to obtain prior authorization for coverage • to assist with appeals of denied claims for coverage • for the operation and administration of the DUPIXENT MyWay ProgramThe Program is intended to help patients access DUPIXENT. Patients with Medicare Part D should contact the program. Patients get more insight into the medication’s cost during its entire lifecycle. Detailed results from a Phase 3 trial showed that adding Dupixent ® (dupilumab) to standard-of-care antihistamines significantly reduced itch and hives at 24 weeks in biologic-naïve patients with chronic spontaneous urticaria (CSU) compared to antihistamines alone in this investigational. The cost for Adbry subcutaneous solution (ldrm 150mg/mL) is around $1,916 for a supply of 2 milliliters, depending on the pharmacy you visit. Dupixent MyWay Program Dupixent (dupilumab injection) CONTACT INFO: Address:, Phone: 1-844-387-4936: Provider Phone: Fax: 1-844-387-3970: Website: Program Website: ELIGIBILITY. Serious side. Tips. consent to receive text messages by or on behalf of the Program. DUPIXENT MyWay team will research each patient’s situation and determine eligibility. Enrollment Form FOR DERMATOLOGISTS Complete the entire form and submit pages 1-2 to ®DUPIXENT MyWay via fax at 1-844-387-9370 or Document Drop at (code: 8443879370) For assistance, call 1-844-DUPIXEN(T) (1-844-387-4936) Option 1,. Easy. These diseases include approved indications for. The Dupixent Patient Support Program offers free or low-cost access to Dupixent for eligible patients. facilitate the filling of my patient’s prescription; to assess, if applicable, my patient’s eligibility for patient assistance and other support programs; and to otherwise administer DUPIXENT MyWay for the patient. $0 is the amount you pay. Patients will need to meet the eligibility criteria, including household income, to qualify. Chronic condition management can be challenging for both patients and their care providers. facilitate the filling of my patient’s prescription; to assess, if applicable, my patient’s eligibility for patient assistance and other support programs; and to otherwise administer DUPIXENT MyWay for the patient. Pricing Principles;. Please see Important Safety Information and Prescribing Information and Patient Information on website. Eligibility Requirements. Patient Access Network Foundation and Dupixent MyWay Program are patient assistance programs that assist underinsured and uninsured patients with access to medications such as Dupixent for free or at a saving. Patient assistance program. These diseases include approved indications for. The PAN Foundation is dedicated to helping patients reach their best health. Patients may have insurance plans that attempt to dilute the impact of the assistance available under the program. Have a Medicare prescription drug plan. Patient Advocate Foundation's Co-Pay Relief program exists to help reduce the financial distress patients, and their families face when paying for treatment. If patients become infected while receiving treatment with DUPIXENT and do not respond to anti-helminth treatment, discontinue treatment with DUPIXENT until the infection resolves. The DUPIXENT MyWay Patient Assistance Program may be able to help. DUPIXENT MyWay is a patient support program that can help enable access to DUPIXENT and offers financial assistance for eligible patients, one-on-one nursing support, and more. I understand the disclosure to the Alliance will be for the purposes of enrolling me in, and providing certain services through the “DUPIXENT MyWay Program,” including: • to determine if I am eligible to participate in DUPIXENT MyWay coverage assistance programs, patient assistancecoverage assistance programs, patient assistance . Deductible is at $3k out of pocket insurance pays 80% and at $6k insurance pays 100%. DUPIXENT MyWay is a patient support program designed to help you get access to DUPIXENT. Just got the fun news that I will need to pay $2,700 for a monthly dose of Dupixent. , Quick Start, Copay Card, and Patient Assistance Program) Nursing Support (e. 3. Have commercial insurance, including health insurance. e.