You may be eligible for the DUPIXENT MyWay Copay Card if you:. Financial Assistance Programs. Start the process today by applying online or by calling (877)386-0206. Have commercial services, including health insurance markets,. People who get GA are also eligible for help with medical and food costs through Medical Assistance (MA) and the. DUPIXENT MyWay team will research each patient’s situation and determine eligibility. O. Acaregiver or patient 12 years of age and older may inject DUPIXENT using the pre-filled syringe or pre-filled pen. XXXXXX XXXXXX 12345678 Viewing window 200 mg 300 mg 30 MIN 45 MINFor more information, dial 1‑844‑DUPIXENT ( 1-844-387-4936 ), option 1 Monday-Friday, 8 am - 9 pm ET. 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. Injection Support Center Help Staying on Track DUPIXENT Pricing Information For. This program may provide a Bridge Program for eligible patients who experience a delay, temporary loss, or change in coverage. That’s why myAbbVie Assist provides free AbbVie medicine to qualifying patients. You may be able to lower your total cost by filling a greater quantity at one time. 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. 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. 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 assistanceSanofi Patient Connection ® can provide certain Sanofi prescription medications at no cost if you meet program eligibility requirements. Please see Important Safety. Inadequate control of asthma symptoms after a minimum of 3 months of compliant use with greater than or equal to 50% adherence with ONE of the following within the. * Public reimbursement under the Ontario Exceptional Access Program and the New Brunswick Drug Plans Formulary will apply for Canadians aged 12 and older and when specific criteria are met. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. In order to be eligible for the program, you must meet the following requirements: You must be a resident of the U. Easy. 4. 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. 2 cartons. It also offers financial assistance for eligible patients, one-on-one nursing support, and more. Self-nominate to become DUPIXENT MyWay® Ambassador, and if selected, you may have opportunities to share your story and offer encouragement to patients and their family members. Dupixent. I certify that I have obtained my patient’s written authorization in accordance with applicable If you’ve had a discussion with your healthcare provider about DUPIXENT or have been prescribed DUPIXENT, register online today to talk one-on-one with trained Patient or Caregiver DUPIXENT Mentors to discuss life with moderate-to-severe asthma and hear about their personal journey with DUPIXENT. The program is intended to help patients afford DUPIXENT. A patient assistance program called GSK for You is available for Nucala. They help people afford expensive prescription medications by lowering their out-of-pocket costs. Patient assistance programs (PAPs) are typically sponsored by pharmaceutical companies and offer cost-free or discounted medicines, as well as copay programs, to individuals with low income or those who are uninsured/under-insured and meet specific criteria. DUPIXENT can cause allergic reactions that can sometimes be severe. Enrolled patients have access to: 1‑844‑387‑4936. You’ll need to become a Simplefill member for us to find you the prescription assistance you need to pay for your Dupixent. 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. DUPIXENT® (dupilumab) is a. 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. g. There is currently no generic alternative to Dupixent. DUPIXENT can be used with or without topical corticosteroids. They’ll help you: Track the status of PAP applications. For treatment of chronic rhinosinusitis with nasal polyposis: Will use Dupixent as an add-on maintenance treatment for inadequately controlled chronic rhinosinusitis with nasal polyposis 4. 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. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. , Quick Start, Copay Card, and Patient Assistance Program) Nursing Support (e. The guidelines to determine the medical necessity of Dupixent (dupilumab) will be utilized in the fee-for-service and managed care delivery systems. Lancet. DUPIXENT MyWay TM will help eligible patients who are uninsured, lack coverage, or need assistance with their out-of-pocket costs. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. Copay coupons are typically for expensive, brand-name medications that don’t have a. 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. Income Limits To be eligible, you must meet the income guidelines, which may vary by product and household size. The maximum annual patient benefit under the DUPIXENT MyWay® Copay Card Program is $13,000. 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. Patient Assistance Foundations; Pricing Principles. Prior to Dupixent therapy, what was the patient’s baseline (e. It may be covered by your Medicare or insurance plan. Is Dupixent being prescribed by or in consultation with an allergist/immunologist or a pulmonologist? Yes No 19. S. 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. DUPIXENT has been FDA approved for use in adults with uncontrolled moderate-to-severe eczema since 2017. If you need help paying for your prescription, the DUPIXENT MyWay Patient Assistance Program may be able to help. 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. These diseases include approved indications forTell your healthcare provider about any new or worsening joint symptoms. See available events. 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. Dupixent on a High Deductible Health Plan. Find help with the cost of medicine. DUPIXENT® is the first and only prescription medicine for eosinophilic esophagitis (EoE) in patients 12 years and older who weigh at least 88lb (40kg). Enrolled patients receive: One-on-one support from our DUPIXENT MyWay support team; Help understanding insurance coverage; Financial assistance (for eligible patients only) Help scheduling deliveries The Program is intended to help patients access DUPIXENT. PSP Contact Information: DUPIXENT ® Freedom Support Program: 1-844-216-1181. * DUPIXENT ® is the only biologic medicine approved by Health Canada to treat moderate-to-severe atopic dermatitis. DUPIXENT MyWay is a patient support program that can help enable access to DUPIXENT and offers financial assistance for eligible patients, one-on-one ongoing support, and more. The most common side effects include: DUPIXENT MyWay. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. 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. If you need help paying for your prescription, the DUPIXENT MyWay Patient Assistance. 2022;400 (10356):908-919. Enroll now to receive emails and resources designed to help patients, caregivers and information seekers through the DUPIXENT® (dupilumab) treatment journey. g. The most common side effects include: DUPIXENT MyWay. Office of Medical Assistance Programs Fee-for-Service, Pharmacy Division Phone 1-800-537-8862 Fax 1-866-327-0191 : 3. The maximum annual patient benefit under the DUPIXENT MyWay® Copay Card Program is $13,000. Long-term results from a clinical trial that studied DUPIXENT for 52 weeks. Within 24 hours, one of our patient advocates will call you to conduct an interview. In those situations, the program may change its terms. DUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process. 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. Dupilumab. Providing free or subsidized treatment for eligible patients with no. 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. By way of background: Dupixent was approved by the Food and Drug Administration in May 2017. Is Dupixent being prescribed by or in consultation with an allergist/immunologist or a pulmonologist? Yes No 19. LEARN HOW WE CAN HELP DUPIXENT MyWay ENROLLMENT FORMS; English Enrollment Form: Spanish Enrollment Form. LEARN HOW WE CAN HELP DUPIXENT MyWay ENROLLMENT FORMS; FOR DERMATOLOGISTS: English Enrollment Form:consent to receive text messages by or on behalf of the Program. * Public reimbursement under the Ontario Exceptional Access Program and the New. Atopic Dermatitis: The most common adverse reactions (incidence ≥1%) in patients are injection site reactions, conjunctivitis, blepharitis, oral herpes, keratitis, eye pruritus, other herpes simplex virus infection, dry eye, and eosinophilia. , Benefits Investigation, Prior Authorization, and Appeals Support) Patient Access Support (e. DUPIXENT® (dupilumab) is indicated for the treatment of patients aged 6 years and older with uncontrolled moderate-to-severe atopic dermatitis. 0206 or Apply Now. S. evaluate this and other Ministry programs, and (c) to manage and plan for the health. g. I received a letter from my insurance (BCBS) saying that next. If you’re having trouble affording Dupixent, you may be eligible for financial assistance programs. Eligible patients will receive their cards by email. Quick Start may be able to provide DUPIXENT at no cost to help bridge patients to. 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. • Store DUPIXENT in the original carton to protect from light. DUPIXENT can be used with or without topical corticosteroids. THE DUPIXENT MyWay PROGRAM. Program: BC Palliative Care Benefits. Please see Important Safety Information and Patient Information on. 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. To enroll or obtain information call 1-877-311-8972 or go to. Sanofi (DUPIXENT®) 844‑387‑4936 (option 1) Only if your insurance does not cover DUPIXENT. INJECTION SUPPORT. 1-844-DUPIXENT 1-844-387-4936. *. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. Box 52080 MC 139 Phoenix, AZ 85072-2080 Attn. 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. Compare monoclonal antibodies. In those situations, the program may change its terms. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. Ask the prescriber about patient assistance. 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. 4. These programs may be provided by national healthcare systems, insurance companies, or pharmaceutical manufacturers, and can help patients receive financial assistance or coverage for the medication. I certify that I have obtained my patient’s written authorization in accordance with applicable understand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. Patient and Co-pay Assistance: DUPIXENT MyWay helps eligible patients get access to. 5. , One-on-One Nurse Education, and Supplemental Injection Training)Any savings provided by the program may vary depending on patients' out-of-pocket costs. 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. Each time you fill your DUPIXENT prescription, please ensure your. g. 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 believe that no patient should go without life changing medications because they cannot afford them. Patients may have insurance plans that attempt to dilute the impact of the assistance available under the program. The program is intended to help patients afford DUPIXENT. For children aged 6 months to 5 years, it is taken as 1 injection every 4 weeks. S. I get one box (2 Dupixent injectors) a month and it costs $250 for the copay, my insurance plan (HMO) premium costs $400 a month. Please be aware that not all Sanofi products are covered under the Sanofi Patient Assistance program. Contact program for details. Program has an annual maximum of $13,000. 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. 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. 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). I certify that I have obtained my patient’s written authorization in accordance with applicable consent to receive text messages by or on behalf of the Program. Pregnancy: A pregnancy exposure registry monitors pregnancy outcomes in women exposed to DUPIXENT during pregnancy. DUPIXENT MyWay reserves the right to. Red tape, paperwork, and communication gaps hijack the time that providers. g. DUPIXENT MyWay ENROLLMENT FORMS; English Enrollment Form. 18. That’s why we offer patient assistance programs that provide free AbbVie medicines to qualifying 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. ago. Drug copay assistance programs have long been controversial. g. 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. Dupixent is an injectable prescription medicine used to treat a number of. 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. Program has an annual maximum of $13,000. Do not put the syringe into direct sunlight. Pivotal trial met primary and all key secondary endpoints; Dupixent significantly reduced itch at 12 weeks, and nearly three times as many. For treatment of eosinophilic. I don't know what medical issues your son is having, but it's likey autoimmune issues. Actual costs to patients, payers, and health systems are anticipated to be lower because the WAC pricing does not reflect discounts, rebates, or patient assistance programs. You can rely on Simplefill to connect you with programs and organizations that offer the prescription assistance you need. Prior Authorization of Dupixent (dupilumab) – Pharmacy Services BY Sally A. Any savings provided by the program may vary depending on patients' out-of-pocket costs. The guidelines to determine the medical necessity of Dupixent (dupilumab) will be utilized in the fee-for-service and managed care delivery systems. Simplefill closely monitors any changes to the eligibility of these patient assistance programs. Learn how DUPIXENT® (dupilumab) works as the first and only FDA-approved treatment for prurigo nodularis (PN) in adults aged 18 years and older. Eligible patients may receive Dupixent for free or at a reduced cost. Save time and money by verifying benefits and copays before services are rendered. Serious side effects can occur. Patients may have insurance plans that attempt to dilute the impact of the assistance available under the Program. or U. 5. DUPIXENT MyWay offers a range of support, including: Coverage Support (e. 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. Genentech reserves the right to modify or discontinue the program at any time and to verify the accuracy of information submitted. There are three variants; a typed, drawn or uploaded signature. 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. Check eligibility (PDF 0. Dupixent Enhanced SGM - 7/2020. 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. How we help. 2 cartons. Serious side effects can occur. The program. 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. Complete the entire form and submit pages 1-3 to ®DUPIXENT MyWay via fax at 1-844. In those situations, the program may change its terms. 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. Once enrolled, the DUPIXENT MyWay support program can help enable access to. 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. For pediatric patients aged 6 to 11 years, Dupixent dosing is based on weight (100 mg every two weeks or 300 mg every four weeks for children ≥15 to <30 kg, and 200 mg every two weeks for children ≥30 kg) and is supplied as a pre-filled syringe. . With our help, you could get your Dupixent prescription for a flat fee of $49 per month. 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. DUPIXENT is a form of medicine called a biologic that targets Type 2 inflammation, an underlying cause of nasal polyps. I certify that I have obtained my patient’s written authorization in accordance with applicable1‑844‑DUPIXENT 1-844-387-4936. or U. Complete a questionnaire, participate in a focus group, or share info. g. Pair the right financial assistance with the patient’s needs at the point of prescribing and fulfillment. understand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. consent to receive text messages by or on behalf of the Program. I certify that I have obtained my patient’s written authorization in accordance with applicableunderstand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. DUPIXENT® (dupilumab) therapy (“My Information”). 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. Have commercial insurance, including health insurance. LEARN HOW WE CAN HELP DUPIXENT MyWay ENROLLMENT FORMS; FOR ALLERGISTS: English Enrollment Form: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. 386. 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. This copay card may be for you if you. 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. Paris and Tarrytown, N. Sanofi and Regeneron announce FDA approval of Dupixent (dupilumab), the first targeted biologic therapy for adults with moderate-to-severe atopic. Dupixent is used to treat certain chronic inflammatory conditions, such as asthma and atopic dermatitis. AbbVie Patient Assistance Program. Copayment Assistance Organizations. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. My Employer's insurance, Canada Life, was a "Smart Plan" that excluded Dupixent under their formulary. These programs and tips can help make your prescription more affordable. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. Over $341,322,695. , call 800-981-2491, fill out the form using the link below or check our Frequently Asked Questions. 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. 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. Create your signature and click Ok. 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. , Quick Start, Copay Card, and Patient Assistance Program) Nursing Support (e. During my first year on the medication (2019), it was covered fully through the MyWay Program. Pricing Principles;. If you still have questions, you can speak with a DUPIXENT MyWay representative or request to join the program over the phone. 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. Sanofi is committed to providing patients with support programs. 90. Pricing Principles;. Patients will need to meet the eligibility criteria, including household income, to qualify. 48 SavedWith NeedyMeds Drug Card. Your doctor or nurse practitioner fills out and submits the application for you. The General Assistance (GA) program (PDF) helps people without children pay for basic needs. DUPIXENT MyWay® Program Taking Dupixent. These unique. BI Cares Patient Assistance Program - Specialty Program P. Eligible patients will receive their cards by email. Home; Patient Assistance Connection. How possessed an annual upper of $13,000. Assistance may be available for patients who do not have. Serious side. Welcome to RxCrossroads. chevron_right. It is not an immunosuppressant or a steroid. 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 understand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. g. After that, it is taken as 1 injection every 2 weeks or every 4 weeks, depending on your age and weight. To qualify for the GSK Patient Assistance Program, you must: Live in one of the 50 states, District of Columbia, Puerto Rico or U. DUPIXENT can be used with or without topical corticosteroids. In 2022, we assisted nearly 200,000 people. Patient assistance program solutions for hospital and health system pharmacies. 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. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. If you are successfully enrolled in the program, we. 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. Patients will need to meet the eligibility criteria, including household income, to qualify. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer Fax the Enrollment Form to DUPIXENT MyWay. 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,. 2 pens of 300mg/2ml. understand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. You’ll need to become a Simplefill member for us to find you the prescription assistance you need to pay for your Dupixent. You can do this by applying online or calling us at 1 (877)386-0206. Uninsured patients can apply to the manufacturer’s patient assistance program, the Dupixent MyWay program. consent to receive text messages by or on behalf of the Program. A DUPIXENT MyWay Nurse Educator can help qualified patients explore additional options to help cover the cost of DUPIXENT. Learn about DUPIXENT® (dupilumab) for moderate-to-severe asthma treatment. Through the program, people can receive up to $1,500 in financial assistance to help pay for Dupixent, access to a dedicated team of nurses, access to free medical supplies, and other resources. A copay assistance program depending on eligibility. About three weeks later they send me a check to reimburse my copay. From my understanding, the Dupixent MyWay Program pays the $125 since your insurance is covering the rest. Help navigate financial support options, such as copay assistance; Contact 1‑844‑DUPIXENT (1‑844‑387‑4936) to speak to a DUPIXENT MyWay Case Manager or representative if. We are here to help. For more information, call 1-844-DUPIXEN (T) (1-844-387-4936. Dupixent Dupixent is a drug used to treat eczema and asthma. Paul, MN 55164-0811 . com), or over the phone (855-204-2410). Within 24 hours, one of our patient advocates will call you for a brief interview. Check the liquid in the prefilled pen or syringe. Plenty of videos on YouTube for further education. Eosinophilic Esophagitis: DUPIXENT is indicated for the treatment of adult and pediatric patients aged 12 years and older, weighing at least 40 kg, with eosinophilic esophagitis (EoE). The randomized, Phase 3, double-blind, placebo-controlled trial evaluated the efficacy and safety of Dupixent in 939 adults who. Prior Authorization of Dupixent (dupilumab) – Pharmacy Services BY Sally A. Select a tab below to get you to helpful information depending on where you are in your treatment journey. You will note that NBC quotes the companies making the. Patient Assistance Foundations; Pricing Principles. Author: SOTO, TIANADupixent – FEP MD Fax Form Revised 10/28/2022 Send completed form to: Service Benefit Plan Prior Approval P. The insurance companies do this by looking at where the money to pay a copay is coming from. LONG-LASTING CLEARER SKIN AT 16 and 52 Weeks 22% taking. , Benefits Investigation, Prior Authorization, and Appeals Support) Patient Access Support (e. The randomized, Phase 3, double-blind, placebo-controlled trial evaluated the efficacy and safety of Dupixent in 939 adults who were current or former smokers aged 40 to 80 years with moderate-to-severe COPD. DUPIXENT® (dupilumab) offers webinars where you can learn from medical professionals and people who live with eosinophilic esophagitis (EoE). A DUPIXENT MyWay Nurse Educator can help qualified patients explore additional options to help cover the cost of DUPIXENT. Patient assistance program. Two years, three dermatologists and multiple other treatments later, I have finally weaned my baby (listen, I’ve been home with her, there’s a pandemic) and am ready to finally give it a try. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. For more information, dial 1-844-DUPIXENT 1-844-387-4936 ), option 5, Monday-Friday, 9 am – 9 pm ET. Each time you fill your DUPIXENT prescription, please ensure your. 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. Alliance partners program Become an advocate Support PAN. Choose My Signature. Dupixent (dupilumab) Prior Authorization Request Form Caterpillar Prescription Drug Benefit Phone: 877-228-7909 Fax: 800-424-7640. 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 assistanceWe would like to show you a description here but the site won’t allow us. 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 DUPIXENT MyWay team can research each patient’s situation and determine eligibility. KEVZARA ® Mobilize Support Program: 1-888-972-6634. 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. 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. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. With of DUPIXENT MyWay Copay Card, right, commercially insured patients might pay as little as $0* copay per fill of DUPIXENT. DUPIXENT MyWay offers a range of support, including: Coverage Support (e. Contact. Patient Assistance Foundations; Pricing Principles. Only a doctor or nurse practitioner can apply for coverage through the Exceptional Access Program. Helminth infections (5 cases of. DUPIXENT® (dupilumab), in moderate-to-severe asthma treatment, is taken as an injection by a pre-filled syringe or pre-filled pen, review both options here. 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. Providers should log into PROMISe to check the revalidation dates of. Financial assistance to help lower the cost of Dupixent is available. 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. Serious side effects can occur. I understand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. Please see. 30 Section: Prescription Drugs Effective Date: April 1, 2021 Subsection: Topical Products Original Policy Date: April 7, 2017 Subject: Dupixent Page: 4 of 10 AND submission of medical records (e. Any savings provided by the program may vary depending on patients' out-of-pocket costs. 2. , One-on-One Nurse Education, and Supplemental Injection Training) Please click “Continue. DUPIXENT (dupilumab) Prescriber Information Patient Information . DUPIXENT® (dupilumab) therapy (“My Information”). Contact. Biologic Drug: Biologic drugs are made from living cells and are often expensive. 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. 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. Have commercial insurance, including health insurance. $0 is the amount you pay. g. To help identify you in our system, please provide the following information. Eligible patients may receive Dupixent for. C M ET DUPIXENT MYWAY ENROLLMENT FORM Moderate-to-Severe Atopic Dermatitis SUBMIT COMPLETED PAGES 1 & 2 Fax: 1-844-387-9370 Document Drop: (code: 8443879370) 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 Program THE DUPIXENT MyWay PROGRAM. 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. You may be eligible for the DUPIXENT MyWay Copay Card if you:. DUPIXENT MyWay ® is a patient support program that can help enable access to DUPIXENT and offers financial assistance to eligible patients, one-on-one nursing support, and more. 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. You can save on your Dupixent cost by using a free coupon available from the manufacturer’s website. DUPIXENT® (dupilumab) is a prescription medicine FDA-approved to treat five conditions. Patients will need to meet the eligibility criteria, including household income, to qualify.