Serious side effects can occur. The program is intended to help patients afford DUPIXENT. Millions of Americans rely on copay assistance — coupons, discount cards, vouchers, and other programs — to afford their prescribed medications. Check your patients' eligibility for insurance coverage with AdvancedMD Eligibility, a web-based application that connects you to hundreds of payers. 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. These diseases include approved indications forTell your healthcare provider about any new or worsening joint symptoms. So we went over my history, I got the script and waited for a call from the pharmacy. Program has an annual maximum of $13,000. I found the carnivore diet helps immensely for autoimmune issues. BI Cares Foundation Patient Assistance Program – Specialty Program Application Patient Assistance Program Please Print Clearly Application. Manufacturer Coupon. , Benefits Investigation, Prior Authorization, and Appeals Support) Patient Access Support (e. • DUPIXENT can be stored at room temperature up to 77°F (25°C) up to 14 days. About the Dupixent COPD Phase 3 Trial Program BOREAS is one of two pivotal trials in the Dupixent COPD program. 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,. It may be covered by your Medicare or insurance plan. Within 24 hours, one of our patient advocates will call you for a brief interview. 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. understand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. I understand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. It is not an immunosuppressant or a steroid. And while everyone’s working through the details, look to DUPIXENT MyWay for additional support. g. Acaregiver or patient 12 years of age and older may inject DUPIXENT using the pre-filled syringe or pre-filled pen. Chronic condition management can be challenging for both patients and their care providers. 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 more information and to find out whether you’re eligible for support, call 844-468-2252 or visit the program website . DUPIXENT MyWay®. Dupixent MyWay ™ will help eligible patients who are uninsured, lack coverage, or need assistance with their out-of-pocket. Red tape, paperwork, and communication gaps hijack the time that providers. support and resources. You will note that NBC quotes the companies making the. 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. We believe that people who need our medicines should be able to get them. DUPIXENT® (dupilumab) therapy (“My Information”). 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. DUPIXENT can be used with or without topical corticosteroids. The Dupixent MyWay program may help reduce its cost. , Quick Start, Copay Card, and Patient Assistance Program) Nursing Support (e. Contact program for details. 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. 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. S. Clinical Services Fax: 1-877-378-4727 Atopic Dermatitis (AD) (eczema) a. DUPIXENT MyWay® is a patient support program that can help enable access to. 90. 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. 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. Genentech reserves the right to modify or discontinue the program at any time and to verify the accuracy of information submitted. DUPIXENT® (dupilumab) is a. 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. Box 64811 St. For questions call 1-888-602-2978 Copay accumulators are programs being adopted by health insurance companies to prevent payments from copay assistance programs like Dupixent MyWay from counting towards your insurance deductible and out-of-pocket maximum. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. DUPIXENT can be used with or without topical corticosteroids. 2 cartons. I don't know what medical issues your son is having, but it's likey autoimmune issues. 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. com to help recruit participants for medical surveys, focus groups, and other medical research projects. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. Each time you fill your DUPIXENT prescription, please ensure your. S. Need additional guidance with the enrollment process? Contact your field access specialist or call 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,. You can do this by applying online or calling us at 1 (877)386-0206. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. DUPIXENT is a form of medicine called a biologic that targets Type 2 inflammation, an underlying cause of nasal polyps. A DUPIXENT MyWay Nurse Educator can help qualified patients explore additional options to help cover the cost of DUPIXENT. LEARN MORE. Prior Authorization of Dupixent (dupilumab) – Pharmacy Services BY Sally A. The DUPIXENT MyWay Program. A DUPIXENT MyWay Nurse Educator can help qualified patients explore additional options to help cover the cost of DUPIXENT. Patient and Co-pay Assistance: DUPIXENT MyWay helps eligible patients get access to therapy whether they are uninsured, lack coverage, or need assistance with their out-of-pocket costs. Applying to myAbbVie Assist is simple. You can save on your Dupixent cost by using a free coupon available from the manufacturer’s website. There is currently no generic alternative to Dupixent. Prurigo Nodularis: The most common adverse reactions (incidence ≥2%) are nasopharyngitis, conjunctivitis, herpes infection, dizziness, myalgia, and diarrhea. 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. Through the Patient Assistance Program, qualified patients who are uninsured or whose insurance does not cover DUPIXENT could receive DUPIXENT at no cost. They’re also called copay savings programs, copay coupons, and copay assistance cards. The DUPIXENT MyWay patient support program is here to help you at every step of your DUPIXENT treatment journey. Paul, MN 55164-0811 . Provide proper training to patients and/or caregivers on the preparation and administration of DUPIXENT prior to use according to the “Instructions for. I certify that I have obtained my patient’s written authorization in accordance with applicable• Store DUPIXENT in the refrigerator at 36°F to 46°F (2°C to 8°C). Injection Support Center Help Staying on Track DUPIXENT Pricing Information For. VO: DUPIXENT is a prescription medicine used: to treat people aged 6 years and older with moderate-to-severe atopic dermatitis (eczema) that is not well controlled with prescription therapies used on the skin (topical), or who cannot use topical therapies. DUPIXENT is not a steroid or immunosuppressant; it is a prescription biologic medicine given under the skin (subcutaneous injection). Pair the right financial assistance with the patient’s needs at the point of prescribing and fulfillment. Resource Number:. chart notes, laboratory values) and use of claims history documenting the following: 1. NeedyMeds is the best source of information on patient assistance programs and their applications. Proponents say that in an age of increasingly high deductibles and coinsurance charges, such help from the manufacturer is the only way. These diseases include approved indications for. People who get GA are also eligible for help with medical and food costs through Medical Assistance (MA) and the. 3. You must have an annual household income of ≤400% of the. Financial Assistance Programs. DUPIXENT MyWay reserves the right to. Patients may have insurance plans that attempt to dilute the impact of the assistance available under the Program. consent to receive text messages by or on behalf of the Program. DUPIXENT® (dupilumab) is taken as an injection by a pre-filled syringe or pre-filled pen. 2022;400 (10356):908-919. 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. Patient Advocate Foundation's Co-Pay Relief program exists to help reduce the financial distress patients, and their families face when paying for treatment. Provincial coverage with exception to Ontario, New Brunswick, and Quebec, do not cover Dupixent under their Provincial formulary. 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). Call 855-204-2410 if you need assistance. Patients may have insurance plans that attempt to dilute the impact of the assistance available under the program. , One-on-One Nurse Education, and Supplemental Injection Training) Please click “Continue. Assistance (MA) Program. This information will ONLY be used to validate your eligibility. Caring. $125 is the amount Dupixent assistance pays. 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. 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. 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,. designated, DUPIXENT MyWay is authorized to transmit this prescription to a network pharmacy it selects or to the pharmacy otherwise indicated. 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. Have commercial insurance, including health insurance. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. 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. The program is intended to help patients afford DUPIXENT. , Quick Start, Copay Card, and Patient Assistance Program) Nursing Support (e. The program is intended to help patients afford DUPIXENT. (800) 657-7613 Call us if you’re a pharmacist or patient looking for support. If you need help paying for your prescription, the DUPIXENT MyWay Patient Assistance Program may be able to help. And while everyone’s working through the details, look to DUPIXENT MyWay for additional support. You may be eligible for the DUPIXENT MyWay Copay Card if you:. If you need help paying for your prescription, the DUPIXENT MyWay® Patient Assistance Program may be able to help. com), or over the phone (855-204-2410). 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. 1-844-DUPIXENT (1-844-387-4936) Topicort (desoximetasone spray 0. BOREAS is one of two pivotal trials in the Dupixent COPD program. I have definitely heard that before from multiple sources. Please visit our Medications Available page to see if assistance. A causal association between DUPIXENT and these conditions has not been established. Helminth infections (5 cases of. For more financial assistance information, dialDUPIXENT MyWay offers a range of support, including: Coverage Support (e. Dupixent ® (dupilumab) is the first biologic to significantly reduce itch and skin lesions in Phase 3 trial for prurigo nodularis, demonstrating the role of type 2 inflammation in this disease. , One-on-One Nurse Education, and Supplemental Injection Training) AbbVie Patient Assistance Program. 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. The U. Providers should log into PROMISe to check the revalidation dates of. Contact the program for details: Re-application: New application yearly : Additional Information: Co-payment assistance, and patient assistance programs are available for eligible patients. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of 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. How to apply. We offer financial assistance to help people with serious illnesses afford their out-of-pocket treatment costs and improve their. 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. 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. Copay assistance helps by bringing down the out. 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). Teva Pharmaceuticals (QVAR ®) Teva Cares Foundation Teva Savings Card for QVAR® Redihaler™ 877-237-4881 DUPIXENT® (dupilumab) therapy (“My Information”). Pricing Principles;. Income Limits To be eligible, you must meet the income guidelines, which may vary by product and household size. 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. This program may provide a Bridge Program for eligible patients who experience a delay, temporary loss, or change in coverage. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. consent to receive text messages by or on behalf of the Program. Copay amounts after applying copay assistance may depend on the patient’s insurance. Patients with Medicare Part D should contact the program. Patient Assistance Program Center: Search Database. g. understand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. 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. 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. We work directly with your healthcare provider and will handle the full enrollment process on your behalf. 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. Has the patient achieved or maintained positive clinical response as evidenced by improvement in signs andDUPIXENT® (dupilumab) is a subcutaneous injectable medication used in the treatment of patients aged 6 years and older with uncontrolled moderate-to-severe atopic dermatitis with two delivery options available, pre-filled syringe & pre-filled pen (aged 12+ years). I certify that I have obtained my patient’s written authorization in accordance with applicable1‑844‑DUPIXENT 1-844-387-4936. Home; Patient Assistance Connection. A causal association between DUPIXENT and these conditions has not been established. The appeal letter aims to present additional information, evidence, or arguments to support the need for Dupixent treatment and to persuade the decision-maker to reverse the denial and provide coverage for the medication. Need additional guidance with the enrollment process? Contact your field access specialist or call DUPIXENT MyWay. g. I certify that I have obtained my patient’s written authorization in accordance with applicable The pharmaceutical giant AstraZeneca offers both PAP and CAP services to eligible individuals. Automate the review and validation of. The income guidelines vary depending on the medication and pharmaceutical company. Paller AS, Simpson EL, Siegfried EC, et al. Let SaveOnSP administer a plan benefit design aimed at lowering these rising costs. DUPIXENT MyWay offers a range of support, including: Coverage Support (e. 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. Switch medications 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. 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. Please see Important Safety. Eligible patients may receive Dupixent for. Have commercial insurance, including health insurance. Complete the At Home Program Application form with the assistance of a physician. Prescription Hope is a service-based company that offers access to brand-name medication through patient assistance programs. 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. All our information is free and updated regularly. 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. 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. Exploring Alternative Assistance Programs. Is the patient currently receiving Dupixent through samples or a manufacturer’s patient assistance program?DUPIXENT® (dupilumab) therapy (“My Information”). And while everyone’s working through the details, look to DUPIXENT MyWay for additional support. 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. Patients may have insurance plans that attempt to dilute the impact of the assistance available under the program. In those situations, the program may change its terms. , One-on-One Nurse Education, and Supplemental Injection Training)3. g. 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. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. 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 MyWay. Is the patient currently receiving Dupixent through samples or a manufacturer’s patient assistance program? DUPIXENT® (dupilumab) therapy (“My Information”). Dupixent. Pivotal trial met primary and all key secondary endpoints; Dupixent significantly reduced itch at 12 weeks, and nearly three times as many. I understand and acknowledge that PASS may revise, change, or terminate any program services at any time without notice to me. Serious side effects can occur. Contact the program for details: Re-application: New application yearly : Additional Information: Co-payment assistance, and patient assistance programs are available for eligible patients. Eligibility Requirements. If you need help paying for your prescription, the DUPIXENT MyWay Patient Assistance. The most common side effects include: DUPIXENT MyWay. We work directly with your healthcare provider and will handle the full enrollment process on your behalf. 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. Have a Medicare prescription drug plan. Have commercial services, including health insurance markets,. LEARN HOW WE CAN. Please see Important Safety Information and Patient Information on. For individuals who may not qualify for Medicaid or face coverage limitations, alternative assistance programs exist to provide access to Dupixent at a reduced cost. S. We are here to help. 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. DUPIXENT in adult subjects who participated in the asthma development program as well as in adult subjects with co-morbid asthma in the CRSwNP development program. 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. 2 pens of 300mg/2ml. There are. Any savings provided by the program may vary depending on patients’ out-of-pocket costs. 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,. So, let's just pretend the total cost is $1,000/month. Download and complete the application form. DUPIXENT was studied in adults and children 6 months of age and older. In adults and children 6 years and older, your initial dose of DUPIXENT is 2 injections under the skin (subcutaneous injection) at different injection sites. We consider each application according to: the drug that is needed. 4. 4 Performing a benefits investigation Determining PA requirementsDUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process. such as copay assistance. The Mission of the Nevada Check Up program is to provide low-cost, comprehensive health care coverage to low. *. 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. PSP Contact Information: DUPIXENT ® Freedom Support Program: 1-844-216-1181. 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. Ways to save on Dupixent. , Quick Start, Copay Card, and Patient Assistance Program) Nursing Support (e. Information regarding eligibility is available on line at or by calling toll free at 1-800-992-0900. These programs, such as patient assistance programs or manufacturer discounts, offer financial support and resources. You’ll need to become a Simplefill member for us to find you the prescription assistance you need to pay for your Dupixent. Learn how DUPIXENT® (dupilumab) works as the first and only FDA-approved treatment for prurigo nodularis (PN) in adults aged 18 years and older. Do not heat the syringe. DUPIXENT 200 mg injections at different injection sites. It is free to apply, and those who qualify will receive their medicine for free — no co-pays or shipping costs. How to get Prescription Assistance. 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. In 2022, we assisted nearly 200,000 people. 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. When patients can’t afford their prescriptions, 52% seek affordability options through their provider – and 29% go without their medications 1. Dupixent is a prescription drug that treats eczema, asthma, and sinusitis in adults and certain children. It is free to apply, and those who qualify will receive their medicine for free — no co-pays or shipping costs. 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. Confusion, unanswered questions, and financial barriers cloud the patient experience. 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. Uninsured patients can apply to the manufacturer’s patient assistance program, the Dupixent MyWay program. In clinical trials, DUPIXENT reduced the. DUPIXENT MyWay offers a range of support, including: Coverage Support (e. You may be able to lower your total cost by filling a greater quantity at one time. Is the request for a continuation of therapy with Dupixent? Yes No If No, skip to #23 20. This form (and attachments) contains protected health. The Patient Assistance Program may be an option if your patient is uninsured or functionally uninsured, or experiences a. 1-844-DUPIXENT 1-844-387-4936. g. Ask the prescriber about patient assistance. Possible cost assistance options. 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,. Dupixent Dupixent is a drug used to treat eczema and asthma. could be spending on patient care. * Public reimbursement under the Ontario Exceptional Access Program and the New. You can do this by applying online or calling us at 1 (877)386-0206. 2 pens of 300mg/2ml. Patient Assistance & Copay Programs for Dupixent. , Benefits Investigation, Prior Authorization, and Appeals Support) Patient Access Support (e. Through the Patient Assistance Program, eligible patients who are uninsured or whose insurance does not cover DUPIXENT could receive DUPIXENT free of charge. Patient assistance programs for medications. Is the patient currently receiving Dupixent through samples or a manufacturer’s patient assistance program? If Yes or Unknown, skip to #8 Yes No Unknown 7. Enrolled patients receive: One-on-one support from our DUPIXENT MyWay support team; Help understanding insurance coverage; Financial assistance (for eligible patients only) Help. Please use our portals–available 24/7–to apply for assistance or manage your grant during this time. For treatment of eosinophilic. 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,. Asthma with. Eligibility requirements for each. With this approval, Dupixent becomes the first and only medicine specifically indicated to. The DUPIXENT MyWay Patient Assistance Program may be able to help. The maximum annual patient benefit under the DUPIXENT MyWay® Copay Card Program is $13,000. 5. Call 1. DUPIXENT MyWay® is a patient support program that can help enable access to DUPIXENT through benefits verification and assistance navigating the insurance process. Dupixent is used to treat certain chronic inflammatory conditions, such as asthma and atopic dermatitis. The Dupixent Patient Support Program offers free or low-cost access to Dupixent for eligible patients. DO NOT inject DUPIXENT into skin that is tender,When filling out the DUPIXENT MyWay Enrollment Form, both you and your patient will be required to supply information, such as the patient’s insurance, diagnosis, and prescription. Any savings provided by the program may vary depending on patients' out-of-pocket costs. 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. 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. 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. These diseases include approved indications for. LONG-LASTING CLEARER SKIN AT 16 and 52 Weeks 22% taking. Pay as little as $0 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. 18. 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 need. The program. Patient has ONE of the following: a. Watch videos for a supplemental demonstration on how to use and dispose of DUPIXENT® (dupilumab), a prescription medicine for subcutaneous injection. In those situations, the program may change its terms. information provided is for the sole use of the Program to verify my patient’s insurance coverage, to assess, if applicable, patient’s eligibility for participation in the Patient Assistance Program and to otherwise administer the Sanofi Patient Connection Program and related services. Patients may have insurance plans that attempt to dilute the impact of the assistance available under the program. territories. Program has an annual maximum of $13,000. consent to receive text messages by or on behalf of the Program. How to get Prescription Assistance. The insurance companies do this by looking at where the money to pay a copay is coming from. Also, some companies require that you have no insurance. How possessed an annual upper of $13,000. 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. To enroll or obtain information call 1-877-311-8972 or go to. 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. This site contains a wealth of resources for providers including enrollment, billing manuals, bulletins, program regulations, plus information on Electronic Data Interchange and the Automated Eligibility Verification. 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. 00 a month for each medication accessed through patient assistance programs to manage medication orders and refills. Deductible is at $3k out of pocket insurance pays 80% and at $6k insurance pays 100%. 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. Create your signature and click Ok. 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. Pricing Principles;. 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. 90. Patients will need to meet the eligibility criteria, including household income, to qualify. 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. 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. Choose My Signature. 0 (Pure hypercholesterolemia, including HeFH)I just spoke to someone through the MyWay Program. Additionally, many insurance companies offer copay assistance programs to help offset the cost of the drug. Alliance partners program Become an advocate Support PAN. Find Your Fund See All Funds. HELPLINE (800) 503-6897; CONTACT US; ABOUT US; EN ESPANOL. , Benefits Investigation, Prior Authorization, and Appeals Support) Patient Access Support (e. It is a single-dose injection that can be taken at home after proper training once a week. Only a doctor or nurse practitioner can apply for coverage through the Exceptional Access Program. consent to receive text messages by or on behalf of the Program. Maybe try that while waiting for the Dupixent. 48 SavedWith NeedyMeds Drug Card. DUPIXENT is intended for use under the guidance of a healthcare provider. 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. About Dupixent Dupixent is a fully human monoclonal antibody that inhibits the signaling of the IL-4 and IL-13 pathways and is not an immunosuppressant. DUPIXENT® (dupilumab) is a prescription medicine used to treat people aged 6 years and older with moderate-to-severe atopic dermatitis (eczema) that is not well controlled with prescription therapies used on the skin (topical), or who cannot use topical therapies. Enroll now to receive emails and resources designed to help patients, caregivers and information seekers through the DUPIXENT® (dupilumab) treatment journey. DUPIXENT MyWay offers a range of support, including: Coverage Support (e. Done. Especially tell your healthcare provider if you. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. 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. 1,000-125=875 $875 is the amount your health insurance pays. Dupixent. 2023, in observance of Thanksgiving. * 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. Once enrolled, the DUPIXENT MyWay support program can help enable access to. Dupixent Enhanced SGM - 7/2020. Fast forward to now, I’m on my third dermatologist (new job=new insurance) and it’s finally safe for me to take Dupixent. 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. Program info. This program may provide a Bridge Program for eligible patients who experience a delay, temporary loss, or change in coverage. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. 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”). DUPIXENT MyWay® is a patient support program that can help enable access to DUPIXENT® (dupilumab), provide financial assistance to eligible patients & offer nursing support. It also offers financial assistance for eligible patients, one-on-one nursing support, and more. You may be eligible for the DUPIXENT MyWay Copay Card if you:. g. Dupilumab. SCHEDULING. With Optum Rx. The insurance companies do this by looking at where the money to pay a copay is coming from. ICD-10-CM Diagnosis Codes Select at least 1 primary and 1 secondary ICD-10-CM code. She wanted to put me on Dupixent immediately but I was breast feeding my baby. One that helps cover co-pays and another assistance program that covers the full cost of it if your income is below a certain level and insurance won't help pay for it. NeedyMeds NeedyMeds has free information on medication and. understand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. You earn extra money, and NeedyMeds earns funding. That’s why myAbbVie Assist provides free AbbVie medicine to qualifying patients.