A DUPIXENT MyWay Nurse Educator can help qualified patients explore additional options to help cover the cost of DUPIXENT. Only a doctor or nurse practitioner can apply for coverage through the Exceptional Access Program. The guidelines to determine the medical necessity of Dupixent (dupilumab) will be utilized in the fee-for-service and managed care delivery systems. 48 SavedWith NeedyMeds Drug Card. The manufacturer can provide additional information and enrollment forms. g. 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. 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. g. You can save on your Dupixent cost by using a free coupon available from the manufacturer’s website. Please call me at [Primary Treating Site Phone Number] if I can be of further assistance or you require additional information. 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. 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. , Quick Start, Copay Card, and Patient Assistance Program) Nursing Support (e. 2022;400 (10356):908-919. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. 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. understand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. To enroll or obtain information call 1-877-311-8972 or go to. PSP Contact Information: DUPIXENT ® Freedom Support Program: 1-844-216-1181. could be spending on patient care. Proponents say that in an age of increasingly high deductibles and coinsurance charges, such help from the manufacturer is the only way. A patient assistance program called GSK for You is available for Nucala. Patients may have insurance plans that attempt to dilute the impact of the assistance available under the Program. Patients will need to meet the eligibility criteria, including household income, to qualify. consent to receive text messages by or on behalf of the Program. The Patient Assistance Program may be an option if your patient is uninsured or functionally uninsured, or experiences a. The insurance companies do this by looking at where the money to pay a copay is coming from. chart notes, laboratory values) and use of claims history documenting the following: 1. 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. When patients can’t afford their prescriptions, 52% seek affordability options through their provider – and 29% go without their medications 1. , Benefits Investigation, Prior Authorization, and Appeals Support) Patient Access Support (e. 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). DUPIXENT MyWay offers a range of support, including: Coverage Support (e. We believe that people who need our medicines should be able to get them. Dupixent MyWay ™ will help eligible patients who are uninsured, lack coverage, or need assistance with their out-of-pocket. References. 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. This component of the program is made possible through Sanofi Cares North America. The program is intended to help patients afford DUPIXENT. In those situations, the program may change its terms. Support Program for DUPIXENT ® (dupilumab) Your healthcare provider has begun your. 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. How to get Prescription Assistance. Just got the fun news that I will need to pay $2,700 for a monthly dose of Dupixent. Patients will need to meet the eligibility criteria, including household income, to qualify. Patient Advocate Foundation's Co-Pay Relief program exists to help reduce the financial distress patients, and their families face when paying for treatment. Prior to Dupixent therapy, what was the patient’s baseline (e. Patients will need to meet the eligibility criteria, including household income, to qualify. Prior Authorization of Dupixent (dupilumab) – Pharmacy Services BY Sally A. Co-pay support is available for people who have commercial insurance 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. 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. The General Assistance (GA) program (PDF) helps people without children pay for basic needs. 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. g. • Store DUPIXENT in the original carton to protect from light. 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 if you’re eligible for support, call 844-387-4936 or visit the program website. Please see Important Safety. Dupixent changed my life completely. Information regarding eligibility is available on line at or by calling toll free at 1-800-992-0900. Serious side effects can occur. Even when using the Copay Card, that would cover only cover 4 months worth, and would not go towards my deductible, totaling about. , Benefits Investigation, Prior Authorization, and Appeals Support) Patient Access Support (e. [Summarize your reasons why DUPIXENT is medically necessary for this patient] In order for me to provide appropriate care for my patient, it is important that [Plan Name] provide adequate coverage for this treatment. Program has an annual maximum of $13,000. Additionally, many insurance companies offer copay assistance programs to help offset the cost of the drug. 4. 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. Have commercial insurance, including health insurance. Learn how DUPIXENT® (dupilumab) works as the first and only FDA-approved treatment for prurigo nodularis (PN) in adults aged 18 years and older. g. So, let's just pretend the total cost is $1,000/month. First few months into taking Dupixent, I got laid off and worked w my doctors/Dupixent to get assistance. 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. 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. 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. 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. The maximum annual patient benefit under the DUPIXENT MyWay® Copay Card Program is $13,000. The patient is not eligible to use this copay savings card if they are enrolled in a state or federally funded prescription insurance program, including, but not limited to, Medicare, Medicaid, TRICARE, Veterans Affairs health care, a state prescription drug assistance program, or the Government Health Insurance Plan available in Puerto Rico (formerly. Dupixent 300 mg – wait for at least 45 minutes. , Benefits Investigation, Prior Authorization, and Appeals Support) Patient Access Support (e. After that, it is taken as 1 injection every 2 weeks or every 4 weeks, depending on your age and weight. 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. Millions of Americans rely on copay assistance — coupons, discount cards, vouchers, and other programs — to afford their prescribed medications. S. 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. KEVZARA ® Mobilize Support Program: 1-888-972-6634. DUPIXENT MyWay. We believe that no patient should go without life changing medications because they cannot afford them. Co-payment assistance, and patient assistance programs are available for eligible. 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. 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. Find DUPIXENT® (dupilumab) injection videos and instructions for the pre-filled pen (200 mg or 300 mg) for ages 2+ years. Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. 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. 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. You may be able to lower your total cost by filling a greater quantity at one time. 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. I found the carnivore diet helps immensely for autoimmune issues. The most common side effects include: DUPIXENT MyWay. 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. 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. Adbry (tralokinumab) is a member of the interleukin inhibitors drug class and is commonly used for Atopic Dermatitis. 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. S. $125 is the amount Dupixent assistance pays. And while everyone’s working through the details, look to DUPIXENT MyWay for additional support. For questions call 1-888-602-2978Copay 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. ” but i don’t know if having insurance with a copay accumulator is the same thing as insurance not. The program is intended to help patients afford DUPIXENT. Patients get more insight into the medication’s cost during its entire lifecycle. Enrolled patients have access to: 1‑844‑387‑4936. Within 24 hours, one of our patient advocates will call you for a brief interview. 5. To learn more and see whether you’re eligible for support, call 844-DUPIXENT (844-387-4936) or visit the manufacturer’s website. Download and complete the application form. The DUPIXENT MyWay Program. Patients may have insurance plans that attempt to dilute the impact of the assistance available under the program. Is the patient currently receiving Dupixent through samples or a manufacturer’s patient assistance program? DUPIXENT® (dupilumab) therapy (“My Information”). , Benefits Investigation, Prior Authorization, and Appeals Support) Patient Access Support (e. Once I got a new job, I called Dupixent MyWay to tell them my status changed and I could now get drugs through my insurance's specialty pharmacy. g. 1-844-DUPIXENT 1-844-387-4936. These diseases include approved indications for. Sanofi (DUPIXENT®) 844‑387‑4936 (option 1) Only if your insurance does not cover DUPIXENT. , One-on-One Nurse Education, and Supplemental Injection Training)3. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. Done. Patients will need to meet the eligibility criteria, including household income, to qualify. Need additional guidance with the enrollment process? Contact your field access specialist or call DUPIXENT MyWay. DUPIXENT can be used with or without topical corticosteroids. We offer financial assistance to help people with serious illnesses afford their out-of-pocket treatment costs and improve their. This information will ONLY be used to validate your eligibility. 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. DUPIXENT® (dupilumab) is a prescription medicine FDA-approved to treat five conditions. In those situations, the program may change its terms. 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. Problem:Dupixent is about $30,000 CAD a year, and no normal person can afford it. 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. Click Tap to Learn MoreFollow the step-by-step instructions below to design your DuPont byway program enrollment form: Select the document you want to sign and click Upload. , Benefits Investigation, Prior Authorization, and Appeals Support) Patient Access Support (e. Check the liquid in the prefilled pen or syringe. Dupixent is contraindicated for breast feeding. Contact. Pay as little as $0 per month. 0 (Pure hypercholesterolemia, including HeFH)I just spoke to someone through the MyWay Program. S. For more information and to find out whether you’re eligible for support, call 844-468-2252 or visit the program website . S. Experience: Been on Dupixent since May 15, 2017. They’re also called copay savings programs, copay coupons, and copay assistance cards. territories. 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 indicated for the treatment of patients aged 6 years and older with uncontrolled moderate-to-severe atopic dermatitis. 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. 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. Is the request for a continuation of therapy with Dupixent? Yes No If No, skip to #23 20. 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,. 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. 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. For children aged 6 months to 5 years, it is taken as 1 injection every 4 weeks. Providers should log into PROMISe to check the revalidation dates of. Is the patient currently receiving Dupixent through samples or a manufacturer’s patient assistance program? If Yes or Unknown, skip #32 Yes No Unknown 31. 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. Therefore, the companies have launched Dupixent MyWay ™, a comprehensive and specialized program that provides support and services to patients throughout every step of the treatment process. 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. Sign up with NeedyMeds' partner Savvy. Any savings provided by the program may vary depending on patients’ out-of-pocket costs. To help identify you in our system, please provide the following information. 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. That’s why myAbbVie Assist provides free AbbVie medicine to qualifying patients. Home; Patient Assistance Connection. by McKesson's Portal! RxCrossroads is pleased to provide you with fast, reliable assistance in obtaining medication copay saving offerings. Confusion, unanswered questions, and financial barriers cloud the patient experience. g. 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. 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. understand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. 13 hours ago · Colorado Avalanche defenseman Samuel Girard will be away from the. You may be eligible for the DUPIXENT MyWay Copay Card if you:. Have commercial insurance, including health insurance. The DUPIXENT MyWay patient support program is here to help you at every step of your DUPIXENT treatment journey. Patient Assistance & Copay Programs for Dupixent. They’ll help you: Track the status of PAP applications. Patient Assistance Foundations; Pricing Principles. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. 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. Copay Reimbursement Program, 200 Jefferson Park, Whippany, NJ 07981. It is not known if DUPIXENT is safe and effective in children with prurigo nodularis under 18 years of age. 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. , Quick Start, Copay Card, and Patient Assistance Program) Nursing Support (e. 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). Ask the prescriber about patient assistance. Y. Assistance may be available for patients who do not have insurance. 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. 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. 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. Get in touch Learn more about McKesson solutions for biopharma and life sciences companies. Red tape, paperwork, and communication gaps hijack the time that providers. Program has an annual maximum of $13,000. These diseases include approved indications for. Serious side effects can occur. 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. free under the Program. Ask the prescriber about patient assistance. During my first year on the medication (2019), it was covered fully through the MyWay Program. Resource Number:. DUPIXENT: your first choice to adequately control this chronic, systemic disease. We believe that people who need our medicines should be able to get them. DUPIXENT is intended for use under the guidance of a healthcare provider. DUPIXENT® is the first and only prescription medicine for eosinophilic esophagitis (EoE) in patients 12 years and older who weigh at least 88lb (40kg). 3. DUPIXENT has been FDA approved for use in adults with uncontrolled moderate-to-severe eczema since 2017. There are no other costs, fees,. 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. SYNVISC ® OnTRACK: 1-800-796-7991. The randomized, Phase 3, double-blind, placebo-controlled trial evaluated the efficacy and safety of Dupixent in 939 adults who. For families/households with more than 8 persons, add $5,140 for each. 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. This program may provide a Bridge Program for eligible patients who experience a delay, temporary loss, or change in coverage. Especially tell your healthcare provider if you. It may be covered by your Medicare or insurance plan. DUPIXENT MyWay® is a patient support program that can help with the enrollment. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. BI Cares Patient Assistance Program - Specialty Program P. Program has an annual maximum of $13,000. Dupixent. Medicine Assistance Tool;. Maybe try that while waiting for the Dupixent. Sanofi US, and their affiliates and agents (together, the “Alliance”) may verify my eligibility for the DUPIXENT MyWay Patient Assistance Program, and I understand that such verification may include contacting me or my healthcare provider for additional information and/or reviewing additional financial, insurance, and/or medical information. g. O. The DUPIXENT Quick Start Program temporarily provides access to DUPIXENT at no cost to eligible patients with commercial insurance who are experiencing a coverage delay of 5 or more business days. It may be covered by your Medicare or insurance plan. DUPIXENT® (dupilumab) is a prescription medicine FDA-approved to treat five conditions. 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. Serious side effects can occur. If you need help paying for your prescription, the DUPIXENT MyWay Patient Assistance. About three weeks later they send me a check to reimburse my copay. XOLAIR Access Solutions can help identify the most appropriate patient assistance option to. DUPIXENT® (dupilumab) therapy (“My Information”). 4 Performing a benefits investigation Determining PA requirementsDUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process. The maximum annual patient benefit under the DUPIXENT MyWay® Copay Card Program is $13,000. 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. 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. 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. Patient assistance programs for medications. Visit Site Visit the copay help site if you're a pharmacist or patient looking for support. 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. Contact program for details. (800) 657-7613 Call us if you’re a pharmacist or patient looking for support. 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. It may be covered by your Medicare or insurance plan. 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. Uninsured patients can apply to the manufacturer’s patient assistance program, the Dupixent MyWay program. , Quick Start, Copay Card, and Patient Assistance Program) Nursing Support (e. Dupixent is used to treat certain chronic inflammatory conditions, such as asthma and atopic dermatitis. Rare Together. Check your patients' eligibility for insurance coverage with AdvancedMD Eligibility, a web-based application that connects you to hundreds of payers. These diseases include approved indications for. I certify that I have obtained my patient’s written authorization in accordance with applicableAssistance (MA) Program. There are three variants; a typed, drawn or uploaded signature. Dupilumab in children aged 6 months to younger than 6 years with uncontrolled atopic dermatitis: a randomised, double-blind, placebo-controlled, phase 3 trial. Please see Important Safety Information and Prescribing Information and Patient. Pregnancy: A pregnancy exposure registry monitors pregnancy outcomes in women exposed to DUPIXENT during pregnancy. Each time you fill your DUPIXENT prescription, please ensure your. The income guidelines vary depending on the medication and pharmaceutical company. Copay amounts after applying copay assistance may depend on the patient’s insurance. ca. 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. 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. If you are experiencing difficulty and need assistance applying online, please call 1-866-SANOFI2 (1-866-726-6342) or click here. There is currently no generic alternative to Dupixent. Financial Eligibility;. 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 assistanceMedicaid, or any other state or federal programs unless you choose not to use your government-sponsored program. And while everyone’s working through the details, look to DUPIXENT MyWay for additional support. LEARN MORE. 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. Eligible patients will receive their cards by email. Serious side effects can occur. Need additional guidance with the enrollment process? Contact your field access specialist or call DUPIXENT MyWay. 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. Please see Important Safety Information and Prescribing Information and Patient Information on website. Y. Choose My Signature. Your doctor or nurse practitioner fills out and submits the application for 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. Copay coupons are typically for expensive, brand-name medications that don’t have a. DUPIXENT (dupilumab) Prescriber Information Patient Information . *. Applying to myAbbVie Assist is simple. With our help, you could get your Dupixent prescription for a flat fee of $49 per month. Eligible patients will receive their cards by email. 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. Through the Patient Assistance Program, qualified patients who are uninsured or whose insurance does not cover DUPIXENT could receive DUPIXENT at no cost. * Public reimbursement under the Ontario Exceptional Access Program and the New. Compare monoclonal antibodies. Within 24 hours, one of our patient advocates will call you for a brief interview. Contact the program for details: Re-application: New application yearly : Additional Information: Co-payment assistance, and patient assistance programs are available for eligible patients. Asthma with. , One-on-One Nurse Education, and Supplemental Injection Training) AbbVie Patient Assistance Program. Dupilumab. Assistance (MA) Program. DUPIXENT MyWay reserves the right to. Patients may have insurance plans that attempt to dilute the impact of the assistance available under the Program. details on drug assistance programs,. Here’s what you’ll need to complete the application: Patient contact information, household income and insurance information. 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. 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. VO: 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. 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. If you need help paying for your prescription, the DUPIXENT MyWay® Patient Assistance Program may be able to help. SCHEDULING. Dupixent (dupilumab) Prior Authorization Request Form Caterpillar Prescription Drug Benefit Phone: 877-228-7909 Fax: 800-424-7640. Financial Assistance Programs. or U. 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. Injection site reactions and eye conditions are the most common side effects reported and, unlike several other biologics, the risk of infection is low. DUPIXENT can be used with or without topical corticosteroids. (844-387-4936) or visit the program website. , One-on-One Nurse Education, and Supplemental Injection Training) Please click “Continue. DUPIXENT MyWay team will research each patient’s situation and determine eligibility. g. With of DUPIXENT MyWay Copay Card, right, commercially insured patients might pay as little as $0* copay per fill of DUPIXENT. Paris and Tarrytown, N. 5. Virgin Islands. Find information on insurance coverage, ordering through a specialty pharmacy, and the cost of DUPIXENT® (dupilumab), a prescription medicine FDA-approved to treat five conditions. Ways to save on Dupixent. consent to receive text messages by or on behalf of the Program. understand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. Children learn how to recognize. We consider each application according to: the drug that is needed. The PAN Foundation is dedicated to helping patients reach their best health. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer Fax the Enrollment Form to DUPIXENT MyWay. to determine if I am eligible to participate in DUPIXENT MyWay coverage assistance. Dupixent MyWay Enrollment Form: Asthma 10/10/23 Dupixent. No hassle, no problem. Sanofi Patient Connection® is a program to help connect you at no cost to the medications and resources you need. 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. 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 applicable1‑844‑DUPIXENT 1-844-387-4936. 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. 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. How to Get Prescription Assistance. Throw away (dispose of) any DUPIXENT that has been left at room temperature for longer than 14 days. understand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. Every patient has unique circumstances, and no one should have to forego the medication they need because they can’t afford it. Providing free or subsidized treatment for eligible patients with no. understand that any free product distributed through the DUPIXENT MyWay Patient Assistance Program is not contingent on any purchase obligations. This program aims to educate and empower kids to manage their asthma through a fun and interactive approach.