Might have to get this medication from a specialty pharmacy instead of your local pharmacy. The Dedham Group Quality of Access Tracking Report. Subsequent fills must be made through Accredo's mail order delivery. to Learn More. Please call THERACOM INC at (888) 843-7226 to discuss your medication and pharmacy needs in ROCKVILLE, MD. They will begin the benefits investigation and inform your office of the next steps. DUPIXENT MyWaywill not conduct the benefits investigation, nor send a Summary of Benefits Form, for providers who have checked the specialty pharmacy box on the Enrollment Form, as this indicates that they wish the specialty pharmacy to conduct the benefits investigation. In some denial cases, a plan may require a peer-to-peer review with a medical reviewer at the health plan. DUPIXENT can cause serious side effects, including: Tell your healthcare provider if you have any side effect that bothers you or that does not go away. Patients should seek medical advice if their asthma remains uncontrolled or worsens after initiation of DUPIXENT. Dupixent is used to treat a condition called chronic rhinosinusitis (long-term sinus inflammation) that is associated with nasal polyps in adults. Using a mail-order specialty pharmacy might help lower the monthly cost of Dupixent. 9 pm ET. Be proactive, take control into your hands and talk to your doctor to see if DUPIXENT is right for you. Use DUPIXENT exactly as prescribed by your doctor. Need additional guidance with the enrollment process? Once the primary ICD-10 code is filled in and the form is completed, write the names of the patient and prescriber at the top of all pages. Limitation of Use: DUPIXENT is not indicated for the relief of acute bronchospasm or status asthmaticus. Be sure to provide only one ICD-10 code, even if the patient has comorbid disease. Dupixent is used to treat eosinophilic esophagitis in adults and children 12 years of age and older, who weigh at least 88 pounds (40 kg). This form should be faxed to Envolve Pharmacy Solutions at 1-866-399-0929. DUPIXENT may also help reduce the amount of oral corticosteroids you need while preventing severe asthma attacks and improving your breathing. Please refer to Regenerons Privacy Notice and Sanofis Privacy Policy for more information regarding processing of your personal data. Total Life Care. PROGRAM, https://mothertobaby.org/ongoing-study/dupixent/. Products are dispensed by CVS Specialty and certain services are only accessed by calling CVS Specialty directly. Added . Atopic Dermatitis: Asthma: DUPIXENT is indicated as an add-on maintenance treatment of adult and pediatric patients aged 6 years and older with moderate-to-severe asthma characterized by an eosinophilic phenotype or with oral corticosteroid dependent asthma. The current location address for Theracom is 9717 Key West Ave, , Rockville, Maryland and the contact number is 301-337-4200 and fax number is 301-337-4135. for the treatment of adult and Vaccinations: Consider completing all age-appropriate vaccinations as recommended by current immunization guidelines prior to initiating DUPIXENT. Learn how to get your patients started with DUPIXENT MyWay. phenotype or with oral Prurigo Nodularis: 2020 Sanofi and Regeneron Pharmaceuticals, Inc. There is currently no generic alternative to Dupixent. for the treatment of adult patients with prurigo nodularis (PN). To enroll inDUPIXENT MyWay, your patients can call 1-844-DUPIXEN(T) (1-844-387-4936) or email or print and fill out the following forms with your assistance. First, allow the patient to review the Patient Authorization and Certifications. Additional terms and conditions apply. - Patients may self-administer . Meijer's team of nurses is specifically dedicated to prior authorizations and appeals. It is important to note that a plan may deny prior authorization. SINUS-24 and SINUS-52 were randomized, double-blind, placebo-controlled pivotal phase 3 trials evaluating Dupixent for up to 24 weeks and 52 weeks, respectively, in patients with severe CRSwNP. The cost for Dupixent subcutaneous solution (200 mg/1.14 mL) is around $3,354 for a supply of 2.28 milliliters, depending on the pharmacy you visit. or obtaining a sample from the doctor's office. Treat patients with pre-existing helminth infections before initiating therapy with DUPIXENT. with an Eosinophilic to treat adults with prurigo nodularis (PN). They will begin the benefits investigation and inform your office of the next steps. Duane Reade and 65,000 pharmacies nationwide. mechanism of dupilumab action DUPIXENT MyWay complements your offices process for accessing DUPIXENT. Putting the pieces together for acquiring DUPIXENT. Patients. Utilization Management. You can refer to DupixentHCP.com for the appeals kit, which will provide information about the process of appealing a denial, and reference sample letters provided byDUPIXENT MyWay. Months, For Patients Ages 6+ Years Some patients reported visual disturbances (e.g., blurred vision) associated with conjunctivitis or keratitis. pediatric patients aged 12 years, About Dupixent Franchise & Partner Markets Europe (PME) Dupixent is the fastest growing brand in specialty care division of Sanofi. more. are breastfeeding or plan to breastfeed. Risk Associated with Abrupt Reduction of Corticosteroid Dosage: Do not discontinue systemic, topical, or inhaled corticosteroids abruptly upon initiation of DUPIXENT. If your patients need further support,DUPIXENT MyWayNursing Support is available as an additional point of contact. If symptoms persist or worsen, consider rheumatological evaluation and/or discontinuation of DUPIXENT. If you need to reach us and don't have a prescription label available, call 1-800-237-2767 (TTY: 711 ). It is not known whether DUPIXENT will harm your unborn baby. Check the formulary status of DUPIXENT in your area with our coverage tool today. Co-payment assistance, and patient assistance programs are available for eligible patients. Once the primary ICD-10 code is filled in and the form is completed, write the names of the patient and prescriber at the top of all pages. Live support is available at 866-452-5017 or covermymeds.com. -to with eosinophilic esophagitis (1-844-387-4936). Chronic Rhinosinusitis with Questions or comments? to treat adults and children 6 months of age and older with moderate-to-severe eczema (atopic dermatitis or AD) that is not well controlled with prescription therapies used on the skin (topical), or who cannot use topical therapies. aTheDUPIXENT MyWayteam will research each patients situation and determine eligibility. characterized by an eosinophilic Consider ophthalmological examination for patients who develop conjunctivitis that does not resolve following standard treatment or signs and symptoms suggestive of keratitis, as appropriate. established. ASTHMA Ages 6+ Years, Add-on Maintenance Treatment for Uncontrolled Your doctor will tell you if you are able to self-inject (if so, training by the HCP will be provided), how much DUPIXENT to inject, and how often to inject it. A Pharmacy is responsible for ensuring the safe and effective use and distribution of pharmaceutical drugs by a pharmacist. Is Dupixent being prescribed by or in consultation with a dermatologist or an allergist/immunologist? The information should be submitted by the practitioner or pharmacist to Envolve Pharmacy Solutions on the Medication Prior Authorization Form. Your healthcare provider will decide if you or your caregiver can inject DUPIXENT. 866-452-5017 or State of New Jersey Contractual Requirements. Insightful tips and tools to help them along the way, One-on-one nursing support, when needed, to provide disease and DUPIXENT education and ongoing follow-up to ensure patients stay on track with DUPIXENT, Reminder when eligible patients must reapply for financial support programs (Copay Card Program, Patient Assistance Program), Supplemental injection training virtually or over the phone. Print the full list Filter by (Filter by drug name, condition or treatment) Sort by Alternatively, you can call us at 833-262-1726 or fax the prescription to 833-263-2871. Support, LEARN ABOUT OUR PATIENT SUPPORT CoverMyMeds support is available for DUPIXENT. This will allow the specialty pharmacy to conduct the benefits investigation, and DUPIXENT MyWay will provide additional support to the patient. Sanofi US and Regeneron provide these links as a service to its website visitors and users; however, they take no responsibility for the information on any website but their own. Gandhi NA, Bennett BL, Graham NMH, Pirozzi G, Stahl N, Yancopoulos GD. Treatment with one medium to very high potency topical corticosteroid (e.g., Diprolene AF (betamethasone dipropionate), Elocon (mometasone furoate), Temovate (clobetasol propionate) (see appendix for complete list), AND Treatment with one topical calcineurin inhibitor (e.g., Elidel (pimecrolimus), Protopic (tacrolimus), AND DUPIXENT can be used with or without topical corticosteroids. By choosing a healthcare provider that has achieved ACHC . Visit website. Reduction in corticosteroid dose may be associated with systemic withdrawal symptoms and/or unmask conditions previously suppressed by systemic corticosteroid therapy. The Specialty Pharmacy Program supports the health care provider/patient relationship to help better manage rare and complex chronic conditions. Hypersensitivity: Hypersensitivity reactions, including anaphylaxis, serum sickness or serum sickness-like reactions, angioedema, generalized urticaria, rash, erythema nodosum, and erythema multiforme have been reported. For patients with commercial insurance who are new to DUPIXENT and are experiencing a For patients with commercial insurance who are new to DUPIXENT Form more information phone: 844-387-4936 or Eosinophilic Conditions: Patients being treated for asthma may present with serious systemic eosinophilia sometimes presenting with clinical features of eosinophilic pneumonia or vasculitis consistent with eosinophilic granulomatosis with polyangiitis (EGPA), conditions which are often treated with systemic corticosteroid therapy. adult and pediatric patients aged 6 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. DUPIXENT FASENRA NUCALA TEZSPIRE XOLAIR Atopic Dermatitis ADBRY CIBINQO . . DUPIXENT, a biologic, is a type of medication that is processed in the body differently than oral medications (pills), or steroids. CVS Caremark Specialty Programs 2969 Mapunapuna Place Honolulu, HI 96819 Phone: 1-808-254-4414 Fax: 1-866-237-5512 www.caremark.com Page 2 of 6 Section A: Atopic Dermatitis 5. Sanofi and Regeneron are industry partners, who are committed to handling personal data in ways that respect your privacy. Consider ophthalmological examination for patients who develop conjunctivitis that does not resolve following standard treatment or signs and symptoms suggestive of keratitis, as appropriate. Read reviews from GoodRx users who have taken Dupixent (dupilumab) and find the latest news on the drug. And many predict that cost will continue to rise over the coming years. After you prescribe DUPIXENT, a correctly filled outDUPIXENT MyWayEnrollment Form helps ensure patient enrollments are processed without delays. Cases of eosinophilic pneumonia were reported in adult subjects who participated in the asthma development program and cases of vasculitis consistent with EGPA have been reported with 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. If the patient has consented, the patients nurse educator will initiate a welcome call with the patient within a few days after enrolling. Treat patients with pre-existing helminth infections before initiating therapy with DUPIXENT. 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. Risk Associated with Abrupt Reduction of Corticosteroid Dosage: Do not discontinue systemic, topical, or inhaled corticosteroids abruptly upon initiation of DUPIXENT. Contact Us Meijer Specialty Pharmacy Corporate Offices & Patient Services 2350 Three Mile Road NW Grand Rapids, MI 49544 Phone: 1-855-263-4537 Fax: 1-877-222-5036 National Distribution Center 8455 Haggerty Road Belleville, MI 48111 Burbank, CA 2514 N Ontario St - Suite 102 Burbank, CA 91504 Phone: 1-800-657-2212 Fax: 1-888-592-7723 Woodbury, NY Some Medicare plans may help cover the cost. aThe Note: This is a drug discount program, not an insurance plan. in adult patients with inadequately For more information, It is not known if DUPIXENT is safe and effective in children with prurigo nodularis under 18 years of age. Terms & Restrictions Apply. Primary Phone: Specialty/facility name (if applicable): REQUEST FOR EXPEDITED REVIEW: By checking this box and signing below, I certify that applying the 72 hour standard review timeframe may seriously jeopardize . The NPI Number for Theracom is 1568443489. Reduction in corticosteroid dose may be associated with systemic withdrawal symptoms and/or unmask conditions previously suppressed by systemic corticosteroid therapy. Sanofi US is hosting this website on behalf of Sanofi and Regeneron Pharmaceuticals, Inc. Sanofi and Regeneron are industry partners, who are committed to handling personal data in ways that respect your privacy. Especially tell your healthcare provider if you are taking oral, topical, or inhaled corticosteroid medicines; have asthma and use an asthma medicine; or have atopic dermatitis, chronic rhinosinusitis with nasal polyposis, eosinophilic esophagitis, or prurigo nodularis and also have asthma. These events may be associated with the reduction of oral corticosteroid therapy. corticosteroid dependent asthma. Need additional guidance with the enrollment process? Haz clic en "Continuar" si quieres proseguir. To help ensure a seamless enrollment process, ask the patient if they would like to provide their email address, mobile phone number, and to consent to receiving text messages. Asthma - Maintenance, Atopic Dermatitis, Chronic Rhinosinusitis with Nasal Polyps, and others. IL-4 and Dupixent (dupilumab) is a brand-name prescription medication. Populate the clinical information corresponding to your patients diagnosis. Some plans, including commercial and Medicare, may even have a separate pharmacy benefit card. Serious adverse reactions may occur. DUPIXENT can be used with or without Please refer to Regeneron's Privacy Noticeand Sanofi'sPrivacy Policyfor more information regarding processing of your personal data. Pharmacy Medical Necessity Determination. prescription therapies or when those Dupixent - Medicare Phone: 215-991-4300 Fax back to: 866-371-3239 . Patient assistance programs (PAPs) are usually sponsored by pharmaceutical companies and provide free or Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. This role is responsible for the overall market access strategy for the Dupixent Respiratory franchise. It is not known whether DUPIXENT passes into your breast milk. Dupixent (dupilumab) Info for Patients. Both companies may independently process your personal data to manage patient support programs and product marketing campaigns. For more information, call1-844-DUPIXEN(T) (1-844-387-4936), option 1. aApproval is not guaranteed. CoverMyMeds provides additional PA process-related support for DUPIXENT. Here are 10 ways to save money on prescription drugs, Dupixent (dupilumab) Approved by FDA as the First and Only Treatment Indicated for Prurigo Nodularis, Must be residing in the US or Puerto Rico. Treat patients with pre-existing helminth infections before initiating therapy with DUPIXENT. A pregnancy registry for women who take DUPIXENT during pregnancy collects information about the health of you and your baby. LEARN ABOUT OUR PATIENT SUPPORT PROGRAM For more information, call 1-844-DUPIXENT ( 1-844-387-4936) option 1 Monday-Friday, 8 am - 9 pm ET Ages 12+ Years weighing older with moderate-to-severe atopic Monday-Friday, 8 am Both companies may independently process your personal data to manage patient support programs and product marketing campaigns. DUPIXENT MyWay is a patient support program that can help enable access to Healthcare providers should be alert to vasculitic rash, worsening pulmonary symptoms, cardiac complications, and/or neuropathy presenting in their patients with eosinophilia. Reductions in corticosteroid dose, if appropriate, should be gradual and performed under the direct supervision of a healthcare provider. Visit Website, Looking to reduce costs at the pharmacy counter? Dupixent calms an overreactive immune system but does not suppress the immune system. nursing support, and more. You can count on our guidance, education, and compassion throughout your entire course of treatment. controlled chronic rhinosinusitis Key points of contact for coverage are located on the card itself. (1-844-387-4936), Fill out the enrollment form with your patients. The primary aim is to develop and commercialize Dupilumab in patients with immune-based chronic inflammatory Type 2-diseases in the fields of dermatology, allergic and respiratory diseases including severe asthma, chronic rhinosinusitis with nasal polyposis . Call 800-689-6592 to enroll and ask an Accredo representative to call your provider if a new prescription is needed. Sano US and Regeneron provide these links as a service to its website visitors and users; however, they take no responsibility for the information on any website but their own. Be the first to write one! Benefits Investigation, Prior Authorization (PA), and Appeals Support. Theracom Pharmacy 345 International Boulevard Brooks, KY 40109 (888) 843-7226 Visit Website Get Directions Similar Businesses Detailed Information Location TypeBranch Year Establishedunknown Annual Revenue Estimateunknown SIC Code show NAICS Code show Employeesunknown There are no reviews yet. Years, For Patients Ages 12+ The CVS Specialty Pharmacy Distribution Drug List is a guide of medications available and distributed through CVS Specialty. 844-387-4936 This will allow the specialty pharmacy to conduct the benefits investigation, andDUPIXENT MyWaywill provide additional support to the patient. temporary access at no cost. Cases of eosinophilic pneumonia were reported in adult subjects who participated in the asthma development program and cases of vasculitis consistent with EGPA have been reported with 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. status asthmaticus. If this is the case, write the preferred specialty pharmacy name and then check the box indicating that you have sent the prescription to the specialty pharmacy, which will be responsible for securing the coverage on the patients behalf. Eosinophilic Esophagitis: It is not known if DUPIXENT is safe and effective in children with chronic rhinosinusitis with nasal polyposis under 18 years of age. And reminding them that the specialty pharmacy may call them from an unknown number. Download our app. CoverMyMeds provides additional PA process-related support for DUPIXENT. Specialty Pharmacy Services, Information and Forms. You or your patients can contact Sanofi and Regeneron are industry partners, who are committed to handling personal data in ways that respect your privacy. enrollment process, offer Dupixent will be given as SC injections, at different injection sites. Reduction in corticosteroid dose may be associated with systemic withdrawal symptoms and/or unmask conditions previously suppressed by systemic corticosteroid therapy. After you prescribe DUPIXENT, a correctly filled out DUPIXENT MyWay Enrollment Form helps ensure patient enrollments are processed without delays. If enrolling in the DUPIXENT MyWay Copay Card Program, I understand that Copay Card information will be sent to my designated specialty pharmacy along with my prescription, and any assistance with my applicable cost-sharing or copayment for DUPIXENT (dupilumab) injection will be made in accordance with the Program terms and conditions. Timely Filing Requirements. Contact your Field Access Specialist or callDUPIXENT MyWayat1-844-387-4936, Monday through Friday, 8 am to 9 pm Eastern Time. Chronic Rhinosinusitis with Nasal Polyposis (CRSwNP): DUPIXENT is indicated as an add-on maintenance treatment in adult patients with inadequately controlled CRSwNP. Together, we can help more people lead longer and healthier lives. DUPIXENT is not indicated for the Sanofi US and Regeneron provide these links as a service to their website visitors and users; however, they take no responsibility for the information on any website but their own. Do not try to prepare and inject DUPIXENT until you or your caregiver have been trained by your healthcare provider. no cost. DUPIXENT MyWaycomplements your offices process for accessing DUPIXENT. (EoE). Axium Healthcare de Puerto Rico 1001 San Roberto Street, Suite 101, San Juan, PR 00926 hours: M-F 8:00 am - 6:00 pm AST 844.355.4191 800.546.2163 711 DUPIXENT is not used to treat sudden breathing problems. These events may be associated with the reduction of oral corticosteroid therapy. The prior authorization information required by the patients insurance to approve coverage for DUPIXENT may include the patients history, medication, and clinical information. Reference table updated to include Preferred Drug footnote. It is recommended that you fax a copy of prior authorization approval toDUPIXENT MyWayto help the office staff continue the process in several ways, such as: Initiating contact with the patient regarding the approval and sharing the specialty pharmacy name and phone number. DUPIXENT MyWay reserves the right to rescind, revoke, terminate, or amend this oer, eligibility, and terms of use at any time without notice. is a patient support program If symptoms persist or worsen, consider rheumatological evaluation and/or discontinuation of DUPIXENT. Learn more about our available resources to help navigate the insurance process. Our preferred way to accept prescriptions for IngenioRx Specialty Pharmacy is through ePrescribing. Remember to monitor and document the patients progress for reauthorization. Atopic Dermatitis: DUPIXENT is indicated for the treatment of adult and pediatric patients aged 6 months and older with moderate-to-severe atopic dermatitis whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable. Both companies may independently process your personal data to manage patient support programs and product marketing campaigns. Do not change or stop your corticosteroid medicine or other asthma medicine without talking to your healthcare provider. DUPIXENT is not used to treat sudden breathing problems. Limitation of Use: DUPIXENT is not indicated for the relief of acute bronchospasm or status asthmaticus. However, the patient's health plan may recommend or mandate a particular specialty pharmacy. A causal association between DUPIXENT and these conditions has not been established. CHRONIC RHINOSINUSITIS WITH NASAL POLYPOSIS (CRSwNP) Ages 18+ Years, EOSINOPHILIC ESOPHAGITIS (EoE) Dupixent (duplilumab) [PA .
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