covermymeds.com. I authorize DUPIXENT MyWay to conduct a benefits investigation for my patient and to act on my behalf for the limited purpose of transmitting this prescription to the appropriate pharmacy designated by the patient per their benefit . I give supplemental injection training to the patient and the patients caregiver. Conjunctivitis and keratitis have been reported with DUPIXENT in postmarketing settings, predominantly in AD patients. Select your current prescription insurance to In order to meet the financial eligibility criteria for receiving Sanofi medication at no cost, you must have an annual household income of 400% of the current Federal Poverty Level. Putting the pieces together for acquiring DUPIXENT. 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. Ores dermatologist trained us on how to do the injection under the skin, and then when we contacted DUPIXENT MyWay, they sent a nurse to the house to give additional training to make sure that we were comfortable giving the injection. I see the injection as something that I just have to do, and it doesnt freak me out as much as it did in the beginning. Joint aches and pain. 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 doctors office, specialty pharmacy, and aDUPIXENT MyWayNurse Educator. 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 Your email is on its way. to a Phenotype or Your healthcare provider will decide if you or your caregiver can inject DUPIXENT. Do not use if you are allergic to dupilumab or to any of the ingredients in DUPIXENT. Patient Assistance Program may be able to help. Unfortunately, your plan does not cover DUPIXENT ( dupilumab). 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. Its important to understand how to identify prescription drug coverage. If you are a New York prescriber, please use an original New York State prescription form. DUPIXENT can cause serious side effects, including: Allergic reactions. DUPIXENT helps prevent severe asthma attacks (exacerbations) and can improve your breathing. 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. That means it may be delivered to you by a specialty pharmacy instead of your local pharmacy. Whether youre considering treatment with DUPIXENT or youre a DUPIXENT patient or caregiver, you can sign up for emails and additional resources from DUPIXENT MyWay that can help you: Uncontrolled moderate-to-severe eosinophilic or oral steroid dependent asthma, Uncontrolled chronic rhinosinusitis with nasal polyposis. mechanism of dupilumab action In some denial cases, a plan may require a peer-to-peer review with a medical reviewer at the health plan. call Contact Sanofi USor call18446437346 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. These are not all possible side effects of DUPIXENT. Some people who use DUPIXENT have had trouble walking or moving due to their joint symptoms, and in some cases needed to be hospitalized. with an Eosinophilic Please refer to Regeneron's Privacy Noticeand Sanofi'sPrivacy Policy for more information regarding processing of your personal data. Risk Associated with Abrupt Reduction of Corticosteroid Dosage: Do not discontinue systemic, topical, or inhaled corticosteroids abruptly upon initiation of DUPIXENT. 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. 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. available for your appropriate It is recommended that you fax a copy of prior authorization approval to DUPIXENT MyWay to 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. with other asthma medicines for the maintenance treatment of moderate-to-severe eosinophilic or oral steroid dependent asthma in adults and children 6 years of age and older whose asthma is not controlled with their current asthma medicines. Chronic Rhinosinusitis with Lactation: There are no data on the presence of DUPIXENT in human milk, the effects on the breastfed infant, or the effects on milk production. to treat adults and children 12 years of age and older, who weigh at least 88 pounds (40 kg), with eosinophilic esophagitis (EoE). 1844DUPIXENT (1-844-387-4936), option 1. Months, For Patients Ages 6+ Years Im a registered nurse withDUPIXENT MyWay. THIS IS NOT INSURANCE. For families/households with more than 8 persons, add $5,140 for each additional person. Some people who use DUPIXENT have had trouble walking or moving due to their joint symptoms, and in some cases needed to be hospitalized. pediatric patients aged 12 years, It is not known if DUPIXENT is safe and effective in children with prurigo nodularis under 18 years of age. Program has an annual maximum of $13,000. For families/households with more than 8 persons, add $5,910 for each additional person. DUPIXENT can be used with or without topical corticosteroids. Payments are averaged across all phases of Medicare coverage, and include coverage gap and catastrophic phase payments. (1-844-387-4936), Do not change or stop your corticosteroid medicine or other asthma medicine without talking to your healthcare provider. Visit our Pricing and Insurance page to get more information on coverage, ordering through a specialty pharmacy, or cost. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Terms & Restrictions Apply. Approximately 60% of commercial/employer-provided insured patients pay between $0-$100 per month for DUPIXENT. If you are a New York prescriber, please use an original New York State prescription form. The Support, LEARN ABOUT OUR your story? So, I asked the parents, Would it be OK if I just come back the next day?. Copay payments vary based on your specific plan. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. THIS IS NOT INSURANCE. 6, To find out if you qualify for Medicaid, or for more information about copays under Medicaid in your state, visit the Medicaid site. team can research each patient's situation and determine eligibility. Reduction in corticosteroid dose may be associated with systemic withdrawal symptoms and/or unmask conditions previously suppressed by systemic corticosteroid therapy. In those situations, the program may change its terms. See how DUPIXENT goes from being prescribed to being delivered to your doorstep. estimate my income in conjunction with the Patient Assistance Program eligibility determination process, if . Enter your email address and we will send you your requested resource. o A pregnancy registry for women who take DUPIXENT during pregnancy collects information about the health of you and your baby. Two of these common policies are called prior authorization and step edits. Please note: By clicking on this link, you will be leaving this Sanofi-hosted US website and going to another, entirely independent website. Tell your healthcare provider if you have any new or worsening eye problems, including eye pain or changes in vision, such as blurred vision. Haz clic en "Continuar" si quieres proseguir. Assistance Program may be able to help. He was trained by my doctor. (1-844-387-4936), option 5. DUPIXENT MyWay 9 pm ET. am enrolling in the DUPIXENT MyWay Program (the "Program") and authorize Regeneron PharmaceuticaIs, Inc., Sanofi US, and their affiliates and agents (together the "Alliance") to provide me services under the Program, as described in the Program Enrollment Form and as may be added in the future. A causal association between DUPIXENT and these conditions has not been established. Eosinophilic Esophagitis: MAT-US-2019257-v3.0-01/2022. Tell your healthcare provider if you have any side effect that bothers you or that does not go away. Advise patients to report new onset or worsening joint symptoms. 2020 Sanofi and Regeneron Pharmaceuticals, Inc. Sanofi offers a Dupixent MyWay copay card to some patients with commercial insurance, but it has eligibility requirements and a yearly maximum of $13,000. We want to hear you tell your story, and, if selected, you may be featured in print materials, social media, or videos. Your healthcare provider may send you to an ophthalmologist for an eye exam if needed. adult and pediatric patients aged 6 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. Sanofi and Regeneron are industry partners, who are committed to handling personal data in ways that respect your privacy. DUP.23.01.0314 Last Update: March 2023, DUP.22.11.0007 Last Update: December 2022, DUP.23.01.0070 Last Update: February 2023, DUP.22.10.0421 Last Update: February 2023, DUP.22.03.0291 Last Update: July 2022, DUP.22.05.0386 Last Update: September 2022, Moderate-to-Severe Eczema (Ages 6+ Months), Moderate-to-Severe Asthma (Ages 6+ Years), Chronic Rhinosinusitis with Nasal Polyposis, Uncontrolled moderate-to-severe eosinophilic or, https://mothertobaby.org/ongoing-study/dupixent/, Conduct virtual or over-the-phone training, How-to supplemental injection training videos, Tips to help manage feelings of uncertainty, Have effective conversations with your healthcare provider, Learn about programs that may help cover the cost of DUPIXENT. I see the injection as something that I just have to do, and it doesnt freak me out as much as it did in the beginning. Use the cost and coverage tool to see whether DUPIXENT may be covered by your insurance plan. ORE: These are not all possible side effects of DUPIXENT. Do not try to prepare and inject DUPIXENT until you or your caregiver have been trained by your healthcare provider. older with moderate-to-severe atopic 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. (EoE). for the treatment of adult patients with prurigo nodularis (PN). DUPIXENT MyWay will also remind the healthcare professional when the authorization is up for reapproval. are breastfeeding or plan to breastfeed. This is typical for a specialty drug like DUPIXENT, and In those situations, the program may change its terms. What's an FSA and how do I use it? DUPIXENT is given as an injection under the skin (subcutaneous injection) into different injection sites. are scheduled to receive any vaccinations. with eosinophilic esophagitis PATIENT SUPPORT household income, to qualify. Contact, Powered by Managed Markets Insight & Technology, LLC. The prior authorization information required by the patients insurance to approve coverage for DUPIXENT may include the patients history, medication, and clinical information. Patient access support: A copay card and other resources available to eligible patients to help optimize access to DUPIXENT Coverage support: Guidance and assistance navigating through the insurance process Patients can enroll in DUPIXENT MyWay by calling 1-844-DUPIXEN (T) or 1-844-387-4936 Haz clic en "Continuar" si quieres proseguir. List price as of 1/3/2023. Im the one that cringes with needles, but she does great. Need additional guidance with the enrollment process? Approval is not guaranteed. with other asthma medicines for the maintenance treatment of moderate-to-severe eosinophilic or oral steroid dependent asthma in adults and children 6 years of age and older whose asthma is not controlled with their current asthma medicines. Ests a punto de abandonar este sitio para visitar nuestro sitio en ingls. For most people on Medicaid, prescription drugs like DUPIXENT range from $4-$9 per month. DUPIXENT (dupilumab)a medicine with special storage requirementsis whats known as a specialty medicine. For more information, PROGRAM, https://mothertobaby.org/ongoing-study/dupixent/. ORE: Please be aware that not all Sanofi products are covered under the Sanofi Patient Assistance program. Please note: By clicking on this link, you will be leaving this Sanofi-hosted US website and going to another, entirely independent website. Individual results may vary. Your healthcare provider may send you to an ophthalmologist for an eye exam if needed. If youre eligible, you can enroll online and recieve your card by email. It is not known if DUPIXENT is safe and effective in children with asthma under 6 years of age. Its an injection given under the skin (subcutaneous injection). And for me to teach. Especially tell your healthcare provider if you are taking oral, topical or inhaled corticosteroid medicines or if you have atopic dermatitis and asthma and use an asthma medicine. If you have any additional questions about this pricing information, please call DUPIXENT You should not receive a live vaccine right before and during treatment with DUPIXENT. are pregnant or plan to become pregnant. see possible cost and coverage. If you have any other questions, DUPIXENT MyWay can help you understand the process. Advise patients to report new onset or worsening eye symptoms to their healthcare provider. If the patient is eligible for copay assistance, the patient or caregiver can then ensure the copay assistance is applied, coordinate delivery with the specialty pharmacy, and access additional DUPIXENT MyWay support. The program is intended to help patients afford DUPIXENT. If you can't find your recommended plan, enter the ZIP Code of the insured patient's employer. 5 Learn how to get your patients started with DUPIXENT MyWay. Share your story Maternal IgG is known to be present in human milk. Dupixent is the only thing that has given me true relief from eczema my entire life (mid-30s), quitting isn't something I want . 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, fever, hives, joint pain, general ill feeling, itching, skin rash, swollen lymph nodes, nausea or vomiting, or cramps in your stomach-area. CMS product no. This program is not valid where prohibited by law, taxed or restricted. The DUPIXENT MyWayPatient Assistance Program may be able to help. Some patients reported visual disturbances (e.g., blurred vision) associated with conjunctivitis or keratitis. When I go to see the patient, I cant wait to travel, no matter how far it is. You are encouraged to report negative side effects of prescription drugs to the FDA. If symptoms persist or worsen, consider rheumatological evaluation and/or discontinuation of DUPIXENT. Interested in speaking controlled chronic rhinosinusitis Accessed 01/18/23. Connect one-on-one with a trained patient or caregiver, ask questions, and hear about their personal journey living with their condition and life on DUPIXENT. . It might feel like this part takes a while, but hang in there. Please note: By clicking on this link, you will be leaving this Sanofi-hosted US website and going to another, entirely independent website. Please visit our Medications Available page to see if assistance is available for medication, Patient Assistance Connection Financial Eligibility. There are several reasons for this, including incomplete documentation, administrative errors, clinical reasons or a no-coverage determination, or a plan exclusion. It is recommended to speak with your insurance provider for any outstanding questions you may have about the cost or dispensing of DUPIXENT because they know the full details of your plan. Sano 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. To enroll or get more information call 1-877-311-8972 or go to https://mothertobaby.org/ongoing-study/dupixent/. You will now be exiting the Sanofi Patient Connection website. 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. Maternal IgG is known to be present in human milk. I dont really get scared anymore. For more information, dial 1-844-DUPIXENT Im ready to make a difference. established. patients situation and determine eligibility. It is not known whether DUPIXENT will harm your unborn baby. Tell your healthcare provider if you have any side effect that bothers you or that does not go away. Arthralgia: Arthralgia has been reported with the use of DUPIXENT with some patients reporting gait disturbances or decreased mobility associated with joint symptoms; some cases resulted in hospitalization. With the Copay Card, You Could Pay as Little as $0 . Parasitic (Helminth) Infections: It is unknown if DUPIXENT will influence the immune response against helminth infections. You should not receive a live vaccine right before and during treatment with DUPIXENT. DUPIXENT is a prescription medicine used: Questions or comments? Once DUPIXENT is approved, a specialty pharmacy may work with you to schedule shipments of DUPIXENT to your home or preferred location. to Learn More. DUPIXENT can be used with or without topical corticosteroids. It is not known if DUPIXENT is safe and effective in children with atopic dermatitis under 6 months of age. Sanofi and Regeneron are industry partners, who are committed to handling personal data in ways that respect your privacy. If a clinically significant hypersensitivity reaction occurs, institute appropriate therapy and discontinue DUPIXENT. You may be eligible for the DUPIXENT MyWay Copay Card if you: Approval is not guaranteed. DUPIXENT can cause allergic reactions that can sometimes be severe. Available at https://aspe.hhs.gov/poverty-guidelines. For more information on how to properly store DUPIXENT after delivery, please review the DUPIXENT Instructions for Use at DUPIXENT.com. It is not known whether DUPIXENT passes into your breast milk. In fact, when you take medications that require refills regularly over time, its always good to periodically check that your pharmacy has your most up-to-date insurance information on file. Publication 60-260. Many specialty medications, such as DUPIXENT, have longer turnaround times because of the prior authorization process. To enroll or get more information call. Both companies may independently process your personal data to manage patient support programs and product marketing campaigns. Dupixent MyWay Program Dupixent (dupilumab injection) Last Updated: 03/09/2023 Application Forms & Instructions The following documents are provided in interactive PDF format, allowing you to type information directly into the form. Im ready to help our patients to have the confidence to proceed with their journey. Advise patients to report new onset or worsening eye symptoms to their healthcare provider. pediatric patients aged 12 years and I think its very important to just be patient. 2023Sanofi and Regeneron Pharmaceuticals, Inc. All Rights Reserved. patients aged 2+ years, Choose a condition to be directed to the correct page, Chronic Rhinosinusitis with Nasal Polyposis, ClickTap Limitation of Use: DUPIXENT is not indicated for the relief of acute bronchospasm or status asthmaticus. Dupixent Enrollment Form - ENT/Pumonologist Dupixent Enrollment Form - Dermatologists Additional terms and conditions apply. Before using DUPIXENT, tell your healthcare provider about all your medical conditions, including if you: are scheduled to receive any vaccinations. DUPIXENT can be used with or without topical corticosteroids. I chose to be a nurse because I wanted to help people, and I believe that people should be in service to others. Acute Asthma Symptoms or Deteriorating Disease: Do not use DUPIXENT to treat acute asthma symptoms, acute exacerbations, acute bronchospasm or status asthmaticus. Mail: DUPIXENT MyWay Copay Reimbursement Program, 200 Jefferson Park, Whippany, NJ 07981 Fax: 1-908-809-6249 I, _____, certify that the information provided for this reimbursement request is accurate to the best of my knowledge, and the product-specific copay, for the treatment of adult and I dont really get scared anymore. It is not known if DUPIXENT is safe and effective in children with chronic rhinosinusitis with nasal polyposis under 18 years of age. Sometimes they can just take a deep breath, well go slow, think about their favorite place, think about something that reminds them and makes them happy and calms them down. Live support is available at When I get the order for the patient, I get really excited. These events may be associated with the reduction of oral corticosteroid therapy. This may cause other symptoms that were controlled by the corticosteroid medicine or other asthma medicine to come back. Once final approval and payment are received, the patient coordinates shipment to their home or their healthcare providers office, depending on treatment plan. Conjunctivitis also occurred more frequently in chronic rhinosinusitis with nasal polyposis subjects and prurigo nodularis subjects who received DUPIXENT compared to those who received placebo. is a patient support program Years, Weighing at status asthmaticus. o A pregnancy registry for women who take DUPIXENT during pregnancy collects information about the health of you and your baby. 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. 32 % Support & Education 24 % Awareness DUPIXENT andDUPIXENT MyWay are registered trademarks of Sanofi Biotechnology. 1-844-DUPIXENT Advising the patient to contact the specialty pharmacy for preferred delivery location. financial assistance to eligible patients, one-on-one nursing support, and more. Call your doctor for medical advice about side effects. Some plans, including commercial and Medicare, may even have a separate pharmacy benefit card. The Medicare & You 2020. Human IgG antibodies are known to cross the placental barrier; therefore, DUPIXENT may be transmitted from the mother to the developing fetus. Please download the application to see if assistance is available for your medication. Approximately 40% pay $100+ 2, per month of DUPIXENT. A pregnancy registry for women who take DUPIXENT during pregnancy collects information about the health of you and your baby. The DUPIXENT MyWay team can research each Legal Disclaimer | Privacy Policy | Contact Sanofi Notify your pharmacy. All Rights Reserved. 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. Some people with Medicare Part D coverage are eligible for the Social Security Administration's Extra Help 4 program (also known as the Low-Income Subsidy or "LIS"), and they typically pay $3-$9 for their prescriptions. Patients will need to meet the eligibility criteria, including household income, to qualify. Be sure to check your inbox. *48 Contiguous States and District of Columbia Source: US Dept of Health & Human Services. charges. Contact Sanofi USor call18446437346 CONTRAINDICATION: DUPIXENT is contraindicated in patients with known hypersensitivity to dupilumab or any of its excipients. Enter the insured patients ZIP Code below. DUPIXENT can be used with or without topical corticosteroids. Eosinophilic Esophagitis: therapies are not advisable. They have set aside this time for us to learn. This price guide is based on using the Drugs.com discount card which is accepted at most U.S. pharmacies. Since DUPIXENT is a specialty medication, it may require additional approval from your insurance company and is typically shipped from a specialty pharmacy. We have the ability to send out package inserts that include all the important safety information for DUPIXENT. Once coverage for DUPIXENT is approved, your patient must work with the specialty pharmacy to arrange for delivery of DUPIXENT to their home or preferred location. I help them to relax. Consider ophthalmological examination for patients who develop conjunctivitis that does not resolve following standard treatment or signs and symptoms suggestive of keratitis, as appropriate. Patient Assistance Connection Financial Eligibility (for uninsured or functionally uninsured patients) Determine the maximum household income requirement to be considered for Patient Assistance Connection by selecting your household size and then viewing the 400% column.
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