I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUPIXENT Quick Start Program product to the patient named herein. The $500 payment counts towards the member’s deductible and out-of-pocket maximum. Subscribe to our channel to stay up-to-date with all things DUPIXENT. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. In this case Dupixent myway will cover the first 13k, which is probably like 5 months. 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. pain, redness, irritation, itching, or swelling of the eye, eyelid, or inner lining of the eyelid. ®DUPIXENT (dupilumab) Prescription Information Prescriber Certification: My signature certifies that the person named on this form is my patient; the information provided on this application, to the best of my knowledge, is complete and accurate; that therapy with DUPIXENT is medically necessary; and that I. Pregnancy: A pregnancy exposure registry monitors pregnancy outcomes in women exposed to DUPIXENT during pregnancy. Monday-Friday, 8 am - 9 pm ET. I don't know what medical issues your son is having, but it's likey autoimmune issues. Copay Reimbursement Program, 200 Jefferson Park, Whippany, NJ 07981. To request access to someone else's record in MyHealth complete the Request Access to Someone Else’s Account form . If you are struggling please consider this drug. Everything they say sounds like they are reading it from the owners manual. DUPIXENT MyWay®. Ways to save on Dupixent. Eligible patients will receive their cards by email. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. Dupixent has an average rating of 6. Dymista - Pay as little as $29. Quitting my job and going back to school isn’t affordable option. 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–9 pm ET Patient Name DOB Prescriber. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing, state-specific. Support. 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. If you are a New York prescriber, please use an original New York State prescription form. 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. Monday-Friday, 8 am-9 pm ET. 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. Serious side effects can occur. Sydnab • 1 yr. insurer. If you are a New York prescriber, please use an original New York State prescription form. That being said, please remember that not everyone is fortunate enough to be able to afford it, either because they don't have insurance or because their insurance won't cover enough/has denied them outright (sometimes appealing this. 26 [95% CI: 0. WARNINGS AND PRECAUTIONS. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUPIXENT Quick Start Program product to the patient named herein. That took about a week. Approval represents the second dermatology indication for Dupixent and fifth disease indication overall in the. Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. In order to be effective and work properly, biologics are injectable medicines. Find DUPIXENT® (dupilumab) injection videos and instructions for the pre-filled pen (200 mg or 300 mg) for ages 2+ years. Throw away (dispose of) anyI can give my personal experience, for what it's worth. You need to have a prescription for DUPIXENT as well as commercial insurance. DATA UP TO 52 WEEKS is available. Try checking out MyWay Dupixent Program!! They cover costs of Dupixent and whatever your insurance won't pay (up to a certain yearly amount). Dedicated Dupixent MyWay Case Managers can explain information related to 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. DUPIXENT is a form of medicine called a biologic that targets Type 2 inflammation, an underlying cause of nasal polyps. You should call your doctor or your insurance company and ask for the specialty pharmacy information. Enroll now to receive emails and resources designed to help patients, caregivers and information seekers through the DUPIXENT® (dupilumab) treatment journey. Please see Important Safety Information and Patient Information on website. Dupixent isn’t available in a biosimilar form. Plus, get the latest information about DUPIXENT, exclusive tools,. I agree to assist in e Éorts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Sign up to connect with a DUPIXENT MyWay® mentor to help patients with Nasal Polyps through their DUPIXENT® (dupilumab) treatment journey. com. Find the definitions of commonly used terms related to uncontrolled, moderate-to-severe eczema, atopic dermatitis, and DUPIXENT® (dupilumab). ( 1-844-387-4936), option 1. I honestly started to taper off Dupixent because I wanted to see how well my body would do without it. *Please enter your. Step One - let's gather our materials. 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. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUPIXENT Quick Start Program product to the patient named herein. Being a nurse for DUPIXENT MyWay is very rewarding. Enrolled patients have access to: 1‑844‑387‑4936. Add the date to the sample using the Date feature. Talk with. Discover clinical, histologic, and endoscopic results 1-3. Learn about the DUPIXENT® (dupilumab) mechanism of action inhibiting IL-4 and IL-13 signaling in appropriate asthma patients. DUPIXENT MyWay complements your office’s process for accessing DUPIXENT. Get the dupixent copay card and you will likely get it for no charge for a while. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. reply . Caring. difficulty in breathing. Sign up or activate your card here. PRESCRIBER TO FILL OUT Section 5a. 02. brand. You can be eligible for and DUPIXENT MyWay Copay Card if you:. - Rachel, DUPIXENT Patient Mentor, living with asthma. *Please enter your patient. If you are a New York prescriber, please use an original New York State prescription form. Based on the questions answered above, you are not eligible to register for a new copay card or to activate a copay card. Sign up or activate your card here. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. I pay nothing. Mine had just exhausted a few months ago after 2 years, and I'm currently paying $70 for 2 shots with Blue Cross Blue Shield. 1-844-387-4936 (toll free) Monday - Friday, 8AM - 9PM (ET) Multilingual options available. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. Does that mean I'd be at ($9000-3,400. 1-844-387-4936 (toll free) Monday - Friday, 8AM - 9PM (ET) Multilingual options available. To get started: Contact your DUPIXENT MyWay Support Team for an 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) PRESCRIBER TO FILL OUT Section 6a. Dupixent is the only monoclonal antibody approved by the FDA to treat atopic dermatitis and eczema. A SingleCare savings card could reduce the cost of Dupixent without insurance as much as $1,600 per month. DUPIXENT® (dupilumab), in moderate-to-severe asthma treatment, is taken as an injection by a pre-filled syringe or pre-filled pen, review both options here. Thankfully, because my insurance counts Dupixent towards my out of pocket maximum, that $2000 Accredo bill (that I never paid, of course) sent me over that limit and I was fine for the year, but I was so angry for another hypothetical me who wasn't so lucky or had a higher OOP Max. DO NOT inject DUPIXENT into skin that is tender,Welp, got prescribed Dupixent. Patient Rebate Portal. This inflammation is an important component in. My skin is now 90 percent cleared. com is a great place to begin your research. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. I would literally give whoever made this drug my life. In children 12 years of age and older,Hello! The Medisafe Web Portal doesn’t work on small screens (yet). Patients may be eligible for the DUPIXENT MyWay Copay Card if: They have a DUPIXENT prescription for an FDA-approved condition. 01. Serious side effects can occur. For more information, dial 1-844-DUPIXENT1-844-387-4936), option 1. One of my favorite parts of providing nursing care to our patients is being able to walk them through their journey, hold their hand through the process, just to give them confidence along the way and we always want them to know that they. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. DUPIXENT Syringes can be stored at room temperature up to 77°F (25°C) up to 14 days. Exception: Requests for drugs administered by a healthcare professional that will be billed to the medical plan, call 1-866-752-7021 or fax. Come back and visit us using a device with a larger screen (laptop, desktop, tablet) at web. Then you give the specialty pharmacy a call regarding the refill & give them the required insurance information and schedule a delivery. I y are a Ne r resrer, ease se a ra Ne r Sae resr r Te resrer s y ser sae-se resr rerees, s as e-resr, sae-se resr r, a aae, e N-ae sae-se rerees res rea e resrer. 99% of commercial patients (6+ months of age) nationally are covered for DUPIXENT. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUPIXENT Quick Start Program product to the patient named herein. Originally went on dupixent as 1st derm thought I had eczema. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. If you are a New York prescriber, please use an original New York State prescription form. I may opt out of receiving Communications, individual support services, including the DUPIXENT MyWay® Copay Card, or opt out of DUPIXENT MyWay® entirely at any time by notifying a representative by telephone at 1-800-633-1610 or by sending a letter to Sanofi US Customer Service P. Combivent - Pay as little as $10 a month. DUPIXENT can be used with or without topical corticosteroids. Eligible commercially insured patients may submit a rebate if they paid in full for their prescription at the pharmacy or their prescription was filled before they enrolled in the program; visit to begin the rebate process; for additional information contact the program at 844-387-4936. In one week after my first Dupixent shot I could feel a positive change in my nasal airway. How to use Dupixent (dupilumab) syringes: 1) Wash your hands with soap and water before injection. Do not try to inject DUPIXENT until you have been shown the right way by your healthcare provider. Watch videos for a supplemental demonstration on how to use and dispose of DUPIXENT® (dupilumab), a prescription medicine for subcutaneous injection. Working with it utilizing electronic means is different from doing this in the physical world. 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. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Both through prescribing physicians, but dupixent's gone pro-active and implemented the my way reporting line for patients to self report adverse events as well. That would be $3,400 and then the Dupixent MyWay card would pay that $3,400, I assume. I'm supposed to start myself at some point, I guess with the pen though I know there's a choice. DUPIXENT is a prescription medicine used to treat certain skin conditions, asthma, and chronic rhinosinusitis with nasal polyps. “My eyes are a little itchy and gunky, but I would choose that side effect in a heartbeat rather than go back to the way things were before starting the treatment. Well at a cost of roughly $3,500/dose which lasts a month, that will all be used up in four months. Yesterday the nurse injected the first dose using a syringe in my leg. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offerEvery enrolled patient is assigned a DUPIXENT MyWay® Nurse Educator who can provide tools, resources, and education throughout the treatment journey. 421 adult patients were randomized to DUPIXENT + TCS or placebo + TCS. 1‑844‑DUPIXENT. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. Limitation of Use: DUPIXENT is not indicated for the relief of acute bronchospasm or status asthmaticus. PRESCRIBER TO FILL OUT Section 6a. Daliresp - Pay as little as $25. The appeal process Example letters. Enroll eligible patients in the DUPIXENT MyWay® patient support program for DUPIXENT® (dupilumab) access, financial assistance & nursing support. DUPIXENT MyWay® Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. Sign up for the DUPIXENT MyWay® mentor program for adults with uncontrolled chronic rhinosinusitis with nasal polyposis that is associated with type 2 inflammation. Monday-Friday, 8 am-9 pm ET. patients cover the out-of-pocket cost of DUPIXENT. Available in two delivery options, pre-filled syringe & pre-filled pen (300mg) for ages 12+ years. Serious side effects can occur. In patients aged 18 years and older with prurigo nodularis, Dupixent 300 mg is administered with a pre-filled syringe or pre-filled pen every two weeks following an initial loading dose. This copay card may be for you if you. If you are a New York prescriber, please use an original New York State prescription form. 1-844-DUPIXENT. Dupilumab se usa para el eczema en adultos y niños de 6 meses o más. ®DUPIXENT (dupilumab) Prescription Information Prescriber Certification: My signature certifies that the person named on this form is my patient; the information provided on this application, to the best of my knowledge, is complete and accurate; that therapy with DUPIXENT is medically necessary; and that I have prescribed DUPIXENT to the insurer. In children 12 years of age and older,I agre e to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Complete every fillable area. medisafe. I also have the dupixent myway card that covers a total of $13,000 for the year. The most common side effects may include injection site reactions, pink eye, eyelid inflammation, cold sores, and mouth or throat. æoßÌ Û©¢h— ¶F Ÿ8Or V¤Ú p´Òúh Òkñ ä ± ~> ~àÒ; ‡ Ì l>û Ø ¬¾ÞÐçž$¸ «>÷û²UôÍñù;?x Keep DUPIXENT Syringes and all medicines out of the reach of children. 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. medisafe. Has been prescribing for the last 10+ years and was essentially told I F'd up on the over use and have to taper down. Send the completed form to: MyHealth@islandhealth. living with prurigo nodularis are most in need of new treatment options . ” IMPORTANT SAFETY INFORMATION: Do not use if you are allergic to dupilumab or to any of the ingredients in DUPIXENT ®. Serious side effects can occur. Serious side effects can occur. Full Prescribing Information: Patient Information: Learn more about DUPIXENT: Thanks for c. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. support and resources. best of luck!! i hope you can get on dupixent soon. Monday-Friday, 8 am-9 pm ET. LONG-LASTING CLEARER SKIN AT 16 and 52 Weeks 22% taking. My monthly copay is $50 and my way picks it up. DUPIXENT below. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing. Get emergency medical help if you have signs of an allergic reaction to Dupixent: hives, rash, itching; fever, swollen glands, joint pain; feeling light-headed, difficult breathing; swelling of your face, lips, tongue, or throat. If you are a New York prescriber, please use an original New York State prescription form. DUPIXENT is not a steroid. Learn how DUPIXENT helped treat children 6 to 11 years old with their moderate-to-severe asthma. Learn about DUPIXENT® (dupilumab) dosage and administration options for adult and pediatric patients aged 6+ with moderate-to-severe asthma characterized by an eosinophilic phenotype or with oral corticosteroid dependent asthma using DUPIXENT® as add-on maintenance treatment. ®DUPIXENT (dupilumab) Prescription Information Prescriber Certification: My signature certifies that the person named on this form is my patient; the information provided on this application, to the best of my knowledge, is complete and accurate; that therapy with DUPIXENT is medically. Step 4: Hold the syringe at a 45-degree angle. And very recently got laid off due to Covid-19. I really enjoy the patient interaction. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. throat pain or soreness. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not affect any disclosure of My Information based on this Authorization made before my request is received and processed by my Healthcare Providers, Health Insurers, DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. Click on the Sign button and make a signature. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. I agre e to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Being a nurse for DUPIXENT MyWay is very rewarding. DUPIXENT, a biologic, is a type of medication that is processed in the body differently than oral or topical medications. Please see Important Safety Information and Prescribing Information and Patient Information on website. Please see Important Safety Information. Welcome to the Patient Support Portal! This site provides patients and healthcare professionals a fast secure way to submit the patient enrollment and supporting documentation to our patient services program team. Ready to connect with actual patients and caregivers being treated with DUPIXENT? The DUPIXENT MyWay Mentor Program helps put current and prospective moderate-to-severe eczema (atopic dermatitis or AD) DUPIXENT patients in contact with people going through similar. The cost of the 300-milligrams per 2-milliliters (mg/mL) shot of Dupixent will vary based on several factors. Like all biologics, Dupixent is made from proteins, and must be given by injection. I agree to assist in e Éorts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. Product Monograph – DUPIXENT (dupilumab injection) Page 4 of 82 Asthma DUPIXENT is indicated as an add-on maintenance treatment in patients aged 12 years and older with severe asthma with a type 2/eosinophilic phenotype or oral corticosteroid-dependent asthma. 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. It was "free" my first 2 years with my insurance hitting me with a $1,000 / month copay but the dupixent my way program gives you $13,000 a year copay assistance so $0 3rd year my insurance changed and it was $3300 a month copay so that sucked the dupixent my way help dry by March so I have been without most of 2022. How is Dupixent supplied? Dupixent comes as a single-use pre-filled syringe (with a needle shield) or as a pre-filled pen. More common side effects in people taking Dupixent for asthma include: reactions where the drug is injected, such as pain and swelling. I agre e to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. web. Start Program product to the patient named herein. Step 3: Take the needle cap off of the syringe right before you are going to inject. Dupixent also isn’t financially in the cards for me. The way it works for me and Dupixent is I pay $250 co-pay a month at the pharmacy. The DUPIXENT pre-filled syringe is for use in adult and pediatric patients aged 6 months and older. In children 12 years of age and older,For more information, dial 1‑844‑DUPIXENT ( 1-844-387-4936 ), option 1 Monday-Friday, 8 am - 9 pm ET. For more information or to enroll in the patient support program, dial 1‑844‑DUPIXENT ( 1-844-387-4936 Monday-Friday, 8 am-9 pm EST. DUPIXENT blocks the signaling of two key sources of Type 2 inflammation (IL-4 and IL-13). We work directly with your healthcare provider and will handle the full enrollment process on your behalf. Compare monoclonal antibodies. After that, it is taken as 1 injection every 2 weeks or every 4 weeks, depending on your age and weight. Check your eligibility for the DUPIXENT MyWay® Copy Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients. DUPIXENT has been prescribed to over 50,000 uncontrolled nasal polyp patients and counting! DUPIXENT is the first biologic nasal polyp treatment that’s an alternative to nasal polyp surgery. When Dupixent is used to treat asthma, there are two possible starting dosages for adults and children ages 12 years and older. The best way to celebrate the drug and its benefits on your quality of life is to understand how it works and why. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing, state-specific. Please see Important Safety Information and Patient Information on website. In children 12 years of age and older,Q7: Why will copay card support no longer be contributed toward my accumulator totals (i. Each time you fill your DUPIXENT prescription, please ensure your. Important Safety Information and Indication. Have commercial insurance, including health insurance. 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. My arms and legs are nowhere near as red and there is pretty much no itch to them. 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). DUPIXENT MyWay Copay Card may help eligible, commercially‑insured patients cover the out-of-pocket cost of DUPIXENT. I took Dupixent over 6 months, and having trouble now. com. You may be eligible for the DUPIXENT MyWay Copay Card if you:. The phone number is 1‑844‑DUPIXEN (T) (1-844-387-4936) Option 1, Monday–Friday, 8 AM–9 PM Eastern time. 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. If you are a New York prescriber, please use an original New York State prescription form. Dupixent is administered as an injection under the skin (subcutaneous injection) at different injection sites. Acaregiver or patient 12 years of age and older may inject DUPIXENT using the pre-filled syringe or pre-filled pen. “When I stay on top of my eczema, I don’t worry about my skin as much. It felt like they were controlling me when it should have been the other way around. x Store DUPIXENT Syringes in the refrigerator between 36°F to 46°F (2°C to 8 °C). This will allow the specialty pharmacy to conduct the benefits investigation, and DUPIXENT MyWay will provide additional support to the patient. Serious adverse side effects can occur. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing,Learn about DUPIXENT® (dupilumab) for moderate-to-severe asthma treatment. Hello! Switching insurance this year and need to prepare for increasing costs of dupixent with my new insurance. Serious adverse. Dupixent® (dupilumab) Note: Precertification review for this medication is handled by Aetna Pharmacy Management Precertification at 1-855-240-0535 or fax applicable request forms to 1-877-269-9916. Check your eligibility for the DUPIXENT MyWay® Copay Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients. I y are a Ne r resrer, ease se a ra Ne r Sae resr r Te resrer s y ser sae-se resr rerees, s as e-resr, sae-se resr r, a aae, e N-ae sae-se rerees res rea e resrer. Biologic Drug: Biologic drugs are made from living cells and are often expensive. And despite those massive growth forecasts, some analysts figure Dupixent could be on. Option 1- you have to meet your deductible without Dupixent myway. 98% of Commercially Insured Patients. Check your eligibility for the DUPIXENT MyWay® Copay Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing,My wife is on Dupixent, and has the MyWay card which allows up to $13,000/year. DUPIXENT is an injectable medicine that is administered by subcutaneous injection and is intended for use under the guidance of a healthcare provider. I authorize the Alliance to use my Social Security number and/or additional. chevron_right. •Keep DUPIXENT Syringes and all medicines out of the reach of children. fever. DUPIXENT® (dupilumab) is a prescription medicine FDA-approved to treat five conditions. The DUPIXENT MyWay Patient App gives patients enrolled in DUPIXENT MyWay access to tools to help you start and stay on track with your treatment. ”. Although you are not eligible, you can sign up DUPIXENT MyWay emails about DUPIXENT below. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUQuick Start Program product to the patient named herein. ear congestion. Box 5925 Mailstop 55A-220A Bridgewater, NJ 08807. Limitation of Use: Not for the relief of acute bronchospasm or status asthmaticus. For more information, dial 1‑844‑DUPIXENT 1-844-387-4936 Monday-Friday, 8 am-9 pm ET. 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–9 pm ET Patient Name DOB Prescriber. insurer. CHRONOS was a 52-week pivotal clinical trial evaluating the efficacy and safety of DUPIXENT in adult patients with uncontrolled moderate-to-severe atopic dermatitis. financial assistance for eligible patients, provide one-on-one nursing support, and more. insurer. for DUPIXENT MyWay emails about. His experience and mine are night and day different. Step 1: Let the syringe sit outside of the fridge for at least 45 minutes. Especially tell your healthcare provider if you. I really liked the fact that DUPIXENT is not an immunosuppressant or a steroid, because it makes me feel that the medicine is a different way of treating atopic dermatitis. Caring. DUPIXENT is taken by injection under the skin (subcutaneous injection) once every two weeks. pretty obvious to both my pharmacist and MyWay nurses that simply running through the $13,000 in a few months is not the way the copay assistance is intended to be used, but. I agree to assist in e Éorts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Please see Important Safety Information and Patient Information on website. Reload page. 1-844-DUPIXENT 1-844-387-4936. How to get Prescription Assistance. insurer. 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. Biopsy done and it’s eczema so back on dupixent. It has to be completed and signed, which can be done manually in hard copy, or by using a certain software like PDFfiller. Just got the fun news that I will need to pay $2,700 for a monthly dose of Dupixent. Tell your healthcare provider about any new or worsening joint symptoms. Serious side effects can occur. Find local businesses, view maps and get driving directions in Google Maps. “It was like something out of a dermatology fairy tale. Especially tell your healthcare provider if you. I have included a detailed explanation of the severity of [Patient’s First Name]’s disease, informationWith DUPIXENT, and less nasal polyps, you can do more of what matters most. Dupixent changed my life completely. Have commercial insurance, including health insurance exchanges, federal employee plans, or state employee plans;. Call 1-844-387-4936, Option 1 to contact DUPIXENT MyWay ®. Today my left knee. (I don't know when it is expiring, I have to look this up). And, if you're eligible, you can sign up and receive your card today. I make a point to say, it’s not a steroid. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. If you are a New York prescriber, please use an original New York State prescription form. For more information, dial 1-844-DUPIXENT1-844-387-4936), option 1. PK !Ñ'/ å è · [Content_Types]. Dupixent Prices, Coupons and Patient Assistance Programs. How DUPIXENT MyWay® Helped Shawn Get Started. This information will ONLY be used to validate your eligibility. 56 billion in sales in 2019 and turned in 8% growth in the first quarter to $832 million. DUPIXENT is taken by injection under the skin (subcutaneous injection) once every two weeks. The Dupixent pre-filled pen is only for use in patients 12 years of age and older. Luckily my supplemental ins pays it all with Medicare paying nothing. One-on-one nursingsupport is availableforDUPIXENT. I already know about the Dupixent my way, and programs, trust me when I say, it’s not happening for me, it’s also not only my choice. If your healthcare provider decides that you or a caregiver can give DUPIXENT injections, you or your caregiver should receive training on the right way to prepare and inject DUPIXENT. Injection. Study description: The safety data in this open-label extension study reflect exposure to DUPIXENT in 2677 subjects, including 2207 exposed for up to 52 weeks, 1065 exposed for up to 100 weeks, 557 exposed for up to 148 weeks, 352 exposed up to 204 weeks, and 202 exposed up to 244 weeks. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. , Benefits Investigation, Prior Authorization, and Appeals Support) Patient Access Support (e. For more information, to speak with a member of the DUPIXENT MyWay support team, or to enroll over the phone, call our toll-free line. Get emergency medical help if you have signs of an allergic reaction to Dupixent: hives, rash, itching; fever, swollen glands, joint pain; feeling light-headed, difficult breathing; swelling of your face, lips, tongue, or throat. At that point we will owe 20% of the cost of the medication, which adds up to just under $700/month. However, Dupixent has a great program (Dupixent My Way) to support people financially. Dedicated Dupixent MyWay Case Managers can explain information related to Dupixent. For patients wanting a copay card, they can access that by visiting our product website at DUPIXENT. Store DUPIXENT Syringes in the refrigerator between 36°F to 46°F (2°C to 8°C). DUPIXENT® (dupilumab) is a prescription medicine FDA-approved to treat five conditions. Needed additional leadership equipped the enrollment process? Contact your section accessories dedicated or call DUPIXENT MyWay. com. 3) Push the plunger down slowly until the syringe is emptied. Middle initial . They never mentioned only covering a certain amount of injections, just said they would cover it for a year. Dupixent works. You may be able to lower your total cost by filling a greater quantity at one time. Dosage for asthma. , 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. after two days im at about a 6 to 7. Registered nurses are also available to speak with eligible patients about DUPIXENT. DUPIXENT is a weekly single-dose injection that can be given by your doctor in an office or a clinic, or can be taken at home. My dr told me Dupixent costs around $10,000 a month at full cost, so insurance companies are bound to put up lots of red tape. 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. Hi, I'm on Dupixent and so far my doctor has done the injections, using the syringe. I think it is a true wonder drug and I am grateful for it. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. . This document provides detailed instructions for using the DUPIXENT Pre-filled Syringe with a 300 mg dose. DUPIXENT is a weekly single-dose injection that can be given by your doctor in an office or a clinic, or can be taken at home. if you are allergic to dupilumab or to any of the ingredients in DUPIXENT®. Using a mail-order specialty pharmacy might help lower the monthly cost of Dupixent. I go to college, and already had to extend my time due to eczema and TSW. Learn more about DUPIXENT® (dupilumab) in moderate-to-severe asthma and if it may be the right treatment option for you. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUPIXENT Quick Start Program product to the patient named herein. • 300 mg every 4 weeks. DUPIXENT MyWay® can work with your insurance provider to identify a preferred, in-network specialty pharmacy. (DUPIXENT + Topical Corticosteroids (TCS) vs TCS only): CLEAR OR ALMOST CLEAR SKIN AT 16 Weeks 39% taking DUPIXENT + TCS vs 12% using TCS only. To get patient-specific information about coverage for a drug, phone Health Insurance BC. Terms & Restrictions apply. coverage delay for DUPIXENT by the patient’s insurer. Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. , Quick Start, Copay Card, and Patient Assistance Program) Nursing Support (e. View all Regeneron Pharmaceuticals Inc. 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. Terms & Restrictions Apply. Be sure the details you add to the Dupixent Enrollment Form is updated and correct.