Income at or below: Not Published: Medical expenses can be. It still covers the same amount. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. Declining androgen levels correlated with increased frailty. 0254 Last Update: February 2023 DUP. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. 8K subscribers in the eczeMABs community. Rx: DUPIXENT® (dupilumab) (100 mg/0. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. withdraw this Authorization at any time by mailing or faxing a written request to DUPIXENT MyWay at 1800 Innovation Point, Fort Mill, SC 29715; Fax: 1-844-387-9370. For more information, call 1. Find the safety profile, including most common side effects, of DUPIXENT® (dupilumab) for infant to preschoolers 6 months to 5 years of age with uncontrolled moderate-to-severe atopic dermatitis . Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. Rx: DUPIXENT® (dupilumab) (100 mg/0. 0129 Last Update:. You or your patients can contact DUPIXENT MyWay® at 1-844-DUPIXEN(T) (1-844-387-4936) 1-844-DUPIXEN(T) (1-844-387-4936) to learn more. Deductible is at $3k out of pocket insurance pays 80% and at $6k insurance pays 100%. DUPIXENT MyWay provides prior authorization and appeals information you may need, as well as helpful examples and guides to assist in obtaining coverage for DUPIXENT. You can email or print the enrollment forms below. Learn more about programs for eligible patients who are insured, underinsured, and uninsured. 2. Dupixent MyWay pays the $500 copay. Human IgG antibodies are known to cross the placental barrier; therefore, DUPIXENT may be transmitted from the mother to the developing fetus. 38]). 1 Reactions. 23. Sanofi and Regeneron are committed to helping patients in the U. Maximum benefit (2023) = $1,483. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. Dupilumab. Each time you fill your DUPIXENT prescription, please ensure your. Nurse Educators Nurse Educators offer one-on-one support to help patients start and stay on track with therapy. , chart notes, laboratory values) and use of claims history documenting the following: 1. 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 any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. If I am completing Section 5b, I authorize for my commercially insured patient one. If you still have questions, you can speak with a DUPIXENT MyWay or request to join the program over the phone. Opinions clash over private equity’s effect on dermatology. Especially tell your healthcare provider if you. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. with household income, to qualify. But either way, after you or Dupixent myway meets your deductible, it should be free to you. In clinical trials, DUPIXENT reduced the. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. Robocalls increase diabetic retinopathy screenings in low-income patients. DUPIXENT MyWay coordinators are available Monday-Friday 8 am to 9 pm ET. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Injection in children 12 and older should be supervised by an adult. 67 mL, 200 mg/1. 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. DUPIXENT® (dupilumab) Prescription Information Quick Start may be able to provide DUPIXENT at no cost to help bridge patients to therapy if there is a coverage delay. Approval represents the second dermatology indication for Dupixent and fifth disease indication overall in the. 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 programs, or other4 ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pmDUPIXENT MyWay complements your office’s process for accessing DUPIXENT. Fax the Enrollment Form to DUPIXENT MyWay. If you are moderate to low-income person with eczema or just need help paying for your health care or prescription costs, you’ve come to the right place. Learn about the DUPIXENT® (dupilumab) mechanism of action inhibiting IL-4 and IL-13 signaling in appropriate asthma patients. 22. Dupixent MyWay ™ will help eligible patients who are uninsured, lack coverage, or need assistance with their out-of-pocket costs. Please see Dosage Regimens, How to Inject DUPIXENT® and Instructions for Use. If I am completing Section 5b, I authorize for my commercially insured patient one. Dupixent will run about $3000 per month with my insurance until my maximum is met. Since 2018, DUPIXENT has been prescribed to over 100,000 asthma patients in the US. In this case Dupixent myway will cover the first 13k, which is probably like 5 months. Monday-Friday, 8 am-9 pm ET. 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 wanted to go out and make a difference and help people. DUPIXENT is not a steroid or immunosuppressant; it is a prescription biologic medicine given under the skin (subcutaneous injection). , Sanofi US, and their affiliates and agents (together, the “Alliance”) may verifyDUPIXENT MyWay Nurse Educators are trained to help provide patients with supplemental injection training either online, over the phone, or in person with a training kit and practice syringe or practice pen. Section 5a. 22. Section 5a. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase. a FDA approved since 2017 for adults, 2019 for adolescents (aged 12‑17 years), 2020 for children (aged 6-11 years), Patients may be eligible for the DUPIXENT MyWay Copay Card if: They have a DUPIXENT prescription for an FDA-approved condition. 23. With the DUPIXENT MyWay Copay Card, eligible,. I’m Laurie. 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. It may be covered by your Medicare or insurance plan. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT (maximum of $13,000 per patient per calendar year) if they meet the eligibility requirements, including: Have commercial insurance, including health insurance exchanges, federal employee plans, or state employee plans 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. 03. LH Patient View; data through June 16, 2023. SIGN UP TO SPEAK WITH A DUPIXENT MyWay ® MENTOR . Lancet. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may payable as little while $0* copay per fill by DUPIXENT. 0252 Last Update: Feb 2023 DUP. You may be able to get a 90-day supply of Dupixent. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3 program consisting of two pivotal trials About 75,000 adults in the U. Biologics and monoclonal antibodies (mabs) for atopic dermatitisVO: 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. 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 programs, or otherI experienced cold sores and eye issues for about the first 6 months of being on Dupixent. THE DUPIXENT MyWay PROGRAM. The $500 payment counts towards the member’s deductible and out-of-pocket maximum. 1-844-DUPIXENT 1-844-387-4936. Pay as little as $0 per month. If you have any additional questions about this pricing information, please call DUPIXENT MyWay at 1-844-DUPIXENT (1-844-387-4936). Note: All information is required unless otherwise indicated. ) 2 Prescription InformationDUPIXENT MYWAY ENROLLMENT FORM Moderate-to-Severe Atopic Dermatitis SUBMIT COMPLETED PAGES 1 & 2 Fax: 1-844-387-9370 Document Drop: (code: 8443879370) Patient Name DOB / / Prescriber Name Prescriber Address NPI # Prescriber State License # (Required in Puerto Rico only). Patient assistance program. What it is used for. DUPIXENT can be used with or without topical corticosteroids. 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. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. For more information, call 1-844-DUPIXENT ( 1-844-387-4936) option 1. DUPIXENT use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Be sure to fill out your enrollment form completely and accurately. Fill out sections 5a and 5b completely to determine patient eligibility. any time by mailing or faxing a written request to DUPIXENT MyWay at 1800 Innovation Point, Fort Mill, SC 29715; Fax: 1-844-387-9370. ithdrawal of this Authoriation will end my participation in the DUPIXENT MyWay Program and will not aect any disclosure of My Information ased on this Authoriation made efore my reuest is received and processed y my ealthcare Providers, ealth Insurers, and Specialty Pharmacies. financial assistance for eligible patients, provide one-on-one nursing. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. 26 [95% CI: 0. Caring. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. March 27, 2018. I know people who make six figures on a joint income and still use MyWay. Some people do injections every 3 weeks, which could stretch that copay card out longer. 02. Check the liquid in the prefilled pen or syringe. Rx: DUPIXENT® (dupilumab) (100 mg/0. For more information, dial 1-844-DUPIXENT 1-844-387-4936 ), option 5, Monday-Friday, 9 am – 9 pm ET. -The MyWay forms themselves changed to a new revision and had to be resubmitted by my doctor -The revised new form needed me to resign then over the phone. 00. Regeneron and Sanofi are committed to helping patients in the U. The patient would prefer not to try. It temporarily provides eligible patients DUPIXENT at no cost, subject to program terms and conditions. The DUPIXENT MyWay patient support program is here to help you at every step of your DUPIXENT treatment journey. For more information, please call 1-844-DUPIXENT (1-844-387-4936) or visit . The DUPIXENT MyWay team can research each patient's situation and determine eligibility. 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. Boguniewicz M, Alexis AF, Beck LA, et al. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3 program consisting of two pivotal trials. Nationally are Covered for DUPIXENT. Eosinophilic Esophagitis: DUPIXENT is indicated for the treatment of adult and pediatric patients aged 12 years and older, weighing at least 40 kg, with eosinophilic esophagitis (EoE). Appears that my out of pocket maximum will be $8000 through insurance. ithdrawal of this Authoriation will end my participation in the DUPIXENT MyWay Program and will not aect any disclosure of My Information ased on this Authoriation made efore my reuest is received and processed y my ealthcare Providers, ealth Insurers, and Specialty Pharmacies. Please see Important Safety Information and full PI on website. ) Please refer to Section 8, Patient Certifications, for. S. Oct 26, 2022 · Dupixent MyWay Program Enrollment Form for Allergists (AD, Asthma, CRSwNP). 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 programs, or otherDUPIXENT . 0156 Last Update: March 2023 DUP. $125 is the amount Dupixent assistance pays. Dupixent is an injection under the skin (subcutaneous injection) at different injection sites. Please see. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. 89 and -1. Ways to save on Dupixent. 01. Clip the card and save • Save up to 80% on medications*Tell your healthcare provider about any new or worsening joint symptoms. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. As far as choosing a better plan with a lower deductible, I don't really have much of a choice. 2017;5 (6):1519-1531. LASTING CHANGE IS ACHIEVABLE. The Dupixent MyWay program is not available to medicare patients. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as a $0* copay per fill of DUPIXENT, maximum of $13,000 per patient per calendar year. Gather all necessary information and documents, such as your insurance information, prescription details, and any supporting documentation. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3 program consisting of two pivotal trials About 75,000 adults in the U. Dupixent MyWay pays the $500 copay. How many people live in your household? _____ Please refer to Section 8, Patient Certifications , for. They are a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI. VO: DUPIXENT is a prescription medicine used: to treat people aged 6 years and older with moderate-to-severe atopic dermatitis (eczema) that is not well controlled with prescription therapies used on the skin (topical), or who cannot use topical therapies. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. 67 mL, 200 mg/1. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. “Eczema otherwise unspecified” is not indicated for Dupixent. Especially tell your healthcare provider if you. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. Fill out sections 5a and 5b completely to determine patient eligibility. 02. Enroll eligible patients in the DUPIXENT MyWay® patient support program for DUPIXENT® (dupilumab) access, financial assistance & nursing support. Ways to save on Dupixent. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. Serious side effects can occur. 99% of commercial patients (6+ months of age) nationally are covered for DUPIXENT. a Coverage varies by type and plan. I just started this week so I look forward to seeing the results. Patients may be eligible for the DUPIXENT MyWay Copay Card if: They have a DUPIXENT prescription for an FDA-approved condition. Eligible clients will receive their cards by email. 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). ithdrawal of this Authoriation will end my participation in the DUPIXENT MyWay Program and will not aect any disclosure of My Information ased on this Authoriation made efore my reuest is received and processed y my ealthcare Providers, ealth Insurers, and Specialty Pharmacies. 2 pens of 300mg/2ml. But either way, after you or Dupixent myway meets your deductible, it should be free to you. Well at a cost of roughly $3,500/dose which lasts a month, that will all be used up in four months. Follow these tips to take DUPIXENT while traveling: Store DUPIXENT in the original carton to protect it from light. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. My wife is on Dupixent, and has the MyWay card which allows up to $13,000/year. chevron_right. Program Website : Program Applications and Forms will need to meet the eligibility criteria, including household income, to qualify. Click Tap to Learn More In an open-label extension study, the long-term safety profile of DUPIXENT ± TCS in pediatric patients observed through Week 52 was consistent with that seen in adults with atopic dermatitis, with hand-foot-and-mouth disease and skin papilloma (incidence ≥2%) reported in patients 6 months to 5 years of age. If you don’t have health insurance, talk. Also if your insurance does cover,Dupixent offers a co-pay card that. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not 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) Section 5a. DUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process. And I would experience blurry vision, red and itchy eyes. Learn how DUPIXENT® (dupilumab) works as the first and only FDA-approved treatment for prurigo nodularis (PN) in adults aged 18 years and older. 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. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. $0!!!!! On April 6 I sent them income paperwork and my year to date prescription invoices. 23. DUPIXENT® is a prescription medicine used as an add-on maintenance treatment for uncontrolled moderate-to-severe eosinophilic or oral steroid dependent asthma in people aged 6 years and older. Do you think that will hurt my chances of qualifying? I know my prescription drug costs are high enough. On dupixent, Dupilumab, I honestly felt I was in my 60 to 70s+ with joint pains throughout my entire body even into the smallest of joints like fingers. Prior authorization and appeals. Needed additional leadership equipped the enrollment process? Contact your section accessories dedicated or call DUPIXENT MyWay. When filling out the DUPIXENT MyWay Enrollment Form, both you and your patient will be required to supply information, such as the patient’s insurance, diagnosis, and prescription. Even when using the Copay Card, that would cover only cover 4 months worth, and would not go towards my deductible, totaling about. Dupixent may cause serious side effects. Dupixent® should be given by or under the supervision of an adult in children 12 years of age and older. E. who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay ® program. Please see Important Safety Information and Prescribing Information and Patient Information on website. The patient must then take the following actions:I just got approved for dupixent this week however the copay is 3,000$ a month! The dupixent my way program only covers up to 13k or something like that. DUPIXENT (dupilumab) Dupixent FEP Clinical Criteria AND submission of medical records (e. 14 mL, or 300 mg/2 mL)Section 5a. • DUPIXENT can be stored at room temperature up to 77°F (25°C) up to 14 days. O. Especially tell your healthcare provider if you. It is not an immunosuppressant or a steroid. 78 L) was seen at Week 2 in patients taking DUPIXENT 200 mg Q2W + SOC (n=264) (baseline blood EOS ≥300 cells/μL, QUEST, secondary endpoint). For more information or to enroll in the patient support program, contact us at: 1‑844‑DUPIXENT 1-844-387-4936 Monday-Friday, 8 am-9 pm ET. Decreased exacerbations and/or improvement in symptoms 2. A 48-year-old man developed left thumb tenderness and bilateral Achilles tendinopathy after 6 weeks of Dupixent. These programs and tips can help make your prescription more affordable. So, let's just pretend the total cost is $1,000/month. If you are a New York prescriber, please use an original New York. The majority of DUPIXENT patients with commercial/employer-provided insurance use the DUPIXENT MyWay ® Copay Card. com. Dupixent side effects. This year the program seems to have changed, requiring a separate 'copay card' with an annual limit of $13,000. Please see Important Safety Information and Prescribing Information and Patient Information on website. Eligible patients or caregivers of a patient must be: *For more information, dial 1-844-DUPIXENT 1-844-387-4936 option 5, Monday-Friday, 9 am - 9 pm ET. How much does Dupixent cost without insurance? The average monthly retail price of Dupixent is $4,910 per 2, 2 mL of 300 mg/2 mL prefilled syringes. How many people live in your household? _____ Please refer to. After that, it is taken as 1 injection every 2 weeks or every 4 weeks, depending on your age and weight. DUPIXENT® (dupilumab) is a. Share your form with others. For patients with commercial insurance who are new to DUPIXENT and experiencing a. It was granted and I pay $0. 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 MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. A 68-year-old woman developed generalized joint pain 6 weeks after starting Dupixent. Learn about DUPIXENT® (dupilumab) for moderate-to-severe asthma treatment. 2 cartons. 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). March 29, 2018. Food and Drug Administration has approved Dupixent ® (dupilumab) as an add-on maintenance therapy in patients with moderate-to-severe asthma aged 12 years and older with an eosinophilic phenotype or with oral corticosteroid-dependent asthma. DUPIXENT use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Serious side effects can occur. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. 09. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. . These programs and tips can help make your prescription more affordable. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. Rx: DUPIXENT® (dupilumab) (100 mg/0. 98% of Commercially Insured Patients. If you still have questions, you can speak with a DUPIXENT MyWay or request to join the program over the phone. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. 2 cartons. J Allergy Clin Immunol Pract. 01. 09. 25%) Taro Pharma patient access. Pregnancy: A pregnancy exposure registry monitors pregnancy outcomes in women exposed to DUPIXENT during pregnancy. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. DUPIXENT® (dupilumab) is indicated as an add-on maintenance treatment in adult patients with inadequately controlled chronic rhinosinusitis with nasal polyposis (CRSwNP). Patient assistance program. If requested, I agree to provide proof of income within thirty (30) days of the request. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. a ®® ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pm600 mg (two 300 mg injections) 300 mg Q4W : 30 to less than 60 kg ; 400 mg (two 200 mg injections) 200 mg Q2W : 60 kg or more : 600 mg (two 300 mg injections)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. 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 programs, or other 4 ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pm This will allow the specialty pharmacy to conduct the benefits investigation, and DUPIXENT MyWay will provide additional support to the patient. You may be eligible for the DUPIXENT MyWayDUPIXENT MyWayAbout Dupixent Dupixent is administered as an injection under the skin (subcutaneous injection) at different injection sites. I suppose it doesn't really matter now. Social Security income, unemployment insurance benefits, disability income, any other income for the household. The formulary status tool below can help check DUPIXENT coverage for various plans. 23. 14 mL, or 300 mg/2 mL)The Dupixent MyWay program is not available to medicare patients. 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. Have commercial insurance, including health insurance. DUPIXENT is available as a single dose in a pre-filled syringe (200 mg or 300 mg) with needle shield, or single-dose pre-filled pen (200 mg or 300 mg) for ages 2+ years. Patient to Fill Out. DUPIXENT® (dupilumab) Prescription Information Quick Start may be able to provide DUPIXENT at no cost to help bridge patients to therapy if there is a coverage delay. DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older, with uncontrolled, moderate-to-severe eczema (atopic dermatitis). For me, the side effects didn’t really bother me or have me second guess my decision with Dupixent because my skin was. 58 for 1. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. 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. (DUPIXENT + Topical Corticosteroids (TCS) vs TCS only): CLEAR OR ALMOST CLEAR SKIN AT 16 Weeks 39% taking DUPIXENT + TCS vs 12% using TCS only. Sign up for the DUPIXENT MyWay® mentor program for adults with uncontrolled chronic rhinosinusitis with nasal polyposis that is associated with type 2 inflammation. Copay Card or you wish to discontinue your participation, please contact us. There is currently no generic alternative to Dupixent. For more information, call 1. Required if enrolling in the DUPIXENT MyWay. Dupixent is currently approved in the U. Dupixent is not intended for episodic use. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. 10 for placebo; difference between Dupixent and placebo: -2. At this rate, I will no longer be able to afford the medication very soon. Want to be a part of the DUPIXENT MyWay® Ambassador Program? Fill out this self-nomination form to see if you qualify. for DUPIXENT® dupilumab therapy My Information. 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. Surgery may remove your nasal polyps, but it may not treat an underlying cause of inflammation—allowing them to grow back. DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. For more information, please call 1-844-DUPIXENT (1-844-387-4936) or visit . Eczema. 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. SINCE 2017, ≈253,000 PATIENTS HAVE FILLED AT LEAST 1 DUPIXENT PRESCRIPTION b,c. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. 1-844-387-4936 (toll free) Monday - Friday, 8AM - 9PM (ET) Multilingual options available. Coverage varies by type and plan. After that, we will have met our family deductible. Dupixent. who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay® program. First few months into taking Dupixent, I got laid off and worked w my doctors/Dupixent to get assistance. DUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process. S. I knocked out the first copay out of pocket and went on the manufacturer website and applied for the dupixent my way card. Sign up or activate your card here. Patient is responsible for any out-of-pocket amounts that exceed the program limit. Do not store DUPIXENT pre-filled syringes at room temperatures more than 77°F (25°C) Do not keep DUPIXENT at room temperature. Dupixent is indicated for the following type 2 inflammatory diseases:,Atopic Dermatitis,Adults and adolescents,Dupixent is indicated for the treatment of moderate to severe atopic dermatitis in patients aged 12 years and older who are candidates for chronic systemic therapy. With and DUPIXENT MyWay Copay Card, eligible, commercially insured care may pay when little as $0* copay by fill the DUPIXENT. To enroll or obtain information call 1-877-311. Patient Signature _____ If you have questions about the . When I was very young, I knew that I wanted to be a nurse. It's like $35k-$40k. 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. For assistance, please call 1-844-468-2252 Monday Friday, 8AM to 8PM ET. Clip the card and save • Save up to 80% on medications* Tell your healthcare provider about any new or worsening joint symptoms. living with prurigo nodularis are most in need of new treatment options . Get a Quick Start. With the DUPIXENT MyWay Copay Card, eligible,. How do my patients enroll in <em>DUPIXENT MyWay®</em>? When filling out the DUPIXENT MyWay Enrollment Form, both you and your patient will be required to. 14 mL Dupixent subcutaneous solution from $3,787. Monday-Friday, 8 am - 9 pm ET I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay, and that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. How many people live in your household? _____ Please refer to. Serious side. Compare . Last time I checked income didn’t matter? The only way it became affordable for me was to get the deluxe package of my insurance. Dupixent inhibits the overactive signaling of interleukin-4 (IL-4) and. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. and other countries to treat several diseases driven by type 2 inflammation. 67 mL, 200 mg/1. DUPIXENT® is indicated as an add-on maintenance treatment of adult and pediatric patients 6 years and older with moderate-to-severe asthma characterized by an eosinophilic phenotype or with oral corticosteroid dependent asthma. Income at or below: Not Published: Medical expenses can be deducted from reported income:. ( 1-844-387-4936 ), option 1. At that point we will owe 20% of the cost of the medication, which adds up to just under $700/month. 14 mL; and 300 mg per 2 mL. Please complete the form, sign, and FA to 1-844-23-312. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. Hello! Switching insurance this year and need to prepare for increasing costs of dupixent with my new insurance. Dupixent MyWay Program Dupixent (dupilumab injection). 2 pens of 300mg/2ml. Depends if your insurance cares that Dupixent myway is paying your deductible. Financial criteria for patient assistance. - Rachel, DUPIXENT Patient Mentor, living with asthma. including household income, to qualify. Fill out sections 5a and 5b completely to determine patient eligibility. DUPIXENT® (dupilumab) Prescription Information Quick Start may be able to provide DUPIXENT at no cost to help bridge patients to therapy if there is a coverage delay. 67 mL, 200 mg/1. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. . It was a process to get into the patient assist program. I wanted to go out and make a difference and help people. This DUPIXENT Pre-filled Pen is a single-dose device. So, even with a "prior authorization" and a "formulary override", the cost to me is $2900 per month, or about $1450. The DUPIXENT MyWay nurse connects patients to a variety of considerate resources, including one-on-one nursing product, financial assistance for right patients, and helpful refill and injection reminders. And very recently got laid off due to Covid-19. How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. Support. for DUPIXENT® dupilumab therapy My Information. Do NOT shakeConoce las dos opciones de administración disponibles: jeringa precargada de 200 mg y 300 mg, y pluma precargada de 200 mg y 300 mg (para edades de 12 años o más), y revisa cómo inyectar DUPIXENT® (dupilumab), un medicamento para inyección subcutánea, de venta con receta, para el eczema moderado a grave en adultos y niños de 6 meses o más. ) Please refer to Section 8, Patient Certifications, for. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will notEnrollment 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. DUPIXENT should not be stored above 77 °F (25 °C). They will begin the benefits investigation and inform your office of the next steps. 58 for 2. Tell your healthcare provider about any new or worsening joint symptoms. g. There is another biologic very similar to Dupixent called Adbry.