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. 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. Dupixent Myway . Enroll now to receive emails and resources designed to help patients, caregivers and information seekers through the DUPIXENT® (dupilumab) treatment journey. QUEST (12+ years) DUPIXENT offers rapid breathing relief patients can feel as early as Week 2. I just got approved thru Dupixent my way for a year of free medication. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. ) Please refer to Section 8, Patient Certifications, for. 23. Dupixent will run about $3000 per month with my insurance until my maximum is met. Watch videos from experts [,download materials,] and explore future events to further understand DUPIXENT® (dupilumab). DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. It temporarily provides eligible patients DUPIXENT at no cost, subject to program terms and conditions. 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. 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. 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. Pay as little as $0 per month. Base amount is $558. Coverage varies by type and plan. Box 5925 Mailstop 55A-220A Bridgewater, NJ 08807. Eligible US residents with an FDA-approved prescription for DUPIXENT may pay as little as $0 copay per fill of DUPIXENT (annual maximum of $13,000). who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay ® program. 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. 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. 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. Patient to Fill Out. $0!!!!! On April 6 I sent them income paperwork and my year to date prescription invoices. 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. I don't know what medical issues your son is having, but it's likey autoimmune issues. I’ve been with DUPIXENT MyWay since the very beginning. 14 mL, or 300 mg/2 mL)The average cash price for a 30-day supply of Dupixent is $5,298. Rx: DUPIXENT® (dupilumab) (100 mg/0. At one point, I was getting cold sores every 2 to 3 weeks consistently. Decreased exacerbations and/or improvement in symptoms 2. For more information and to find out if you’re eligible for support, call 844-DUPIXENT (844-387-4936) or visit the program website. 1-844-DUPIXENT 1-844-387-4936. Fill out sections 5a and 5b completely to determine patient eligibility. out and fax back to DUPIXENT MyWay at 1-844-387-9370 • You or your specialist can call 1-844-DUPIXEN(T), option 1 • Providing your email address allows DUPIXENT MyWay to give you more support resources about DUPIXENT. . Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will notDUPIXENT MyWay may ask for proof of income at any time for the purpose of audit/verification. 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. 00. Normally my copay would be about $970 per refill, but with about 12 refills per year this does not max out the Dupixent MyWay copay card. 67 mL, 200 mg/1. I suppose it doesn't really matter now. PRESCRIBER TO FILL OUT 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) Complete the entire form and submit pages 1-3 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 Enrollment Form FOR ALLERGISTS Using a mail-order specialty pharmacy might help lower the monthly cost of Dupixent. Patient Signature _____ If you have questions about the . Dupixent is indicated for the treatment of severe atopic dermatitis in patients aged 6 to 11Dupilumab. 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. Nurse Educators Nurse Educators offer one-on-one support to help patients start and stay on track with therapy. DUPIXENT® (dupilumab) is a subcutaneous injectable medication used in the treatment of patients aged 6 years and older with uncontrolled moderate-to-severe atopic dermatitis with two delivery options available, pre-filled syringe & pre-filled pen (aged 12+ years). 5. Serious side effects can occur. Advertisement. They never mentioned only covering a. DUPIXENT MyWay ENROLLMENT FORMS; English Enrollment Form. 0156 Last Update: March 2023 DUP. Share your form with others. Rx: DUPIXENT® (dupilumab) (100 mg/0. For more information, call 1-844-DUPIXENT. I was given the MyWay copay card but it had a limit of $13,000/calendar year and that has been exhausted at this point. 23. I wanted to go out and make a difference and help people. And I would experience blurry vision, red and itchy eyes. A quantity of Dupixent will be considered medically necessary if the above criteria are met, as indicated in the table below:. If I am completing Section 5b, I authorize for my commercially insured patient one. With the DUPIXENT MyWay Copay Card, eligible,. 00 per injection. Dedicated Dupixent MyWay Case Managers can explain information related to Dupixent. Patient is responsible for any out-of-pocket amounts that exceed the program limit. Serious side effects can occur. DUPIXENT MyWay®. 67 mL Dupixent subcutaneous solution from $3,787. Copay Card or you wish to discontinue your participation, please contact us. For more information, call 1. I’m a registered nurse with DUPIXENT MyWay. 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. Patient assistance program. 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. Clip the card and save • Save up to 80% on medications* Tell your healthcare provider about any new or worsening joint symptoms. Continuation in the DUPIXENT MyWay Patient Assistance Program is conditioned upon timely verification of income. 0156 Past Update: March 2023 DUP. $0 is the amount you pay. LONG-LASTING CLEARER SKIN AT 16 and 52 Weeks 22% taking. It's like $35k-$40k. How many people live in your household? _____ Please refer to. Dupixent changed my life completely. any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. March 27, 2018. In this case Dupixent myway will cover the first 13k, which is probably like 5 months. 4. 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. DUP. 1‑844‑DUPIXENT 1-844-387-4936. 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. If you are a New York prescriber, please use an original New York State prescription form. Type text, add images, blackout confidential details, add comments, highlights and more. 28. 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. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. Dupixent is administered as an injection under the skin (subcutaneous injection) at different injection sites. The majority of DUPIXENT patients with commercial/employer-provided insurance use the DUPIXENT MyWay ® Copay Card. Support. 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. Learn more about programs for eligible patients who are insured, underinsured, and uninsured. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Rx: DUPIXENT® (dupilumab) (100 mg/0. If requested, I agree to provide proof of income within thirty (30) days of the request. Get ongoing, personalized nursing support; help scheduling monthly prescription refills and deliveries; and in-home, in-office, or online supplemental injection training. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will notOnce you’ve been prescribed DUPIXENT, your healthcare provider can download the enrollment form, help you fill it out, and fax it back to DUPIXENT MyWay at 1-844-387-9370. Does anyone know of any assistance programs I can use to help assist in the copay after dupixent my way limit is reached?33% and 27% reduction in their nasal polyps score compared to a 7% and 4% increase with placebo in SINUS-24 and SINUS-52, respectively (LS mean change from baseline of -1. 2 Eligible US residents with an FDA-approved prescription for DUPIXENT may pay as little as $0 copay per fill of DUPIXENT (annual maximum of $13,000). The DUPIXENT MyWay program also provides useful tools and resources to help you stay on track with your treatment. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Eligible patients will receive their cards by email. Long-term results from a clinical trial that studied DUPIXENT for 52 weeks. 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. 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. With the DUPIXENT MyWay Copay Card, eligible,. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not affect any disclosure of My Information based on 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. 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. To enroll or obtain information call 1-877-311. Dupixent MyWay Program Dupixent (dupilumab injection). with household income, to qualify. The formulary status tool below can help check DUPIXENT coverage for various plans. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. 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, The DUPIXENT MyWay Copay Card Program includes the Copay Card, the Debit Card, and any direct patient rebate, and has a combined annual maximum benefit of $13,000 per patient per calendar year. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. . If you’re the spouse or. Fill out sections 5a and 5b completely to determine patient eligibility. Program Website : Program Applications and Forms will need to meet the eligibility criteria, including household income, to qualify. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. 67 mL, 200 mg/1. Serious adverse reactions may occur. For more information or to enroll in the patient support program, contact us at: 1‑844‑DUPIXENT. This copay card may be for you if you. You have to game the system instead of trying to get full coverage. will need to meet the eligibility criteria, including household income, to qualify. In a clinical trial at 16 weeks in teens (aged 12-17 years) taking DUPIXENT* when used alone compared to teens not taking DUPIXENT: Clearer skinSAW CLEAR or Almost clear SKIN 24% vs 2% not taking DUPIXENT (placebo) nOTICEABLY LESS ITCHEXPERIENCED ITCH 37% vs 5% not taking DUPIXENT (placebo) ≥75%SKIN. Edit your dupixent myway enrollment form online. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. From my understanding, the Dupixent MyWay Program pays the $125 since your insurance is covering the rest. The patient must then take the following actions:I just got approved for dupixent this week however the copay is 3,000$ a month! The dupixent my way program only covers up to 13k or something like that. 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. Fill a 90-Day Supply to Save. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. PRESCRIBER TO FILL OUT 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) Education and Nurse Support: One-on-one nursing support is available to educate and empower patients to use DUPIXENT as prescribed. At that point we will owe 20% of the cost of the medication, which adds up to just under $700/month. Refrigerate it at 36 °F to 46 °F. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Learn why DUPIXENT® (dupilumab) may be an. 18, 0. 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. Oct 26, 2022 · Dupixent MyWay Program Enrollment Form for Allergists (AD, Asthma, CRSwNP). Human IgG antibodies are known to cross the placental barrier; therefore, DUPIXENT may be transmitted from the mother to the developing fetus. 58 for 2. Regeneron and Sanofi are committed to helping patients in the U. DUPIXENT® (dupilumab) is a prescription medicine FDA-approved to treat five conditions. The language of the MyWay program back then never mentioned the $13,000 limit: they simply asked for income requirements, etc. 06 and -1. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. DUPIXENT MyWay Ambassador. DUPIXENT® ® 1-844-387-9370 or Document Drop at (code: 8443879370) 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. The formulary status tool below can help check DUPIXENT coverage for various plans. For any questions or concerns, or to report side effects with a Sanofi and Regeneron product while enrolled in DUPIXENT MyWay®, please contact 1-844-DUPIXEN(T) (1-844-387-4936) Option 1, Monday–Friday, 8 am–9 pm Eastern time. 2. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. For more information, call 1-844-DUPIXENT ( 1-844-387-4936) option 1. if speciality. How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. I was given the MyWay copay card but it had a limit of $13,000/calendar year and that has been exhausted at this point. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. If you are a New York prescriber, please use an original New York State. 0156 Past Update: March 2023 DUP. Find videos and downloadable instructions for the two injection administration options available for DUPIXENT® (dupilumab), pre-filled syringe (200 mg or 300 mg) with needle shield for ages 6 months & older, or pre-filled pen (200 mg or 300 mg) for ages 2+ years. And very recently got laid off due to Covid-19. including household income, to qualify. 80). 23. It temporarily provides eligible patients DUPIXENT at no cost, subject to program terms and conditions. Do you think that will hurt my chances of qualifying? I know my prescription drug costs are high enough. I wanted to go out and make a difference and help people. 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. 14 mL, or 300 mg/2 mL)Section 5a. 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. Section 5a. Appears that my out of pocket maximum will be $8000 through insurance. It may be covered by your Medicare or insurance plan. ( 1-844-387-4936 ), option 1. DUPIXENT can be used with or without topical corticosteroids. Social Security income, unemployment insurance benefits, disability income, any other income for the household. living with prurigo nodularis. BIN: 020750 RX PCN: NMeds RX GRP: PDFPDF ID: NMNA019309901930 This is a drug discount program, not an insurance plan. It’s a change in how copay assistance and coupons are counted toward your. With MyWay, I get the year for free. The increase was approved by the Minnesota Legislature and will help expand SNAP eligibility to families who may have previously been ineligible for the. Dupixent MyWay Program CONTACT INFO: Address:, Phone: 1-844-387-4936: Provider Phone: Fax: 1-844-387-3970: Website: Program Website: ELIGIBILITY Eligibility Info:. Access the dupixent reimbursement form either online or through your healthcare provider. 5011 XXX X < M A T > 00000 0 300 mg/ 2 m L Look at theFull Prescribing Information: Patient Information: Learn more about DUPIXENT: Thanks for c. LEARN ABOUT OUR PATIENT SUPPORT PROGRAM. 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). 22. Serious side effects can occur. Please see accompanying full Prescribing Information. Eligible commercially insured patients may pay $0 per prescription with a maximum savings of $13,000 per year; for additional information contact the program at 844-387-4936. What it is used for. The DUPIXENT MyWay patient support program is here to help you at every step of your DUPIXENT treatment journey. PRESCRIBER TO FILL OUT Section 6a. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may payable as little while $0* copay per fill by DUPIXENT. Experience: Been on Dupixent since May 15, 2017. I have applied for grants, financial hardships (my household income surpasses every programs caps, even with 6 children), etc and now I'm just being told to pay $3,000/month or too bad. For any questions or concerns, or to report side effects with a Sanofi and Regeneron product while enrolled in DUPIXENT MyWay®, please contact 1-844-DUPIXEN(T) (1-844-387-4936) Option 1, Monday–Friday, 8 am–9 pm Eastern time. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. A group of skin conditions characterized by skin inflammation, rash, and itch. For more information, call 1. 1, 2022, the gross income limit for Supplemental Nutrition Assistance Program (SNAP) eligibility in Minnesota increased from 165% to 200% of the federal poverty line for most households. · If the insurer does have a copay accumulator in place: the insurer pays the entire cost of the refill except for $500. ®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. 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. About Dupixent. Patient Signature _____ If you have questions about the . Check the liquid in the prefilled pen or syringe. Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. I. The most common side effects include: DUPIXENT MyWay. DUPIXENT MyWay®. 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. LEARN ABOUT OUR PATIENT SUPPORT PROGRAM. 01. 0254 Last Update: February 2023 DUP. Data on file, Regeneron Pharmaceuticals, Inc. The patient would prefer not to try. Please see Important Safety Information and Patient Information on. 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 Enrollment FormYes, it does appear that Dupixent can cause weight gain, although this is not listed as a side effect in the product information. Children 6 to 11 years of age . 98% of Commercially Insured Patients. 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. With of DUPIXENT MyWay Copay Card, right, commercially insured patients might pay as little as $0* copay per fill of DUPIXENT. United Healthcare covers it but I get insurance through my employer and it was a huge pain to get approved. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. DUPIXENT . DUPIXENT® (dupilumab) is a. Patient is responsible for any out-of-pocket amounts that exceed the program limit. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. 2 cartons. S. ago It is actually not a change in the myway program. You don’t have to put your life on hold to fit your dosing schedule. Be sure to fill out your enrollment form completely and accurately. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. Each time you fill your DUPIXENT prescription, please ensure your. Pay as little as $0 per month. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. Connect with someone, ask questions, and learn about their experience with DUPIXENT® (dupilumab) treatment. Fill out sections 5a and 5b completely to determine patient eligibility. For any questions or concerns, or to report side effects with a Sanofi and Regeneron product while enrolled in DUPIXENT MyWay®, please contact 1-844-DUPIXEN(T)(1-844-387-4936) Option 1, Monday–Friday, 8 am–9 pm Eastern time. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not affect any disclosure of My Information based on1-844-DUPIXENT 1-844-387-4936. Dupixent. For more information and to find out if you’re eligible for support, call 844-DUPIXENT (844-387-4936) or visit the program website. There is another biologic very similar to Dupixent called Adbry. 01. S. And I would experience blurry vision, red and itchy eyes. Call 1-844-387-4936 SUMIT COMPLETED PAGES 1 2 Fax: 1-844-387-9370 MF, 8am9pm ET Document Drop: (code: 8443879370) Patient Name DO / / Prescriber Name Prescriber AddressDupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. Dedicated Dupixent MyWay Case Managers can explain information related to Dupixent. Maximum benefit (2023) = $1,483. Dupixent® (dupilumab) approved by FDA as the first and only treatment indicated for prurigo nodularis Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3. For patients with commercial insurance who are new to DUPIXENT and experiencing a. DUPIXENT is a prescription medicine used as an add-on maintenance treatment for adults and children 6 years of age and older who have moderate-to-severe eosinophilic or oral steroid dependent asthma that is not controlled with their current asthma medicines. Decreased utilization of rescue medications 3. 80). 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. Additionally, Dupixent MyWay ™ offers personalized support from registered nurses and other specialists who are available 24/7 to speak with patients and help them navigate the complex insurance. 01. And, if you're eligible, you can sign up and receive your card today. Serious side effects can occur. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. DUPIXENT should not be stored above 77 °F (25 °C). 14 mL, or 300 mg/2 mL)The Dupixent MyWay program is not available to medicare patients. financial assistance for eligible patients, provide one-on-one nursing. • Store DUPIXENT in the refrigerator at 36°F to 46°F (2°C to 8°C). After that, it is taken as 1 injection every 2 weeks or every 4 weeks, depending on your age and weight. you offering to give them $170 they assumed you didn’t want to bother contacting dupixent myway. He continued with Dupixent and his symptoms had partially improved 24 weeks after their onset. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. Get a Quick Start. Ways to save on Dupixent. Approval represents the second dermatology indication for Dupixent and fifth disease indication overall in the. comfysnail • 1 yr. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. - Rachel, DUPIXENT Patient Mentor, living with asthma. Dupixent inhibits the overactive signaling of interleukin-4 (IL-4) and. It's like $35k-$40k. You may be able to get a 90-day supply of Dupixent. Manufacturer Coupon. In patients aged 6 months to 5 years, Dupixent is administered with a pre-filled syringe every four weeks based on weight (200 mg for children ≥5 to <15 kg and 300 mg for children ≥15 to <30 kg). Sign it in a few clicks. How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. 23. Effective Sept. Especially tell your healthcare provider if you. DUPIXENT MyWay® is a patient support program designed to help you get access to DUPIXENT and help eligible patients cover the out-of-pocket costs of DUPIXENT. • DUPIXENT can be stored at room temperature up to 77°F (25°C) up to 14 days. The fax number is 1. DUPIXENT is not a steroid or immunosuppressant; it is a prescription biologic medicine given under the skin (subcutaneous injection). S. 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. 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) 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. Dupixent is not intended for episodic use. for DUPIXENT® dupilumab therapy My Information. Your insurance has to deny twice and then you can apply for patient assistance. Continuation in the program is conditioned upon timely verification of income. Although you are not eligible, you can sign up DUPIXENT MyWay. 8K subscribers in the eczeMABs community. 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. DUPIXENT MyWay team will research each patient’s situation and determine eligibility. 2017;5 (6):1519-1531. The DUPIXENT MyWay team will research each patient’s situation and determine eligibility. Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. 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. 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 . Just got off the phone with Dupixent My Way. Financial criteria for patient assistance. DUPIXENT is not used to treat sudden breathing problems. Prior authorization and appeals. 00, but I do have some money invested. THE DUPIXENT MyWay COPAY CARD. According to the manufacturers, Dupixent can be dosed to a maximum daily dose as indicated below. 99% of commercial patients (6+ months of age) nationally are covered for DUPIXENT. Type text, add images, blackout confidential details, add comments, highlights and more. “It’s an incredible feeling to be validated and. Household Size. Option 1- you have to meet your deductible without Dupixent myway. It took the price from 2K to 1K. But either way, after you or Dupixent myway meets your deductible, it should be free to you. J Allergy Clin Immunol Pract. Eligible patients covered by commercial health insurance may pay as little as a $0 p copay per fill of DUPIXENT. 58 for 1. 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. DUPIXENT MyWay. March 27, 2018. For me, the side effects didn’t really bother me or have me second guess my decision with Dupixent because my skin was. 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. How to fill out dupixent reimbursement: 01. We'll keep those "Instructions for Use" nearby and then lay the pre-filled syringe on a flat surface and let it naturally warm at a room temperature of less than 77°F (25°C). (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Data from DUPIXENT ® clinical trials have shown that IL-4 and IL-13 are key drivers of the type 2 inflammation that plays a major role in asthma, atopic. Got off of it as soon as I realized it was getting worse with every shot after spacing them out every other month. DUPIXENT was studied in adults and children 6 months of age and older. If you don't have insurance at all, the only realistic option is to qualify for income-based help from Dupixent directly. 67 mL, 200 mg/1. 17 and 0. 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 otherThis DUPIXENT Pre-filled Pen is only for use in adults and children aged 2 years and older. ®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 Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program.