It’s a change in how copay assistance and coupons are counted toward your. DUPIXENT can be used with or without topical corticosteroids. 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. Oct 26, 2022 · Dupixent MyWay Program Enrollment Form for Allergists (AD, Asthma, CRSwNP). Continuation in the program is conditioned upon timely verification of income. 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. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. 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. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. financial assistance for eligible patients, provide one-on-one nursing support, and more. Learn more about programs for eligible patients who are insured, underinsured, and uninsured. E. 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. S. Hear from DUPIXENT® (dupilumab) patients & caregivers of patients 6 years and older with uncontrolled moderate-to-severe atopic dermatitis & healthcare professionals who treat atopic dermatitis, download helpful resources & explore future events. chevron_right. I’m a registered nurse with DUPIXENT MyWay. My income is only 30000. When I was very young, I knew that I wanted to be a nurse. ®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. For more information and to find out if you’re eligible for support, call 844-DUPIXENT (844-387-4936) or visit the program website. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of. 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. 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. Especially tell your healthcare provider if you. There is another biologic very similar to Dupixent called Adbry. 14 mL; and 300 mg per 2 mL. 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. Learn how DUPIXENT helped treat children 6 to 11 years old with their moderate-to-severe asthma. Serious adverse reactions may occur. 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. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. About 75,000 adults in the U. 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. Sign up to connect with a DUPIXENT MyWay® mentor to help patients with Nasal Polyps through their DUPIXENT. I’ve been with DUPIXENT MyWay since the very beginning. It contains 300 mg of DUPIXENT for injection under the skin (subcutaneous injection). Section 5a. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Option 1- you have to meet your deductible without Dupixent myway. Well at a cost of roughly $3,500/dose which lasts a month, that will all be used up in four months. 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. You must also meet certain household income eligibility requirements as outlined below: 48 States and DC. 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 prescription form. ENROLLMENT FORMDUPIXENT is a form of medicine called a biologic that targets Type 2 inflammation, an underlying cause of nasal polyps. 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® is a prescription medicine FDA-approved to treat five conditions. 23. Share your form with others. Susie16 Oct 15, 2023 • 9:37 PM. 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. DUPIXENT MyWay®. DUP. Nationally are Covered for DUPIXENT. 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. 4 ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pm 01. 02. My doctor gave me a copay card to cover mine. Upon receipt of the completed Enrollment Form, DUPIXENT MyWay will: Conduct a benefits investigation to confirm commercial coverage Assess if the patient meets the eligibility criteria for the Quick Start Program 1 2 Approve the patient (if they are eligible). Dupixent is currently approved in the U. And I would experience blurry vision, red and itchy eyes. With the Copay Card, You Could Pay as Little as $0 † The majority of DUPIXENT patients with commercial/employer-provided insurance use the DUPIXENT MyWay ® Copay Card. Copay Card or you wish to discontinue your participation, please contact us. Dupixent is not intended for episodic use. Self-nominate to become DUPIXENT MyWay® Ambassador, and if selected, you may have opportunities to share your story and offer encouragement to patients and their family members. DUP. March 27, 2018. Please see accompanying full Prescribing Information. Patient assistance program. $4,930. Eligible clients will receive their cards by email. living with prurigo nodularis are most in need of new treatment options . Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. 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 on a High Deductible Health Plan. They are a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. 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. DUPIXENT can be used with or without topical corticosteroids. 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. a FDA approved since 2017 for adults, 2019 for adolescents (aged 12‑17 years), 2020 for children (aged 6-11 years), and 2022 for infants to preschoolers (aged 6 months-5 years) with uncontrolled moderate‑to‑severe atopic dermatitis. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. 06 and -1. Continuation in the DUPIXENT MyWay Patient Assistance Program is conditioned upon timely verification of income. LONG-LASTING CLEARER SKIN AT 16 and 52 Weeks 22% taking. Check your eligibility for the DUPIXENT MyWay® Copay Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients. 67 mL, 200 mg/1. 67 mL, 200 mg/1. Fill out sections 5a and 5b completely to determine patient eligibility. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. 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). Share your form with others. Applies to: Dupixent Number of uses: per prescription per year. Dupixent inhibits the overactive signaling of interleukin-4 (IL-4) and. United Healthcare covers it but I get insurance through my employer and it was a huge pain to get approved. S. The $500 payment counts towards the member’s deductible and out-of-pocket maximum. 02. DUPIXENT MyWay team will research each patient’s situation and determine eligibility. Dupixent MyWay pays the $500 copay. 99% of commercial patients (6+ months of age) nationally are covered for DUPIXENT. Dedicated Dupixent MyWay Case Managers can explain information related to Dupixent. A group of skin conditions characterized by skin inflammation, rash, and itch. 00. 0kg. Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. 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. 4. 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. 0252 Last Update: Feb 2023 DUP. Hello! Switching insurance this year and need to prepare for increasing costs of dupixent with my new insurance. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. Not valid for prescriptions paid, in whole or in part, by Medicaid, Medicare, VA, DOD, TRICARE, or. Maximum Monthly Gross Income. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not affect any disclosure of My Information based onto DUPIXENT MyWay at 1-844-387-9370. 1,000-125=875 $875 is the amount your health insurance pays. Fill out sections 5a and 5b completely to determine patient eligibility. will need to meet the eligibility criteria, including household income, to qualify. There is currently no generic alternative to Dupixent. Serious side effects can occur. 58 for 1. 89 and -1. 0185 Last Update: November 2022 DUP. ) Please refer to Section 8, Patient Certifications, for. $3,645. 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. 38]). I'm "only" 61 now though on Dupixent MyWay copay help. Dupilumab. Access the dupixent reimbursement form either online or through your healthcare provider. It may be covered by your Medicare or insurance plan. Patients in each age group saw improved lung function in as little as 2 weeks. com, help you fill it out, and fax it back to DUPIXENT MyWay at 1-844-387-9370 • You or your healthcare provider can call 1-844-DUPIXEN(T), option 1 • Providing your email address allows DUPIXENT MyWay to give you more support resources about DUPIXENT HAS YOUR DOCTOR PRESCRIBED DUPIXENT ® (dupilumab)? 14 15. DUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process. *For patients on DUPIXENT 300 mg in a 24-week and a 52-week clinical trial vs 17% for placebo group. 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. 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. 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. 23. 71 for Dupixent compared to 0. For more information or to enroll in the patient support program, contact us at: 1‑844‑DUPIXENT. For more information, dial 1‑844‑DUPIXENT( 1-844-387-4936 ), option 1. Registered nurses are also available to speak with eligible patients about DUPIXENT. Connect with someone, ask questions, and learn about their experience with DUPIXENT® (dupilumab) treatment. Experience: Been on Dupixent since May 15, 2017. Get a Quick Start. In SINUS-24 and SINUS-52, 74% fewer patients required SCS use at Week 52 with DUPIXENT 300 mg Q2W + INCS compared to placebo + INCS (HR: 0. Especially tell your healthcare provider if you. 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. The DUPIXENT MyWay patient support program is here to help you at every step of your DUPIXENT treatment journey. 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 many people live in your household? _____ Please refer to. Your cost may depend on your treatment plan, your insurance coverage (if you have it), and the pharmacy you use. Get a Quick Start. DUPIXENT MyWay. Fill out sections 5a and 5b completely to determine patient eligibility. dupixent myway income guidelinesstellaris unbidden and war in heaven. Asthma: DUPIXENT is indicated as an add-on maintenance treatment of adult and pediatric patients aged 6 years and older with moderate-to-severe asthma characterized. 50 for a single person. Sign up or activate your card here. DUPIXENT MyWay Ambassador. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. My wife is on Dupixent, and has the MyWay card which allows up to $13,000/year. For more information, call 1-844-DUPIXEN (T) (1-844-387-4936. . Quantity Limits: Dupixent: 200 mg/1. In this case Dupixent myway will cover the first 13k, which is probably like 5 months. Step One - let's gather our materials. With the DUPIXENT MyWay Copay Card, eligible,. A 48-year-old man developed left thumb tenderness and bilateral Achilles tendinopathy after 6 weeks of Dupixent. Once 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. S. for reimbursement to any payer, including Medicare and Medicaid; and no free product may be sold, traded, or distributed for sale. 1kg over one year – the amount of weight gained ranged from 0. The DUPIXENT MyWay program also provides useful tools and resources to help you stay on track with your treatment. 1-844-DUPIXENT (1-844-387-4936) Topicort (desoximetasone spray 0. DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older, with uncontrolled, moderate-to-severe eczema (atopic dermatitis). 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 . 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. 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). 12. There is currently no generic alternative to Dupixent. Prior authorization and appeals. You may be able to lower your total cost by filling a greater quantity at one time. You may be able to lower your total cost by filling a greater quantity at one time. Compare . 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. Monday-Friday, 8 am - 9 pm ETto DUPIXENT MyWay at 1-844-387-9370. I suppose it doesn't really matter now. 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. Edit your dupixent myway enrollment form online. You can email or print the enrollment forms below. a,b a Data on file, Sanofi and Regeneron, US. 98% of Commercially Insured Patients. Maximum benefit (2023) = $1,483. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. DUPIXENT can cause serious side effects, including: The most common side effects in patients with eczema include. 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. For more informational, page 1‑844‑DUPIXENT (1-844-387-4936), option. Want to be a part of the DUPIXENT MyWay® Ambassador Program? Fill out this self-nomination form to see if you qualify. Injection Support Center Injection Reminders and Tips FREQUENTLY ASKED QUESTIONS; Español. This DUPIXENT Pre-filled Pen is a single-dose device. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. Fill a 90-Day Supply to Save. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. Dupixent Myway . The specialty pharmacy is responsible for securing coverage on my patient’s behalf. DUPIXENT can be used with or without topical corticosteroids. 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. DUPIXENT use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. 67 mL, 200 mg/1. Injection site reactions and eye conditions are the most common side effects reported and, unlike several other biologics, the risk of infection is low. A program called Dupixent MyWay is available for this drug. 2 cartons. THIS IS NOT INSURANCE. Injection in children 12 and older should be supervised by an adult. 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. 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. 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. I just spoke to someone through the MyWay Program. 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. How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. 03. Some Medicare plans may help cover the cost of mail-order drugs. 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. 6 Submitting a PA request The appeal. According to the manufacturers, Dupixent can be dosed to a maximum daily dose as indicated below. Serious side effects can occur. Appears that my out of pocket maximum will be $8000 through insurance. 23. 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. 18, 0. 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. 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. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. DUPIXENT MyWay®. 12. “It’s an incredible feeling to be validated and. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. 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. Please see accompanying full Prescribing Information. These programs and tips can help make your prescription more affordable. 23. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. 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 1‑844‑DUPIXENT 1-844-387-4936. 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. The DUPIXENT MyWay team will research each patient’s situation and determine eligibility. 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. was not paid in whole or in part by Medicare, Medicaid, or any federal or state programs. Fill out the form accurately and completely, providing all. 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. 0254 Last Update: February 2023 DUP. In addition, I agree to notify DUPIXENT MyWay if my insurance situation changes. DUPIXENT can be used with or without topical corticosteroids. It was granted and I pay $0. Check the liquid in the prefilled pen or syringe. 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 . 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. 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. Patients will need on hit the eligibility benchmark, including household income, to qualify. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. will not conduct a benefits verification. 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. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. So, how can you save? Manufacturer Sanofi offers Dupixent MyWay, a patient support program. 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. Rx: DUPIXENT® (dupilumab) (100 mg/0. It's like $35k-$40k. It may be covered by your Medicare or insurance plan. 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. Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. About Dupixent. Eligible patients covered by commercial health insurance may pay as little as a $0 p copay per fill of DUPIXENT. 01. Program Website : Program Applications and Forms will need to meet the eligibility criteria, including household income, to qualify. 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. 22. Serious side effects can occur. They pay the first $13K (in a year) then when that is exhausted I will have to pay around $250 per month and the $13K starts over in January 2019. How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. Guam or the USVI, and demonstrate a financial need with a total annual adjusted gross income of $100,000 or less. The increase was approved by the Minnesota Legislature and will help expand SNAP eligibility to families who may have previously been ineligible for the. Program Website : Patient Assistance Applications for DUPIXENT® dupilumab therapy My Information. For patients with commercial insurance who are new to DUPIXENT and experiencing a. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. 14 mL, or 300 mg/2 mL)Section 5a. for DUPIXENT® dupilumab therapy My Information. 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. Long-term results from a clinical trial that studied DUPIXENT for 52 weeks. Since 2017, Dupixent has increased in price by 13%. Decreased utilization of rescue medications 3. Fax the Enrollment Form to DUPIXENT MyWay. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. I. For more information, dial 1. The Dupixent MyWay program is not available to medicare patients. What it is used for. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. A 68-year-old woman developed generalized joint pain 6 weeks after starting Dupixent. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. $0!!!!! On April 6 I sent them income paperwork and my year to date prescription invoices. Caring. If necessary, DUPIXENT may be kept at room temperature up to 77 °F (25 °C) for a maximum of 14 days. S. DUPIXENT MyWay®. March 29, 2018. XXXX 00/0000 b y: A B C c o m pa n y, I n c. DUPIXENT use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. For more information and to find out if you’re eligible for support, call 844-DUPIXENT (844-387-4936) or visit the program website. Financial criteria for patient assistance. DUPIXENT® and DUPIXENT MyWay® are entered commercial of Sanofi Biotechnological. Since 2017, Dupixent has increased in price by 13%. You don’t have to put your life on hold to fit your dosing schedule. Fill out sections 5a and 5b completely to determine patient eligibility. chevron_right. Rx: DUPIXENT® (dupilumab) (100 mg/0. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. 06 and -1. 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. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. 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). I'm guessing this will not be allowed once I'm on Medicare. It temporarily provides eligible patients DUPIXENT at no cost, subject to program terms and conditions. Opinions clash over private equity’s effect on dermatology. 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. Also, make sure to store the DUPIXENT MyWay phone number in your phone’s contacts so you. BIN: 020750 RX PCN: NMeds RX GRP: PDFPDF ID: NMNA019309901930 This is a drug discount program, not an insurance plan. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. With the DUPIXENT MyWay Copay Card, eligible,. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. 8K subscribers in the eczeMABs community. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. 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 otherBy checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. 2 pens of 300mg/2ml. • Store DUPIXENT in the refrigerator at 36°F to 46°F (2°C to 8°C). 0129 Last Update:. It may be covered by your Medicare or insurance plan. who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay ® program. Fill a 90-Day Supply to Save. A case series of 12 people prescribed Dupixent reported an average weight gain of 6. Compare monoclonal antibodies. Dupixent. Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. ) I agree that Regeneron Pharmaceuticals, Inc. 10 for placebo; difference between Dupixent and placebo: -2. 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 consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. 01. DUPIXENT® (dupilumab) is a prescription medicine FDA-approved to treat five conditions. 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. 26 [95% CI: 0. and other countries to treat several diseases driven by type 2 inflammation. 3. For more information, please call 1-844-DUPIXENT (1-844-387-4936) or visit . You can email or print the enrollment forms below. For more information, call 1-844-DUPIXENT. 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. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. you offering to give them $170 they assumed you didn’t want to bother contacting dupixent myway.