Have commercial insurance, including health insurance. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. Even when using the Copay Card, that would cover only cover 4 months worth, and would not go towards my deductible, totaling about. An eDocument can be viewed as legally binding provided that certain requirements are satisfied. There is another biologic very similar to Dupixent called Adbry. facilitate the filling of my patient’s prescription; to assess, if applicable, my patient’s eligibility for patient assistance and other support programs; and to otherwise administer. 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. Please see Important Safety Information and Patient Information on website. Although you are not eligible, you can sign up DUPIXENT MyWay. Appears that my out of pocket maximum will be $8000 through insurance. Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat. Do not try to inject DUPIXENT until you have been shown the right way by your healthcare provider. You can be eligible for and DUPIXENT MyWay Copay Card if you:. 99% of commercial patients (6+ months of age) nationally are covered for DUPIXENT. See available events. Serious side effects can occur. Find DUPIXENT® (dupilumab) injection videos and instructions for the pre-filled syringe (200 mg or 300 mg) with needle shield for ages 6 months & older. Dupixent side effects. How possessed an annual upper of $13,000. patients cover the out-of-pocket cost of DUPIXENT. DUPIXENT Syringes can be stored at room temperature up to 77°F (25°C) up to 14 days. Send the completed form to: MyHealth@islandhealth. Eligible patients covered by commercial health insurance may pay as little as a $0 p copay per fill of DUPIXENT. Nationally are Covered for DUPIXENT. Option 1- you have to meet your deductible without Dupixent myway. The formulary status tool below can help check DUPIXENT coverage for various plans. Enroll eligible patients in the DUPIXENT MyWay® patient support program for DUPIXENT® (dupilumab) access, financial assistance & nursing support. Dupixent may cause serious side effects. I also have the dupixent myway card that covers a total of $13,000 for the year. medisafe. 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. DUPIXENT® (dupilumab) is a prescription medicine FDA-approved to treat five conditions. Serious side effects can occur. El dermatólogo de Ora nos capacitó sobre cómo colocar las inyecciones debajo de la piel y, luego, cuando nos comunicamos con DUPIXENT My Way, enviaron una enfermera a casa para que nos diera una capacitación adicional para asegurarse de que nos sintiéramos cómodos para colocarponiendo la inyección”. Indication. That took about a week. Most do, some don't. DUPIXENT can be used with or without topical corticosteroids. Discover clinical, histologic, and endoscopic results 1-3. In order to get my patient and her mother more comfortable with using a medication that’s an injection, I explained to them that injection therapy is not a new treatment. DUPIXENT MyWay® Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. After that, we will have met our family deductible. As noticed side effect, my eyes got dry and itchy which is still bearable. Most dermatologists should know about it. Atopic Dermatitis: The most common adverse reactions (incidence ≥1%) in patients are injection site reactions, conjunctivitis, blepharitis, oral herpes, keratitis, eye pruritus, other herpes simplex virus infection, dry eye, and eosinophilia. pain, redness, irritation, itching, or swelling of the eye, eyelid, or inner lining of the eyelid. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. insurer. Step 2: After washing your hands, clean the area you are going to inject with an alcohol wipe. Watch videos from experts [,download materials,] and explore future events to further understand DUPIXENT® (dupilumab). Please see Important Safety Information and Patient Information on. 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. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. Dupixent. Depends if your insurance cares that Dupixent myway is paying your deductible. Contact Phone Number: (604) 734-1313. 1-844-387-4936 (toll free) Monday - Friday, 8AM - 9PM (ET) Multilingual options available. Contact Regeneron for information about corporate communications, media relations, investor relations or business development. Patient assistance program. You must be shown the right way by your healthcare provider before injecting DUPIXENT. Serious side effects can occur. 1 Patient Information Please provide copies of front and back of all medical and prescription insurance cards. I’m ready to make a difference. Learn about the DUPIXENT® (dupilumab) mechanism of action inhibiting IL-4 and IL-13 signaling in appropriate asthma patients. If you are a New York prescriber, please use an original New York State prescription form. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUPIXENT Quick Start Program product to the patient named herein. Dupixent side effects. insurer. In children 6 months to less than 12 years of age, DUPIXENT should. 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 is a weekly single-dose injection that can be given by your doctor in an office or a clinic, or can be taken at home. Those who may qualify must be at least 18 years of age or older, a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI, and demonstrate a financial need. I y are a Ne r resrer, ease se a ra Ne r Sae resr r Te resrer s y ser sae-se resr rerees, s as e-resr, sae-se resr r, a aae, e N-ae sae-se rerees res rea e resrer. Program has an annual maximum of $13,000. Ready to connect with actual patients and caregivers being treated with DUPIXENT? The DUPIXENT MyWay Mentor Program helps put current and prospective moderate-to-severe eczema (atopic dermatitis or AD) DUPIXENT patients in contact with people going through similar. Serious adverse side effects can occur. Dupilumab, sold under the brand name Dupixent, is a monoclonal antibody blocking interleukin 4 and interleukin 13, used for allergic diseases such as eczema (atopic dermatitis), asthma and nasal polyps which result in chronic sinusitis. DUPIXENT MyWay. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Eligible patients will receive their cards by email. DUPIXENT MyWay® Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay®. 18, 0. Then you give the specialty pharmacy a call regarding the refill & give them the required insurance information and schedule a delivery. Eligible patients will receive their cards by email. WARNINGS AND PRECAUTIONS. DO NOT inject DUPIXENT into skin that is tender,Welp, got prescribed Dupixent. Product Monograph – DUPIXENT (dupilumab injection) Page 4 of 82 Asthma DUPIXENT is indicated as an add-on maintenance treatment in patients aged 12 years and older with severe asthma with a type 2/eosinophilic phenotype or oral corticosteroid-dependent asthma. . In children 12 years of age and older,I agre e to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. If your healthcare provider decides that you or a caregiver can give DUPIXENT injections, you or your caregiver should receive training on the right way to prepare and inject DUPIXENT. 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). INJECTION. During that time I experienced some injection site redness that appears 3 days after the injection and takes about 7-8 weeks to go away. com . That would be $3,400 and then the Dupixent MyWay card would pay that $3,400, I assume. To get patient-specific information about coverage for a drug, phone Health Insurance BC. Pay as little as $0 per month. *. Start Program product to the patient named herein. This copay card may be for you if you. Dupixent - Pay as little as $0 per month. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Insurance providers often require use of a specialty pharmacy instead of your local retail pharmacy. ”. Address: 4255 Laurel St, Vancouver, BC V5Z 2G9. Quitting my job and going back to school isn’t affordable option. Went to the dermatologist today and came clean on my over use of steroid topical that my Primary Dr. We work directly with your healthcare provider and will handle the full enrollment process on your behalf. x DUPIXENT Syringes can be stored at room temperature up to 77°F (25°C) up to 14 days. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not affect any disclosure of My Information based on this Authorization made before my request is received and processed by my Healthcare Providers, Health Insurers, DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. Deductible is at $3k out of pocket insurance pays 80% and at $6k insurance pays 100%. if you are allergic to dupilumab or to any of the ingredients in DUPIXENT®. Please see Important Safety Information. DUPIXENT 200 mg injections at different injection sites. Have commercial services, including health insurance markets,. DUPIXENT MyWay® can work with your insurance provider to identify a preferred, in-network specialty pharmacy. I chose to be a nurse because I wanted to help people, and I believe that people should be in service to others. Biopsy done and it’s eczema so back on dupixent. The DUPIXENT MyWay program also provides useful tools and resources to help you stay on track with your treatment. My itching was a 15 out of 10. How to get Prescription Assistance. ®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. Caring. DUPIXENT is a weekly single-dose injection that can be given by your doctor in an office or a clinic, or can be taken at home. DUPIXENT blocks the signaling of two key sources of Type 2 inflammation (IL-4 and IL-13). Dupixent will run about $3000 per month with my insurance until my maximum is met. Caring. I authorize the Alliance to use my Social Security number and/or additional. DUPIXENT, a biologic, is a type of medicine that is processed in the body differently than oral medicines (pills) or steroids. Serious side effects can occur. You must be shown the right way by your healthcare provider before injecting DUPIXENT. I'm an adult and I just started Dupixent yesterday. To get started: Contact your DUPIXENT MyWay Support Team for an C M ET DUPIXENT MYWAY ENROLLMENT FORM Moderate-to-Severe Atopic Dermatitis SUBMIT COMPLETED PAGES 1 & 2 Fax: 1-844-387-9370 Document Drop: (code: 8443879370) PRESCRIBER TO FILL OUT Section 6a. com. In children 12 years of age and older,For more information, dial 1‑844‑DUPIXENT ( 1-844-387-4936 ), option 1 Monday-Friday, 8 am - 9 pm ET. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing, state-specific. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing, state-specific. Reload page. If you are a New York prescriber, please use an original New York State prescription form. ®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 CONTRAINDICATION: DUPIXENT is contraindicated in patients with known hypersensitivity to dupilumab or any of its excipients. 2. chevron_right. In children 12 years of age and older,Dupilumab se usa para tratar el eczema (dermatitis atópica) de moderado a severo que no se puede controlar con medicamentos tópicos aplicados a la piel. , deductible and MOOP)? A7: Deductibles are established as a means of cost sharing with your plan sponsor while a MOOP is the most you will pay during a policy period. Helminth infections (5 cases of enterobiasis and 1 case of ascariasis) were reported in pediatric patients 6 to 11 years old in the pediatric asthma development program. I have done syringes for almost 2 years now, but started to get anxiety around the needle so switched to the pen in order to hopefully avoid that anxiety. insurer. Available. SIGN UP TO SPEAK WITH A DUPIXENT MyWay ® MENTOR . Here’s what you can expect from DUPIXENT MyWay: (1) Help getting DUPIXENT to you: We research and explain your insurance benefits to help you understand how the process works to get DUPIXENT. Education and Nurse Support: One-on-one nursing support is available to educate and empower patients to use DUPIXENT as prescribed. Eye pain, redness, irritation, or discharge with blurry or decreased vision. Have commercial insurance, including health insurance. Dupixent. Does that mean I'd be at ($9000-3,400. Please see Important Safety Information and Patient Information on website. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. This information will ONLY be used to validate your eligibility. web. Atopic Dermatitis: DUPIXENT is indicated for the treatment of adult and pediatric patients aged 6 months and older with moderate-to-severe atopic dermatitis whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable. TRANSFORM THE WAY YOU MANAGE EoE. Foradil Aerolizer - Save up to $120. When Dupixent is used to treat asthma, there are two possible starting dosages for adults and children ages 12 years and older. Ways to save on Dupixent. 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. Limitation of Use: Not for the relief of acute bronchospasm or status asthmaticus. For children aged 6 months to 5 years, it is taken as 1 injection every 4 weeks. 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. Please see Important Safety Information and Patient Information on website. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUPIXENT Quick Start Program product to the patient named herein. insurer. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. Although you are not eligible, you can sign up DUPIXENT MyWay emails about DUPIXENT below. DUPIXENT can be used with or without topical corticosteroids. 1 Disease severity was defined by an IGA score ≥3 in the overall assessment of atopic dermatitis. Step One - let's gather our materials. My recommendation is to find an expert to help. 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. Be sure to fill out your enrollment form completely and accurately. DUPIXENT® (dupilumab) is 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. Call 1-844-387-4936, Option 1 to contact DUPIXENT MyWay ®. In order to be effective and work properly, most biologics are injectable medicines. Acaregiver or patient 12 years of age and older may inject DUPIXENT using the pre-filled syringe or pre-filled pen. Terms & Restrictions Apply. The average monthly retail price of Dupixent is $4,910 per 2, 2 mL of 300 mg/2 mL prefilled syringes. Visit the official website of Dupixent My Way enrollment. It’s a biologic drug, which means it’s made from parts of living organisms. DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older with uncontrolled, moderate-to-severe. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. “When I stay on top of my eczema, I don’t worry about my skin as much. Try checking out MyWay Dupixent Program!! They cover costs of Dupixent and whatever your insurance won't pay (up to a certain yearly amount). It is supplied in a carton with two pens or syringes in each package. 1‑844‑DUPIXENT 1-844-387-4936 ), option 1 Monday-Friday, 8 am-9 pm ET. brand. CHRONOS was a 52-week pivotal clinical trial evaluating the efficacy and safety of DUPIXENT in adult patients with uncontrolled moderate-to-severe atopic dermatitis. ®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. If you are a New York prescriber, please use an original New York State prescription form. DUPIXENT is a weekly single-dose injection that can be given by your doctor in an office or a clinic, or can be taken at home. 4) Lift your thumb to release the. Pay as little as $0 per month. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. my eligibility for the DUPIXENT MyWay Patient Assistance Program, and I understand that such verification may include contacting me or my healthcare provider for additional information and/or reviewing additional financial, insurance, and/or medical information. 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). You might experience some resistance. DUPIXENT is taken by injection under the skin (subcutaneous injection) once every two weeks. Compare monoclonal antibodies. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3 program consisting of two pivotal trials. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. loss of voice. medisafe. For more information or to enroll in the patient support program, dial 1‑844‑DUPIXENT ( 1-844-387-4936 Monday-Friday, 8 am-9 pm EST. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. For families/households with more than 8 persons, add $5,140 for each. Please see Important Safety. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. Well at a cost of roughly $3,500/dose which lasts a month, that will all be used up in four months. 1 A patient may self-inject DUPIXENT—or a caregiver may administer DUPIXENT—after training has been provided by a healthcare provider on proper subcutaneous injection technique using the pre-filled. Human IgG antibodies are known to cross the placental barrier; therefore, DUPIXENT may be transmitted from the mother to the developing fetus. The parts of the DUPIXENT Syringe are shown below: • The DUPIXENT Pre-filled Syringe • 1 alcohol wipe* • 1 cotton ball or gauze* • a sharps disposal container* In children 6 months to less than 12 years of age, DUPIXENT should be given by a caregiver. 2 pens of 300mg/2ml. 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). 2 cartons. DUPIXENT® (dupilumab) is a. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. Find DUPIXENT® (dupilumab) injection videos and instructions for the pre-filled pen (200 mg or 300 mg) for ages 2+ years. 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. PRESCRIBER TO FILL OUT Section 5a. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. You will find 3 options; typing, drawing, or uploading one. In this case Dupixent myway will cover the first 13k, which is probably like 5 months. Of the total drug interactions, 38 are major, 29 are moderate, and 7 are minor. The way it works without copay accumulators is: myway covers your copay/deductible and by the time you have exhausted the benefit you’ve hit your deductible and your insurance is footing the bill for the rest of the year. My dr pioneered eoe for many years and ran a lot of the trials. I guess ill have to see how much more improvement comes. Leaving me with $12,400 left on the card. 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 patient named on this form for an DA-approved indication. a Coverage varies by type and plan. com. Good luck. I found the carnivore diet helps immensely for autoimmune issues. DUPIXENT is an injectable medicine that is administered by subcutaneous injection and is intended for use under the guidance of a healthcare provider. Combivent - Pay as little as $10 a month. Yes it was left out and room temp. To request access to someone else's record in MyHealth complete the Request Access to Someone Else’s Account form . That being said, please remember that not everyone is fortunate enough to be able to afford it, either because they don't have insurance or because their insurance won't cover enough/has denied them outright (sometimes appealing this. Find DUPIXENT® (dupilumab) injection videos and instructions for the pre-filled pen (200 mg or 300 mg) for ages 2+ years. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing,I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. In my second year on Dupixent (2020), it was covered in full as the copay assistance payments of $13,000 counted against my deductible/out-of-pocket maximum ($8,500). Coverage varies by type and plan. I saw my dermatologist today(a new one, my other passed away) and she did not think the hair loss is from coming off of the prednisone, so I still do to know what is going on. Learn how DUPIXENT® (dupilumab), the first FDA-approved weekly injectable biologic treatment for eosinophilic esophagitis (EoE) in patients 12 years and older who weigh at least 88lb (40kg) targets a source of inflammation, which contributes to EoE. Surgery may remove your nasal polyps, but it may not treat an underlying cause of inflammation—allowing them to grow back. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. . The cost of Dupixent may vary based on the strength and dosage form you use. I’m ready to make a difference. Dupixent is the first and only medicine indicated to treat eosinophilic esophagitis in the United States; approval granted more than two months ahead of FDA’s Priority Review action dateSince [Date], [Patient Full Name] has been under my care for [diagnosis] (ICD-10-CM code: [insert code]). Being a nurse for DUPIXENT MyWay is very rewarding. 421 adult patients were randomized to DUPIXENT + TCS or placebo + TCS. If you are a New York prescriber, please use an original New York State prescription form. Get your personalized discussion guide to help yourself have a productive conversation with your doctor & see if DUPIXENT® (dupilumab) for uncontrolled moderate-to-severe atopic dermatitis is right for you. Enrolled patients have access to: 1‑844‑387‑4936. DUPIXENT can be used with or without topical corticosteroids. DUPIXENT has been FDA approved for use in adults with uncontrolled moderate-to-severe eczema since 2017. It's hard enough dealing with all of this and having different doctors tell you different things is mind boggling. Find the definitions of commonly used terms related to uncontrolled, moderate-to-severe eczema, atopic dermatitis, and DUPIXENT® (dupilumab). Serious adverse reactions may occur. In addition to the guidance your doctor provides, the app lets you connect with your DUPIXENT MyWay Support Team with one tap. Education and Nurse Support: One-on-one nursing support is available to educate and empower patients to use DUPIXENT as prescribed. Dupixent on a High Deductible Health Plan. Monday-Friday, 8 am-9 pm ET. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. Serious side effects can occur. financial assistance for eligible patients, provide one-on-one nursing support, and more. PRESCRIBER TO FILL OUT Section 6a. DUPIXENT MyWay offers a range of support, including: Coverage Support (e. About Dupixent. Dupixent® (dupilumab) Note: Precertification review for this medication is handled by Aetna Pharmacy Management Precertification at 1-855-240-0535 or fax applicable request forms to 1-877-269-9916. 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. This letter serves as my determination of medical necessity for DUPIXENT® (dupilumab) for this patient. Fill in your personal information, such as your name, date of birth, and contact details. For families/households with more than 8 persons, add $5,140 for each. The dupixent my way enrollment form isn’t an exception. Step 1: Let the syringe sit outside of the fridge for at least 45 minutes. Serious side effects can. It offers financial assistance, nursing support, and information on the safety profile of DUPIXENT and its interactions with other medications. xml ¢ ( ´•ËjÃ0 E÷…þƒÑ¶ØJº(¥ÄÉ¢ e hú Š5vD Òäõ÷ ÇŽ)%‰C o Ö̽÷h Òh²Ñe´ ”5) & ɬT¦HÙ×ì-~dQ@a¤( ”m!°Éøöf4Û: ©MHÙ Ñ=q ² h ëÀP%·^ ¤__p'²oQ¿ xf ‚Á + 6 ½@. ®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 DUPIXENT: your first choice to adequately control this chronic, systemic disease. DUPIXENT is a prescription medicine used to treat adults and children 6 months of age and older with moderate-to-severe eczema (atopic dermatitis or AD) that is not well controlled with prescription therapies used on the skin (topical), or who cannot use topical therapies. reply . 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. The Dupixent pre-filled pen is only for use in patients 12 years of age and older. DUPIXENT MyWay® is a program that helps eligible patients start and stay on track with their therapy for atopic dermatitis, asthma, chronic rhinosinusitis with nasal polyposis, eosinophilic esophagitis and prurigo nodularis. 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. I agre e to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. I think it is a true wonder drug and I am grateful for it. Has been prescribing for the last 10+ years and was essentially told I F'd up on the over use and have to taper down. Manufacturer Coupon. For more information, dial 1-844-DUPIXENT1-844-387-4936), option 1. For more information, dial 1‑844‑DUPIXENT( 1-844-387-4936 ), option 1. This will allow the specialty pharmacy to conduct the benefits investigation, and DUPIXENT MyWay will provide additional support to the patient. It allows to complete any PDF or Word document right in the web, customize it depending on. com. First few months into taking Dupixent, I got laid off and worked w my doctors/Dupixent to get assistance. Dupixent may cause serious side effects. The formulary status tool below can help check DUPIXENT coverage for various plans. Save. chevron_right. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. If you are a New York prescriber, please use an original New York State prescription form. Dupixent is prescribed for eczema and certain types of asthma. [4] [5] [6] [2] It is also used for the treatment of eosinophilic esophagitis [7] and prurigo nodularis. In one week after my first Dupixent shot I could feel a positive change in my nasal airway. DUPIXENT is a prescription medicine used to treat certain skin conditions, asthma, and chronic rhinosinusitis with nasal polyps. I feel so judged when I say I don’t want to go on Dupixent. DUPIXENT MyWay. 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. Fax: 1-908-809-6249. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. I y are a Ne r resrer, ease se a ra Ne r Sae resr r Te resrer s y ser sae-se resr rerees, s as e-resr, sae-se resr r, a aae, e N-ae sae-se rerees res rea e resrer. If you’re eligible, you can enroll online or by phone and receive your card by email. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. g. Re-check each area has been filled in correctly. Nationally are Covered for DUPIXENT. 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. For more information, dial. These programs and tips can help make your prescription more affordable. Be sure to. If given in a pill, our digestive tract will easily break these proteins down – much like it does when we eat a piece of steak – and make the drug ineffective. DUPIXENT is a form of medicine called a biologic that targets Type 2 inflammation, an underlying cause of nasal polyps. Good luck to all! I still have it on legs and arms but it's nothing compared to full body day and night. Serious adverse reactions may occur. After that, we will have met our family deductible. Program has an annual maximum of $13,000. To enroll or obtain information call 1-877-311. Welcome to the Patient Support Portal! This site provides patients and healthcare professionals a fast secure way to submit the patient enrollment and supporting documentation to our patient services program team. In pediatric patients 12 to 17 years of age, administer DUPIXENT under the supervision of an adult. 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:. If you still have questions, you can speak with a DUPIXENT MyWay or request to join the program over the phone. ®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. Patients in each age group saw improved lung function in as little as 2 weeks. with DUPIXENT Help schedule deliveries of DUPIXENT Provide supplemental injection training—in person, virtually, or over the phone—to help patients or caregivers become more familiar with injecting DUPIXENT Offer a needle disposing kit, or sharps container, for proper disposal of DUPIXENT Remind patients when it is time toMy doctor gave me a copay card to cover mine. Tell your healthcare provider about any new or worsening joint symptoms. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing,1‑844‑DUPIXENT 1-844-387-4936. I honestly started to taper off Dupixent because I wanted to see how well my body would do without it. Hello cinc: I have been on Dupixent approx 1-1/2 years with very rare eye irritation. In clinical trials, DUPIXENT reduced the. I certify that I have obtained my patient’s written authorization in accordance with applicable Patients may be eligible for the DUPIXENT MyWay® copay card if they: Have commercial insurance; Have a DUPIXENT prescription for an FDA-approved condition; Are a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI; and are a patient or caregiver aged 18 years or older For patients wanting a copay card, they can access that by visiting our product website at DUPIXENT. Something went wrong. Dedicated Dupixent MyWay Case Managers can explain information related to Dupixent. Monday-Friday, 8 am-9 pm ET. Check your eligibility for the DUPIXENT MyWay® Copay Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients.