I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Be sure to. ago. DUPIXENT can be used with or without topical corticosteroids. I agree to assist in e Éorts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Box 5925 Mailstop 55A-220A Bridgewater, NJ 08807. Dupixent is a miracle. I, _____, certify that the information provided for this reimbursement request is accurate to the best of my knowledge, and the product-specific copay, DUPIXENT MyWay is a patient support program designed to help you get access to DUPIXENT and stay on track while providing helpful tools and resources. The most common side effects may include injection site reactions, pink eye, eyelid inflammation, cold sores, and mouth or throat. The most common side effects include: DUPIXENT MyWay. In addition to the guidance your doctor provides, the app lets you connect with your DUPIXENT MyWay Support Team with one tap. My dermatologist said I had some of the worst eczema she had ever seen and literally cried at one of my visits. Tell your healthcare provider about any new or worsening joint symptoms. I agre e to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Otherwise, it's been a miracle for me, after suffering terrible with eczema for 20 years. 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. Count to 5 to be sure you get the full dose. DUPIXENT is an injectable medicine that is administered by subcutaneous injection and is intended for use under the guidance of a healthcare provider. LONG-LASTING CLEARER SKIN AT 16 and 52 Weeks 22% taking. 2) Pull the needle cap off the syringe, and inject the medication under the skin at a 45-degree angle. Program has an annual maximum of $13,000. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Learn more about DUPIXENT® (dupilumab) in moderate-to-severe asthma and if it may be the right treatment option for you. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing. 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. For families/households with more than 8 persons, add $5,140 for each. This morning my nose was less congested than usual, that's a positive sign. Welcome to Co-Pay Relief! Are you eligible to get help. Just got the fun news that I will need to pay $2,700 for a monthly dose of Dupixent. 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. Dupixent side effects. Hello cinc: I have been on Dupixent approx 1-1/2 years with very rare eye irritation. DUPIXENT® (dupilumab) is indicated as an add-on maintenance treatment in adult patients with inadequately controlled chronic rhinosinusitis with nasal polyposis (CRSwNP). Inspire has over 250 health communities supporting more than 3000 conditions. 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. What makes the dupixent digital document center legally binding? As the society ditches in-office work, the completion of documents more and more takes place electronically. I guess ill have to see how much more improvement comes. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. I then submit a copy of my receipt via snail mail to the Dupixent my way reimbursement program and they send me a check for $250 via snail mail. e. Im in the same boat, my out of cost payment with insurance is also $325 but is now 0 when i applied and was approved for my way. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing,How someone else should inject Dupixent. Dupixent Side Effects (Took my first 2 shots about 2 weeks ago) Hello all. PK !û˜õ ‹ _ [Content_Types]. 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 by an eosinophilic phenotype or with oral corticosteroid dependent asthma. Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. Step 2: After washing your hands, clean the area you are going to inject with an alcohol wipe. 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@. ”. This letter serves as my determination of medical necessity for DUPIXENT® (dupilumab) for this patient. Please see Important Safety Information and Prescribing Information and Patient. Although you are not eligible, you can sign up DUPIXENT MyWay. Sydnab • 1 yr. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. Watch videos for a supplemental demonstration on how to use and dispose of DUPIXENT® (dupilumab), a prescription medicine for subcutaneous injection. My wife is on Dupixent, and has the MyWay card which allows up to $13,000/year. They are a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI. DUPIXENT was studied in adults and children 6 months of age and older. if you are allergic to dupilumab or to any of the ingredients in DUPIXENT®. Find DUPIXENT® (dupilumab) injection videos and instructions for the pre-filled pen (200 mg or 300 mg) for ages 2+ years. Review patient eligibility for the DUPIXENT MyWay® Copay Card for DUPIXENT® (dupilumab) and explore patient assistance programs for eligible patients. DUPIXENT has been prescribed to over 50,000 uncontrolled nasal polyp patients and counting! DUPIXENT is the first biologic nasal polyp treatment that’s an alternative to nasal polyp surgery. I chose to be a nurse because I wanted to help people, and I believe that people should be in service to others. chevron_right. If you’re eligible, you can enroll online or by phone and receive your card by email. Limitation of Use: Not for the relief of acute bronchospasm or status asthmaticus. Full. It contains 300 mg of DUPIXENT for injection under the skin (subcutaneous injection). I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Dupixent may cause serious side effects. reply . Talk with. In children 12 years of age and older,It was granted and I pay $0. 5. 2 pens of 300mg/2ml. Dymista - Pay as little as $29. For brand name drugs under review and drug reviews completed on or. brand. I found the carnivore diet helps immensely for autoimmune issues. (2) Financial support for eligible patients: Get information about potential. PRESCRIBER TO FILL OUT Section 5a. Working with it utilizing electronic means is different from doing this in the physical world. DUPIXENT Syringes can be stored at room temperature up to 77°F (25°C) up to 14 days. 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. 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. Mine had just exhausted a few months ago after 2 years, and I'm currently paying $70 for 2 shots with Blue Cross Blue Shield. Dupixent® should be given by or under the supervision of an adult in children 12 years of age and older. View all Regeneron Pharmaceuticals Inc. That took about a week. It has extremely quickly resolved almost all of my eczema. This inflammation is an important component in. There is another biologic very similar to Dupixent called Adbry. 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. ago. PK !Ñ'/ å è · [Content_Types]. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUQuick Start Program product to the patient named herein. You will find 3 options; typing, drawing, or uploading one. Save. It is not known if DUPIXENT is safe and effective in children with prurigo nodularis under 18 years of age. Ask to speak to a nurse and ask about the "Dupixent My Way program". DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. If you are a New York prescriber, please use an original New York State prescription form. pretty obvious to both my pharmacist and MyWay nurses that simply running through the $13,000 in a few months is not the way the copay assistance is intended to be used, but. 99% of commercial patients (6+ months of age) nationally are covered for DUPIXENT. My allergist doctor said I was a super reactive patient to Dupixent, in a positive way. Luckily my supplemental ins pays it all with Medicare paying nothing. The relief is indescribable, honestly. Learn more about programs for eligible patients who are insured, underinsured, and uninsured. For Healthcare Professionals. If you’re eligible, you can enroll online and recieve your card by email. 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. Serious side effects can occur. Like all biologics, Dupixent is made from proteins, and must be given by injection. My face/neck which has always. I don't know what medical issues your son is having, but it's likey autoimmune issues. 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. Have commercial insurance, including health insurance. Serious adverse reactions may occur. One-on-one supplemental injection support training with nurse educators in person, virtually, or by phone. (I am one of those patients!) have seen a great results. DUPIXENT is an injectable medicine that is administered by subcutaneous injection and is intended for use under the guidance of a healthcare provider. Dupixent - extreme pain while injecting. Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. Serious side effects can occur. DUPIXENT ® ️ can cause serious side effects, including:. I agree to assist in e Éorts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Please see Important Safety Information. There’s no laboratory monitoring required, not at the beginning, not during therapy. DUPIXENT® (dupilumab) is a prescription medicine FDA-approved to treat five conditions. 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. 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. Program has an annual maximum of $13,000. *. Start Program product to the patient named herein. The most common side effects include: DUPIXENT MyWay. Hi, I'm on Dupixent and so far my doctor has done the injections, using the syringe. Currently no side effects, just 95% clear and I had full body, severe eczema. Filter by condition. 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. Patient assistance program. How possessed an annual upper of $13,000. Peter Bunting Moderator & Contributor <p>Thanks for your response, Ashley. Have commercial insurance, including health insurance. Dupixent® should be given by or under the supervision of an adult in children 12 years of age and older. Based on the questions answered above, you are not eligible to register for a new copay card or to activate a copay card. DUPIXENT has been FDA approved for use in adults with uncontrolled moderate-to-severe eczema since 2017. I’m ready to make a difference. Unusual weakness or fatigue, fever, headache, skin rash, muscle or joint pain, loss of appetite, pain, tingling, or numbness in the hands or feet. by McKesson's Portal! RxCrossroads is pleased to provide you with fast, reliable assistance in obtaining medication copay saving offerings. For more information, dial 1-844-DUPIXENT1-844-387-4936), option 1. 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. These programs and tips can help make your prescription more affordable. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. Experience: Been on Dupixent since May 15, 2017. I pay nothing. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. DUPIXENT® (dupilumab) Full Prescribing Information: Patient Information: Learn more about DUPIXENT: Show more. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. 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”. Tips. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUPIXENT Quick Start Program product to the patient named herein. My husband has been on it several months for severe asthma. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. 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. Dupixent may cause serious side effects. MELINDA: Before I started DUPIXENT, I told my doctor about all the medical conditions I had and medications I was taking. 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,. One of my favorite parts of providing nursing care to our patients is being able to walk them through their journey, hold their hand through the process, just to give them confidence along the way and we always want them to know that they. DUPIXENT is administered by subcutaneous injection and intended for use under the guidance of a healthcare provider 1; Rotate injection site with each injection 1; A patient may self-inject DUPIXENT after training in subcutaneous injection technique using the pre-filled syringe or pre-filled pen 1; Provide proper training to patients and/or caregivers on the. Be sure the details you add to the Dupixent Enrollment Form is updated and correct. 2 cartons. This information will ONLY be used to validate your eligibility. Last name . Brovana - Save up to $30 per month. Is412270-I have been on Dupixent for 4 months. DUPIXENT can be used with or without topical corticosteroids. Dulera - Save up to $90 on 12 Prescriptions, Free Trial. Being a nurse for DUPIXENT MyWay is very rewarding. Throw away (dispose of) anyI can give my personal experience, for what it's worth. Refer your appropriate uncontrolled asthma patients to an allergist or pulmonologist to learn if DUPIXENT® (dupilumab) is a treatment option. 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. Once the prescription went to the pharmacy I called the pharmacy and they did the myway paperwork for me. Start Program product to the patient named herein. Program has an annual maximum of $13,000. For more information, call 1. 5K subscribers. Tell your healthcare provider about any new or worsening joint symptoms. insurer. Today my left knee. Please see. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUPIXENT Quick Start Program product to the patient named herein. LASTING CHANGE IS ACHIEVABLE. 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:. 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 MyWay is a patient support program designed to help you get access to DUPIXENT and stay on track while providing helpful tools and resources. Serious side effects can. I'm supposed to start myself at some point, I guess with the pen though I know there's a choice. Sign up or activate your card here. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. (DUPIXENT + Topical Corticosteroids (TCS) vs TCS only): CLEAR OR ALMOST CLEAR SKIN AT 16 Weeks 39% taking DUPIXENT + TCS vs 12% using TCS only. DUPIXENT is not indicated for relief of acute bronchospasm or status. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. Box 5925 Mailstop 55A-220A Bridgewater, NJ 08807. n¬©® &í]ÃÎê)«ÀI¯´[5ì×âÛä#« §„ñ ¶…Ä. The DUPIXENT MyWay Patient App gives patients enrolled in DUPIXENT MyWay access to tools to help you start and stay on track with your treatment. Fast forward to tonight, first time using the pen, and it took me FOREVER to commit. For more information, call 1-844-DUPIXENT ( 1-844-387-4936) option 1. The Dupixent pre-filled pen is only for use in patients 12 years of age and older. Monday-Friday, 8 am-9 pm ET. Step 3: Take the needle cap off of the syringe right before you are going to inject. I cried hopeful tears as I gave myself my. My question is - my next refill for 2024 would be early January. 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]). insurer. Being a nurse for DUPIXENT MyWay is very rewarding. Fill out this form with a valid email address and see if you’re eligible for the DUPIXENT MyWay ® Copay Card. I think it is a true wonder drug and I am grateful for it. Throw away. For any questions or concerns, please contact us at the phone number located on your enrollment form. I’m ready to make a difference. ️ ️ ReplyDupixent® (dupilumab) Four simple steps to submit your referral. They are especially crucial when it comes to stipulations and signatures associated with them. Find information on insurance coverage, ordering through a specialty pharmacy, and the cost of DUPIXENT® (dupilumab), a prescription medicine FDA-approved to treat five conditions. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing, state-specific. Injection. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. 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. •Keep DUPIXENT Syringes and all medicines out of the reach of children. Find local businesses, view maps and get driving directions in Google Maps. , 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. Dedicated Dupixent MyWay Case Managers can explain information related to Dupixent. For families/households with more than 8 persons, add $5,140 for each. Please see Important Safety Information and full PI on website. First few months into taking Dupixent, I got laid off and worked w my doctors/Dupixent to get assistance. My monthly copay is $50 and my way picks it up. Serious side effects can occur. Enrolled patients have access to: 1‑844‑387‑4936. If you are a New York prescriber, please use an original New York State prescription form. 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. Fill a 90-Day Supply to Save. For more information, please call 1-844-Dupixent (1-844-387-4936) or visit The Wholesale Acquisition Cost (WAC) of Dupixent in the United States is $37,000 annually. It's hard enough dealing with all of this and having different doctors tell you different things is mind boggling. insurer. The formulary status tool below can help check DUPIXENT coverage for various plans. So far this has happened 4 times - once with 2 injections from the. 7 out of 10 from a total of 188 reviews for the treatment of Eczema. At that point we will owe 20% of the cost of the medication, which adds up to just under $700/month. 2 pens of 300mg/2ml. (Biosimilars are like. Coverage varies by type and plan. In order to be effective and work properly, most biologics are injectable medicines. DUPIXENT® is a subcutaneous injectable prescription medicine for adults with uncontrolled chronic. DUPIXENT 200 mg injections at different injection sites. Serious side. I really enjoy the patient interaction. DUPIXENT MyWay® can work with your insurance provider to identify a preferred, in-network specialty pharmacy. Learn more about DUPIXENT® (dupilumab), the first and only FDA approved treatment option for prurigo nodularis (PN) in adults aged 18 years and older. DUPIXENT blocks the signaling of two key sources of Type 2 inflammation (IL-4 and IL-13). Even when using the Copay Card, that would cover only cover 4 months worth, and would not go towards my deductible, totaling about. Monday-Friday, 8 am-9 pm ET. It is given as a subcutaneous (under the skin) injection. DUPIXENT MyWay®. DUPIXENT MyWay complements your office’s process for accessing DUPIXENT. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. PRESCRIBER TO FILL OUT Section 6a. With our help, you could get your Dupixent prescription for a flat fee of $49 per month. Acaregiver or patient 12 years of age and older may inject DUPIXENT using the pre-filled syringe or pre-filled pen. Available. My name is Shari and I’m a registered nurse with DUPIXENT MyWay. The recommended dosage of DUPIXENT for pediatric patients 6 months to 5 years of age is specified in Table 1. Serious adverse. I may opt out of receiving Communications, individual support services, including the DUPIXENT MyWay® Copay Card, or opt out of DUPIXENT MyWay® entirely at any time by notifying a representative by telephone at 1-800-633-1610 or by sending a letter to Sanofi US Customer Service P. Option 1- you have to meet your deductible without Dupixent myway. GF Strong Rehabilitation Centre. Despite all of the freedom this miracle drug has graciously granted me, I purposely and consciously chose to begin tapering off Dupixent in May of 2017. Dupixent Prices, Coupons and Patient Assistance Programs. Study description: The safety data in this open-label extension study reflect exposure to DUPIXENT in 2677 subjects, including 2207 exposed for up to 52 weeks, 1065 exposed for up to 100 weeks, 557 exposed for up to 148 weeks, 352 exposed up to 204 weeks, and 202 exposed up to 244 weeks. 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. What it is used for. 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. Terms & Restrictions Apply. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. medisafe. Dupilumab se usa para el eczema en adultos y niños de 6 meses o más. You must be shown the right way by your healthcare provider before injecting DUPIXENT. DUPIXENT MyWay offers a range of support, including: Coverage Support (e. Associate Director, Global Strategy & Operations Dupixent / Immunology will work closely with Global Dupixent / Immunology leaders as well as cross-functional… Posted Posted 27 days ago · More. The way it works for me and Dupixent is I pay $250 co-pay a month at the pharmacy. Dupixent. DUPIXENT MyWay. Do not try to inject DUPIXENT until you have been shown the right way by your healthcare provider. jobs in Sleepy Hollow, NY - Sleepy Hollow jobs - Director of Strategy jobs in Sleepy Hollow, NYDUPIXENTDupixent plays in managing their condition • What to expect from treatment and long-term adherence success • Lifestyle counselling and goal setting For many patients, having someone they can turn to for advice, or simply chat with, makes all the difference when navigating a long-term chronic condition and a new treatment. Learn more about programs for eligible patients who are insured, underinsured, and uninsured. This has happened a few times, and I thought the medication itself was bad. Patient and Co-pay Assistance: DUPIXENT MyWay helps eligible patients get access to therapy whether they are uninsured, lack. throat pain or soreness. coverage delay for DUPIXENT by the patient’s insurer. Reload page. The formulary status tool below can help check DUPIXENT coverage for various plans. PRESCRIBER TO FILL OUT Section 6a. Anomalous_Creature • 1 yr. INJECTION SUPPORT. Watch videos from experts [,download materials,] and explore future events to further understand DUPIXENT® (dupilumab). Ways to save on Dupixent. . DUPIXENT is a weekly single-dose injection that can be given by your doctor in an office or a clinic, or can be taken at home. 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. Monday-Friday, 8 am-9 pm ET. With of DUPIXENT MyWay Copay Card, right, commercially insured patients might pay as little as $0* copay per fill of DUPIXENT. Eligible patients will receive their cards by email. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUPIXENT Quick Start Program product to the patient named herein. 14 mL) is around $3,788 for a supply of 2. The cost for Dupixent subcutaneous solution (200 mg/1. For children aged 6 months to 5 years, it is taken as 1 injection every 4 weeks. Have commercial insurance, including health insurance. ( 1-844-387-4936 ), option 1. The cost of the 300-milligrams per 2-milliliters (mg/mL) shot of Dupixent will vary based on several factors. Stop using DUPIXENT and tell your healthcare provider or get emergency help right away if you get any of the following signs or symptoms: breathing problems or wheezing, swelling of the face, lips, mouth, tongue or throat, fainting, dizziness, feeling lightheaded, fast pulse. About 75,000 adults in the U. 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. Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUPIXENT Quick Start Program product to the patient named herein. 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. Serious adverse reactions may occur. I feel so lucky I have one of the best insurance companies at the moment. Come back and visit us using a device with a larger screen (laptop, desktop, tablet) at web. Approval represents the second dermatology indication for Dupixent and fifth disease indication overall in the. Limitation of Use: Not for the relief of acute bronchospasm or status asthmaticus. Female Preferred pronouns Last 4 digits of SSN . Well at a cost of roughly $3,500/dose which lasts a month, that will all be used up in four months. Sorry you interpreted my post that way. Serious side effects can occur. Good luck. Monday-Friday, 8 am-9 pm ET. excessive tearing. •Store DUPIXENT Syringes in the original carton to protect them from light. 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. Explore safety data across clinical trials in patients aged 12+ with moderate-to-severe asthma characterized by an eosinophilic phenotype or with oral corticosteroid dependent asthma using DUPIXENT® (dupilumab) as add-on maintenance treatment. Select a tab below to get you to helpful information depending on where you are in your treatment journey. Dupixent changed my life completely. 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. 05. The help you get from a copay card is provided by theBUT, the Dupixent MyWay card paid the $600 for me. Sign up or activate your card here. financial assistance for eligible patients, provide one-on-one nursing support, and more. And while everyone’s working through the details, look to DUPIXENT MyWay for additional support. Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. 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. Eligible patients will receive their cards by email. Dupixent started March 2018, did little until adding the Protopic about 6-8 months later. 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. Stop using DUPIXENT and tell your healthcare provider or get emergency help right away if you get any of the following signs or symptoms: breathing problems or wheezing, swelling of the face, lips, mouth, tongue or throat, fainting, dizziness, feeling lightheaded, fast pulse. For more information, to speak with a member of the DUPIXENT MyWay support team, or to enroll over the phone, call our toll-free line. 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. 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. Available in two delivery options, pre-filled syringe & pre-filled pen (300mg) for ages 12+ years. pain, redness, irritation, itching, or swelling of the eye, eyelid, or inner lining of the eyelid. fever. Deductible is at $3k out of pocket insurance pays 80% and at $6k insurance pays 100%. How is Dupixent supplied? Dupixent comes as a single-use pre-filled syringe (with a needle shield) or as a pre-filled pen. –%F¯ Z®Iœ)Xô÷UQ)SºÒWëü ÂC þH„s¥Ê R ¯Œüà 7L )w=a¡¸£†# Uåx@£û az%!š ïBS _[/¹´ÙR“29ms€Óæ¹Ê ÕWnÎÛ B. 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,DUPIXENT can cause allergic reactions that can sometimes be severe. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing, state-specific. DUPIXENT is a biologic and can help reduce your patients' use of systemic corticosteroids. If you are a New York prescriber, please use an original New York State prescription form. DUPIXENT® (dupilumab) 13. Side effects Interactions FAQ What is Dupixent? Dupixent is an injectable prescription medicine used to treat a number of inflammatory conditions. Before using DUPIXENT, tell your healthcare provider about all your medical conditions, including if you: have eye problems; have a parasitic (helminth)The most foolproof way to reduce out-of-pocket costs for Dupixent is a free coupon from SingleCare. Biologic Drug: Biologic drugs are made from living cells and are often expensive. Nationally are Covered for DUPIXENT. Or you can google their info and contact them directly. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUPIXENT Quick Start Program product to the patient named herein. You can connect with DUPIXENT MyWay Nurse Educators by phone to receive supplemental injection training, help scheduling deliveries and prescription refills, or help navigating financial support options, such as copay assistance. Current patient Patient’s first name . 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. Eligible patients covered by commercial health insurance may pay as little as a $0 p copay per fill of DUPIXENT. 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) 1‑844‑DUPIXENT 1-844-387-4936. com . I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. I really enjoy the patient interaction. To request access to someone else's record in MyHealth complete the Request Access to Someone Else’s Account form . 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. com. If you are a New York prescriber, please use an original New York State prescription form. It is not known if DUPIXENT is safe and effective in children with prurigo nodularis under 18 years of age. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. best of luck!! i hope you can get on dupixent soon. In clinical trials, the impact of DUPIXENT on lung function was studied in patients 6 to 11 years of age and patients 12 years of age and older.