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. Every enrolled patient is assigned a phone-based DUPIXENT MyWay® Nurse Educator, who takes a patient-centric approach to providing tools, support resources, and education throughout the patient’s treatment journey. Just got the fun news that I will need to pay $2,700 for a monthly dose of Dupixent. 1,000-125=875 $875 is the amount your health insurance pays. 0185 Last Update: November 2022 DUP. But either way, after you or Dupixent myway meets your deductible, it should be free to you. chevron_right. 38]). Check your eligibility for the DUPIXENT MyWay® Copay Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients. out and fax back to DUPIXENT MyWay at 1-844-387-9370 • You or your specialist can call 1-844-DUPIXEN(T), option 1 • Providing your email address allows DUPIXENT MyWay to give you more support resources about DUPIXENT. DUPIXENT MyWay is a patient support program that can help enable access to DUPIXENT and offers financial assistance for eligible patients, one-on-one nursing support, and more. Eosinophilic Esophagitis: DUPIXENT is indicated for the treatment of adult and pediatric patients aged 12 years and older, weighing at least 40 kg, with eosinophilic esophagitis (EoE). ®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. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. Option 1- you have to meet your deductible without Dupixent myway. 01. 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. 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. 01. 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). Tips. For more information, please call 1-844-DUPIXENT (1-844-387-4936) or visit got Dupixent MyWay copay assistance and they never asked one question about my income. For more information, dial 1. 2 cartons. You have to game the system instead of trying to get full coverage. if speciality. To more financial assistance news, dial 1‑844‑DUPIXENT ( 1-844-387-4936), option 1 Monday-Friday, 8 am - 9 pm ESTPRESCRIBER TO FILL OUT Section 6a. The DUPIXENT MyWay patient support program is here to help you at every step of your DUPIXENT treatment journey. 17 and 0. *For patients on DUPIXENT 300 mg in a 24-week and a 52-week clinical trial vs 17% for placebo group. XXXX 00/0000 b y: A B C c o m pa n y, I n c. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. 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. 2 pens of 300mg/2ml. Use DUPIXENT exactly as prescribed by your doctor. 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. Program Website : Patient Assistance Applicationsfor DUPIXENT® dupilumab therapy My Information. S. Please complete the form, sign, and FA to 1-844-23-312. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. Applies to: Dupixent Number of uses: per prescription per year. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. 74 (2023), plus an amount based on how much you. With and DUPIXENT MyWay Copay Card, eligible, commercially insured care may pay when little as $0* copay by fill the DUPIXENT. The most common side effects include: DUPIXENT MyWay. Dupixent Myway . Sign up or activate your card here. Have commercial insurance, including health insurance. · If the insurer does have a copay accumulator in place: the insurer pays the entire cost of the refill except for $500. Patient assistance program. 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 . The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Pregnancy: A pregnancy exposure registry monitors pregnancy outcomes in women exposed to DUPIXENT during pregnancy. It may be covered by your Medicare or insurance plan. When I was very young, I knew that I wanted to be a nurse. 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. 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. including household income, to qualify. 00 per injection. Rx: DUPIXENT® (dupilumab) (100 mg/0. Check the liquid in the prefilled pen or syringe. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. 22. Dupixent inhibits the overactive signaling of interleukin-4 (IL-4) and. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. Fax the Enrollment Form to DUPIXENT MyWay. g. Section 5a. With MyWay, I get the year for free. For additional information or if you have questions, contact your Field Representative or call DUPIXENT MyWay at 1-844-DUPIXEN(T) (1-844-387-4936) Option 1, Monday–Friday, 8 am–9 pm Eastern time. It may be covered by your Medicare or insurance plan. 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). 1-844-DUPIXENT (1-844-387-4936) Topicort (desoximetasone spray 0. I have a $40 copay but I got the dupixent my way copay card its free for me. I’ve been with DUPIXENT MyWay since the very beginning. Please see Dosage Regimens, How to Inject DUPIXENT® and Instructions for Use. 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. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as a $0* copay per fill of DUPIXENT, maximum of $13,000 per patient per calendar year. Learn more about DUPIXENT® (dupilumab), is the first FDA-approved biologic to treat eosinophilic esophagitis (EoE) in patients 12 years and older who weigh at least 88lb (40kg). 1kg over one year – the amount of weight gained ranged from 0. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. Patient is responsible for any out-of-pocket amounts that exceed the program limit. I’ve been with DUPIXENT MyWay since the very beginning. Please see. Depends if your insurance cares that Dupixent myway is paying your deductible. DUPIXENT MyWay team will research each patient’s situation and determine eligibility. DUPIXENT® (dupilumab), is the first FDA-approved biologic to treat eosinophilic esophagitis (EoE) in patients 12 years and older who weigh at least 88lb (40kg). Serious side effects can occur. Household Size. 25%) Taro Pharma patient access. They are a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI. S. Johns Hopkins EHP i think goes with cigna and CVS Specialty pharmacy covers. When filling out the DUPIXENT MyWay Enrollment Form, both you and your patient will be required to supply information, such as the patient’s insurance, diagnosis, and prescription. Do you think that will hurt my chances of qualifying? I know my prescription drug costs are high enough. Especially tell your healthcare provider if you. The patient must then take the following actions:I just got approved for dupixent this week however the copay is 3,000$ a month! The dupixent my way program only covers up to 13k or something like that. Access the dupixent reimbursement form either online or through your healthcare provider. 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. any time by mailing or faxing a written request to DUPIXENT MyWay at 1800 Innovation Point, Fort Mill, SC 29715; Fax: 1-844-387-9370. Dupixent MyWay pays the $500 copay. I was given the MyWay copay card but it had a limit of $13,000/calendar year and that has been exhausted at this point. Last time I checked income didn’t matter? The only way it became affordable for me was to get the deluxe package of my insurance. Program Website : Program Applications and FormsView the possible side effects of DUPIXENT in patients with uncontrolled chronic rhinosinusitis with nasal polyposis. 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. 14 mL Dupixent subcutaneous solution from $3,787. THE DUPIXENT MyWay PROGRAM. Subcutaneous Solution 100 mg/0. including household income, to qualify. Serious side effects can occur. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. 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). You may be eligibility on the DUPIXENT MyWay Copay Card if you:DUPIXENT MyWay Copay Card if you:Dupixent® should be given by or under the supervision of an adult in children 12 years of age and older. Please see. a Coverage varies by type and plan. 14 mL, or 300 mg/2 mL)Section 5a. Although you are not eligible, you can sign up DUPIXENT MyWay. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. Please see Important Safety Information and Prescribing Information and Patient Information on website. Type text, add images, blackout confidential details, add comments, highlights and more. chevron_right. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. Check your eligibility for the DUPIXENT MyWay® Copay Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients. Dupixent is an injection that is usually given under the skin every other week for the treatment of asthma, eczema, and some other inflammatory conditions. For more information, please call 1-844-Dupixent (1-844-387-4936) or visit a personalized discussion guide to make the most of your doctor's visit whether you're beginning your EoE treatment journey or looking for another option. If I am completing Section 5b, I authorize for my commercially insured patient one. 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. for reimbursement to any payer, including Medicare and Medicaid; and no free product may be sold, traded, or distributed for sale. On dupixent, Dupilumab, I honestly felt I was in my 60 to 70s+ with joint pains throughout my entire body even into the smallest of joints like fingers. 23. I understand that. I've been on Dupixent for over 2 years now and it has been such a great experience keeping my eczema under control. Patient has been compliant on Dupixent therapy 4. DUPIXENT MyWay. If you are a New York prescriber, please use an original New York State prescription form. DUPIXENT MyWay® is a patient support program designed to help you get access to DUPIXENT and help eligible patients cover the out-of-pocket costs of DUPIXENT. O. Regeneron and Sanofi are committed to helping patients in the U. I also have the dupixent myway card that covers a total of $13,000 for the year. Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. I don't know what medical issues your son is having, but it's likey autoimmune issues. Eligible patients covered by commercial health insurance may pay as little as a $0 p copay per fill of DUPIXENT. any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. 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. Monday-Friday, 8 am-9 pm ET. Griffinej5 • 2 yr. 00 copay. March 27, 2018. 80). Learn more about programs for eligible patients who are insured, underinsured, and uninsured. The fax number is 1. DUPIXENT use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. BIN: 020750 RX PCN: NMeds RX GRP: PDFPDF ID: NMNA019309901930 This is a drug discount program, not an insurance plan. So, even with a "prior authorization" and a "formulary override", the cost to me is $2900 per month, or about $1450. Need additional guidance with the enrollment process? Call DUPIXENT MyWay at 1-844-387-4936 Monday through Friday, 8 am to 9 pm Eastern Time. Sign it in a few clicks. So, how can you save? Manufacturer Sanofi offers Dupixent MyWay, a patient support program. A group of skin conditions characterized by skin inflammation, rash, and itch. , Sanofi US, and their affiliates and agents (together, the “Alliance”) may verifyBy checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. 10 for placebo; difference between Dupixent and placebo: -2. If I am completing Section 5b, I authorize for my commercially insured patient one. Does anyone know of any assistance programs I can use to help assist in the copay after dupixent my way limit is reached?I experienced cold sores and eye issues for about the first 6 months of being on Dupixent. 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 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. 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). S. Dupixent is not intended for episodic use. Got off of it as soon as I realized it was getting worse with every shot after spacing them out every other month. My insurance plan only covers a small amount of it with the rest being carried by the Copay program, which has a limit per year. 10 for placebo; difference between Dupixent and placebo: -2. These programs and tips can help make your prescription more affordable. Quantity Limits: Dupixent: 200 mg/1. 67 mL, 200 mg/1. dupixent myway income guidelinesstellaris unbidden and war in heaven. 03. 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. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. ) 2 Prescription Informationany time by mailing or faxing a written request to DUPIXENT MyWay at 1800 Innovation Point, Fort Mill, SC 29715; Fax: 1-844-387-9370. 00, but I do have some money invested. Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. Lot EXP Mfd. ENROLLMENT FORMDUPIXENT is a form of medicine called a biologic that targets Type 2 inflammation, an underlying cause of nasal polyps. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. A program called Dupixent MyWay is available for this drug. DUPIXENT® (dupilumab) is indicated as an add-on maintenance treatment in adult patients with inadequately controlled chronic rhinosinusitis with nasal polyposis (CRSwNP). 02. r/eczema • I wish there was an eczema simulator so others could feel what we do when they say “don’t. 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. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. Injection site reactions and eye conditions are the most common side effects reported and, unlike several other biologics, the risk of infection is low. Rx: DUPIXENT® (dupilumab) (100 mg/0. Social Security income, unemployment insurance benefits, disability income, any other income for the household. If you are a New York prescriber, please use an original New York. Since 2018, DUPIXENT has been prescribed to over 100,000 asthma patients in the US. Patient Signature _____ If you have questions about the . financial assistance for eligible patients, provide one-on-one nursing. DUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process. 02. Enrolled patients receive: One-on-one support from our DUPIXENT MyWay support team; Help understanding insurance coverage; Financial assistance (for eligible patients only) Help scheduling deliveries any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. Guam or the USVI, and demonstrate a financial need with a total annual adjusted gross income of $100,000 or less. Patient is responsible for any out-of-pocket amounts that exceed the program limit. 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. DUPIXENT is taken by injection under the skin (subcutaneous injection) once every two weeks. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. Step One - let's gather our materials. 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. was not paid in whole or in part by Medicare, Medicaid, or any federal or state programs. 50 for a single person. At one point, I was getting cold sores every 2 to 3 weeks consistently. It may be covered by your Medicare or insurance plan. Compare monoclonal antibodies. DUPIXENT can be used with or without topical corticosteroids. I wanted to go out and make a difference and help people. (2 of 3) Patient signature/Legal representative if patient is <18 years Date Section 2. ithdrawal of this Authoriation will end my participation in the DUPIXENT MyWay Program and will not aect any disclosure of My Information ased on this Authoriation made efore my reuest is received and processed y my ealthcare Providers, ealth Insurers, and Specialty Pharmacies. Please see Important Safety Information and Patient Information on website. Your office may choose to use a preferred specialty pharmacy to start the benefits investigation. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. 0156 Past Update: March 2023 DUP. Continuation in the program is conditioned upon timely verification of income. C M ET DUPIXENT MYWAY ENROLLMENT FORM Moderate-to-Severe Atopic Dermatitis SUBMIT COMPLETED PAGES 1 & 2 Fax: 1-844-387-9370 Document Drop: (code: 8443879370) When filling out the DUPIXENT MyWay Enrollment Form, both you and your patient will be required to supply information, such as the patient’s insurance, diagnosis, and prescription. If you have any additional questions about this pricing information, please call DUPIXENT MyWay at 1-844-DUPIXENT (1-844-387-4936). ®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. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. For more information, please call 1-844-DUPIXENT (1-844-387-4936) or visit . 06 and -1. Serious side effects can occur. The most common side effects include: DUPIXENT MyWay. Coverage varies by. 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. This DUPIXENT Pre-filled Pen is a single-dose device. 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)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. 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. Lancet. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. I give supplemental injection training to the patient and the patient’s caregiver. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. Get a Quick Start. Rx: DUPIXENT® (dupilumab) (100 mg/0. . ) 2 Prescription InformationDUPIXENT MYWAY ENROLLMENT FORM Moderate-to-Severe Atopic Dermatitis SUBMIT COMPLETED PAGES 1 & 2 Fax: 1-844-387-9370 Document Drop: (code: 8443879370) Patient Name DOB / / Prescriber Name Prescriber Address NPI # Prescriber State License # (Required in Puerto Rico only). 14 mL, or 300 mg/2 mL)My insurance provider covers 85% and our Canadian version of 'MyWay' pays the remainder. 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. 23. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. THE DUPIXENT MyWay COPAY CARD. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may payable as little while $0* copay per fill by DUPIXENT. Rx: DUPIXENT® (dupilumab) (100 mg/0. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. 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. E. 14 mL, or 300 mg/2 mL)Call 1-844-387-4936, Option 1 to contact DUPIXENT MyWay ®. 67 mL, 200 mg/1. Eligible patients will receive they cards by e-mail. S. If this is the case, write the preferred specialty pharmacy. Rx: DUPIXENT® (dupilumab) (100 mg/0. 4 ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pm01. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. Serious adverse reactions may occur. You may be eligible for the DUPIXENT MyWayDUPIXENT MyWayAbout Dupixent Dupixent is administered as an injection under the skin (subcutaneous injection) at different injection sites. 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. 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. (DUPIXENT + Topical Corticosteroids (TCS) vs TCS only): CLEAR OR ALMOST CLEAR SKIN AT 16 Weeks 39% taking DUPIXENT + TCS vs 12% using TCS only. Social Security income, unemployment insurance benefits, disability income, any other income for the household. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. 01. Program Website : Program Applications and Forms will need to meet the eligibility criteria, including household income, to qualify. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. It's like $35k-$40k. Im so stressed out about. LASTING CHANGE IS ACHIEVABLE. Dupixent changed my life completely. 0185 Last Update: November 2022 DUP. For more information, dial 1-844-DUPIXENT 1-844-387-4936 ), option 5, Monday-Friday, 9 am – 9 pm ET. DUPIXENT is not used to treat sudden breathing problems. Serious side effects can occur. Also if your insurance does cover,Dupixent offers a co-pay card that. The increase was approved by the Minnesota Legislature and will help expand SNAP eligibility to families who may have previously been ineligible for the. For more information, please call 1-844-DUPIXENT (1-844-387-4936) or visit . -The original form (from the first guy) was still in the system and the folks at MyWay were “confused” by it. Your insurance has to deny twice and then you can apply for patient assistance. Nationally are Covered for DUPIXENT. For patients with commercial insurance who are new to DUPIXENT and experiencing a. Dupixent MyWay ™ will help eligible patients who are uninsured, lack coverage, or need assistance with their out-of-pocket costs. ) Please refer to Section 8, Patient Certifications, for. Serious adverse reactions may. 1‑844‑DUPIXENT 1-844-387-4936. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. Partner with a specialist near you to see if DUPIXENT® (dupilumab) is an option for you for uncontrolled moderate-to-severe eczema in adults and children aged 6 months & older. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. Dupixent side effects. Most do, some don't. I just spoke to someone through the MyWay Program. DUPIXENT® (dupilumab) is taken as an injection by a pre-filled syringe or pre-filled pen. In clinical trials, DUPIXENT reduced the. Caring. Get a Quick Start. The Dupixent MyWay program is not available to medicare patients. Deductible is at $3k out of pocket insurance pays 80% and at $6k insurance pays 100%. Approval represents the second dermatology indication for Dupixent and fifth disease indication overall in the. 58 for 2. DUPIXENT MyWay® A program to provide support to patients starting DUPIXENT. Dupixent MyWay pays the $500 copay. 0252 Last Update: Feb 2023 DUP. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Regeneron and Sanofi are committed to helping patients in the U. I knocked out the first copay out of pocket and went on the manufacturer website and applied for the dupixent my way card. Serious side effects can occur. Do not store DUPIXENT pre-filled syringes at room temperatures more than 77°F (25°C) Do not keep DUPIXENT at room temperature. If I am completing Section 5b, I authorize for my commercially insured patient one. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. About Dupixent. Effective Sept. The $500 payment counts towards the member’s deductible and out-of-pocket maximum. See All. Please see accompanying full Prescribing InformationTell us about yourself. SIGN UP TO SPEAK WITH A DUPIXENT MyWay ® MENTOR . financial assistance for eligible patients, provide one-on-one nursing support, and more. 71 for Dupixent compared to 0. DUPIXENT® (dupilumab), in moderate-to-severe asthma treatment, is taken as an injection by a pre-filled syringe or pre-filled pen, review both options here. 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. 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. 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. After that, we will have met our family deductible. comfysnail • 1 yr. Learn how DUPIXENT® (dupilumab) works as the first and only FDA-approved treatment for prurigo nodularis (PN) in adults aged 18 years and older. DUPIXENT MyWay®. LH Patient View; data through June 16, 2023. Fill out sections 5a and 5b completely to determine patient eligibility. Please see accompanying full Prescribing Information. Appears that my out of pocket maximum will be $8000 through insurance. DUPIXENT MyWay® can assist with: Verifying patient’s specific health plan coverage for DUPIXENT; Determining utilization management (UM) criteria; Identifying patient’s possible out-of-pocket responsibilities; Helping navigate any required prior authorization (PA) processes; Educating you and your patient about the appeals process if. If I am completing Section 5b, I authorize for my commercially insured patient one. Decreased exacerbations and/or improvement in symptoms 2. There is currently no generic alternative to Dupixent. 28. 67 mL Dupixent subcutaneous solution from $3,787. I suppose it doesn't really matter now. DUPIXENT can cause serious side effects, including: The most common side effects in patients with eczema include. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. To enroll or obtain information call 1-877-311. DUPIXENT MyWay coordinators are available Monday-Friday 8 am to 9 pm ET. 0156 Past Update: March 2023 DUP. DUPIXENT is a biologic and can help reduce your patients' use of systemic corticosteroids. 2022;400 (10356):908-919. 1-844-387-4936 (toll free) Monday - Friday, 8AM - 9PM (ET) Multilingual options available. How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. I have applied for grants, financial hardships (my household income surpasses every programs caps, even with 6 children), etc and now I'm just being told to pay $3,000/month or too bad. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. living with prurigo nodularis are most in need of new treatment options . 00 per injection. DUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process. For more information, dial 1‑844‑DUPIXENT ( 1-844-387-4936 ), option 1 Monday-Friday, 8 am - 9 pm ET. How many people live in your household? _____ Please refer to. If you have an adjusted net income or adjusted household net income between $30,000 and $32,000, you may receive a reduced supplement amount. $4,930. 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. So the nurse told me to fax receipts for year to date prescriptions and last year's income forms (W2, 1099, etc). DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older, with uncontrolled, moderate-to-severe eczema (atopic dermatitis). Form more information phone: 844-387-4936 or Visit website Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. with household income, to qualify. Nationally are Covered for DUPIXENT. ®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. 3. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. For assistance, please call 1-844-468-2252 Monday Friday, 8AM to 8PM ET. 02. Prurigo Nodularis: The most common adverse reactions (incidence ≥2%) are nasopharyngitis, conjunctivitis, herpes infection, dizziness, myalgia, and diarrhea. 67 mL, 200 mg/1. Support. Rx: DUPIXENT® (dupilumab) (100 mg/0. Your cost may depend on your treatment plan, your insurance coverage (if you have it), and the pharmacy you use. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. 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. 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 MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources.