Data on file, Regeneron Pharmaceuticals, Inc. 14 mL, or 300 mg/2 mL)The Dupixent MyWay program is not available to medicare patients. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. DUPIXENT use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. 0156 Last Update: March 2023 DUP. How many people live in your household? _____ Please refer to. Hello! Switching insurance this year and need to prepare for increasing costs of dupixent with my new insurance. The DUPIXENT MyWay team will research each patient’s situation and determine eligibility. At this rate, I will no longer be able to afford the medication very soon. Dedicated Dupixent MyWay Case Managers can explain information related to Dupixent. 34 milliliters 200 mg/1. The DUPIXENT MyWay patient support program is here to help you at every step of your DUPIXENT treatment journey. Dupixent MyWay Program Dupixent (dupilumab injection). Not valid for prescriptions paid, in whole or in part, by Medicaid, Medicare, VA, DOD, TRICARE, or. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. Fill out sections 5a and 5b completely to determine patient eligibility. For more information, call 1. Do not store DUPIXENT pre-filled syringes at room temperatures more than 77°F (25°C) Do not keep DUPIXENT at room temperature. A program called Dupixent MyWay is available for this drug. Access the dupixent reimbursement form either online or through your healthcare provider. DUPIXENT® (dupilumab) Prescription Information Quick Start may be able to provide DUPIXENT at no cost to help bridge patients to therapy if there is a coverage delay. withdraw this Authorization at any time by mailing or faxing a written request to DUPIXENT MyWay at 1800 Innovation Point, Fort Mill, SC 29715; Fax: 1-844-387-9370. Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. After that, it is taken as 1 injection every 2 weeks or every 4 weeks, depending on your age and weight. DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older, with uncontrolled, moderate-to-severe eczema (atopic dermatitis). Sign it in a few clicks. And I would experience blurry vision, red and itchy eyes. 14 mL, or 300 mg/2 mL)Section 5a. 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. 17 and 0. 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). For more information or to enroll in the patient support program, contact us at: 1‑844‑DUPIXENT. Get ongoing, personalized nursing support; help scheduling monthly prescription refills and deliveries; and in-home, in-office, or online supplemental injection training. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will 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. Appears that my out of pocket maximum will be $8000 through insurance. For more information, dial 1-844-DUPIXENT 1-844-387-4936 ), option 5, Monday-Friday, 9 am – 9 pm ET. Approximately 72% of the total FEV 1 improvement (470 mL improvement at Week 52 from baseline FEV 1 of 1. So the nurse told me to fax receipts for year to date prescriptions and last year's income forms (W2, 1099, etc). 12. When I was very young, I knew that I wanted to be a nurse. 01. 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. Eligible clients will receive their cards by email. Eligible patients or caregivers of a patient must be: *For more information, dial 1-844-DUPIXENT 1-844-387-4936 option 5, Monday-Friday, 9 am - 9 pm ET. ®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. 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. You have to game the system instead of trying to get full coverage. Please see accompanying full Prescribing Information. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. After removal from the refrigerator, DUPIXENT must be used within 14 days or discarded; DUPIXENT should not be exposed to heat or direct sunlight; Do NOT freeze. Even when using the Copay Card, that would cover only cover 4 months worth, and would not go towards my deductible, totaling about. Please complete the form, sign, and FA to 1-844-23-312. Option 1- you have to meet your deductible without Dupixent myway. What it is used for. There is currently no generic alternative to Dupixent. The most common side effects include: DUPIXENT MyWay. In a clinical trial at 16 weeks in teens (aged 12-17 years) taking DUPIXENT* when used alone compared to teens not taking DUPIXENT: Clearer skinSAW CLEAR or Almost clear SKIN 24% vs 2% not taking DUPIXENT (placebo) nOTICEABLY LESS ITCHEXPERIENCED ITCH 37% vs 5% not taking DUPIXENT (placebo) ≥75%SKIN. Also, make sure to store the DUPIXENT MyWay phone number in your phone’s contacts so you. 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. for DUPIXENT® dupilumab therapy My Information. 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. Please see. 0254 Last Update: February 2023 DUP. And I would experience blurry vision, red and itchy eyes. Denied because of 2022 income threshold for household of two. 2 pens of 300mg/2ml. Learn about the DUPIXENT® (dupilumab) mechanism of action inhibiting IL-4 and IL-13 signaling in appropriate asthma patients. Depends if your insurance cares that Dupixent myway is paying your deductible. b Data as of January 2023. Hello! Switching insurance this year and need to prepare for increasing costs of dupixent with my new insurance. 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. 00 copay. Serious side effects can occur. ) Please refer to Section 8, Patient Certifications, for. For children aged 6 months to 5 years, it is taken as 1 injection every 4 weeks. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. DUPIXENT has been FDA approved for use in adults with uncontrolled moderate-to-severe eczema since 2017. A 48-year-old man developed left thumb tenderness and bilateral Achilles tendinopathy after 6 weeks of Dupixent. Hear real patients stories of life with uncontrolled moderate-to-severe asthma and how discovering DUPIXENT® (dupilumab) impacted their journey. 1-844-387-4936 (toll free) Monday - Friday, 8AM - 9PM (ET) Multilingual options available. Income at or below: Not Published: Medical expenses can be deducted from reported income:. I've been on Dupixent for over 2 years now and it has been such a great experience keeping my eczema under control. 03. Patient and Co-pay Assistance: DUPIXENT MyWay helps eligible patients get access to therapy whether they are uninsured, lack. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. -The original form (from the first guy) was still in the system and the folks at MyWay were “confused” by it. Dupixent will run about $3000 per month with my insurance until my maximum is met. DUPIXENT MyWay is a patient support program that can help enable access to DUPIXENT and offers financial assistance to eligible patients, one-on-one nursing support, and. Fill a 90-Day Supply to Save. Program has an annual maximum of $13,000. 0156 Last Update: March 2023 DUP. To enroll or obtain information call 1-877-311. Select Condition Indication Moderate-to-Severe Eczema (Ages 6+ Months) Moderate-to-Severe Asthma (Ages 6+ Years) Chronic Rhinosinusitis with Nasal Polyposis (Ages 18+. Be sure to fill out your enrollment form completely and accurately. But either way, after you or Dupixent myway meets your deductible, it should be free to you. They are a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI. Want to be a part of the DUPIXENT MyWay® Ambassador Program? Fill out this self-nomination form to see if you qualify. 4. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. 71 for Dupixent compared to 0. 12. Enroll eligible patients in the DUPIXENT MyWay® patient support program for DUPIXENT® (dupilumab) access, financial assistance & nursing support. Compare monoclonal antibodies. Your cost may depend on your treatment plan, your insurance coverage (if you have it), and the pharmacy you use. If patients become infected while receiving treatment with DUPIXENT and do not respond to anti-helminth treatment, discontinue treatment with DUPIXENT until the infection resolves. They never mentioned only covering a. Registered nurses are also available to speak with eligible patients about DUPIXENT. Monday-Friday, 8 am - 9 pm ET I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay, and that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Food and Drug Administration has approved Dupixent ® (dupilumab) as an add-on maintenance therapy in patients with moderate-to-severe asthma aged 12 years and older with an eosinophilic phenotype or with oral corticosteroid-dependent asthma. Watch videos from experts [,download materials,] and explore future events to further understand DUPIXENT® (dupilumab). FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. 09. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. Patients may be eligible for the DUPIXENT MyWay Copay Card if: They have a DUPIXENT prescription for an FDA-approved condition. S. I understand the disclosure to the Alliance will be for the purposes of enrolling me in, and providing certain services through the DUPIXENT MyWay Program, including • to determine if I am eligible to participate in DUPIXENT MyWay coverage assistance programs, patient assistance programs, or other4 ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pmDUPIXENT MyWay complements your office’s process for accessing DUPIXENT. Find videos and downloadable instructions for the two injection administration options available for DUPIXENT® (dupilumab), pre-filled syringe (200 mg or 300 mg) with needle shield for ages 6 months & older, or pre-filled pen (200 mg or 300 mg) for ages 2+ years. ) I agree that Regeneron Pharmaceuticals, Inc. 17 and 0. Rx: DUPIXENT® (dupilumab) (100 mg/0. LH Patient View; data through June 16, 2023. There is another biologic very similar to Dupixent called Adbry. Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. 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. DUPIXENT can be used with or without topical corticosteroids. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not affect any disclosure of My Information based on1-844-DUPIXENT 1-844-387-4936. That is what I am in the middle of. Support. I also have the dupixent myway card that covers a total of $13,000 for the year. Eligible patients covered by commercial health insurance may pay as little as a $0 p copay per fill of DUPIXENT. 67 mL, 200 mg/1. Refrigerate it at 36 °F to 46 °F. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may payable as little while $0* copay per fill by DUPIXENT. S. Please see accompanying full Prescribing InformationTell us about yourself. Dupixent on a High Deductible Health Plan. will not conduct a benefits verification. Tips. A 68-year-old woman developed generalized joint pain 6 weeks after starting Dupixent. The DUPIXENT MyWay program also provides useful tools and resources to help you stay on track with your treatment. If you still have questions, you can speak with a DUPIXENT MyWay or request to join the program over the phone. Form more information phone: 844-387-4936 or Visit website Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. Patient is responsible for any out-of-pocket amounts that exceed the program limit. 4 ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pm01. DUPIXENT® (dupilumab) is a. 0252 Last Update: Feb 2023 DUP. For more information or to enroll in the patient support program, contact us at: 1‑844‑DUPIXENT 1-844-387-4936 Monday-Friday, 8 am-9 pm ET. Dupixent is administered as an injection under the skin (subcutaneous injection) at different injection sites. Just got off the phone with Dupixent My Way. Browse the DUPIXENT® (dupilumab) sitemap to help you learn more about eosinophilic esophagitis (EoE) in patients 12 years and older who weigh at least 88lb (40kg) and navigate DUPIXENT. Experience: Been on Dupixent since May 15, 2017. Please see Dosage Regimens, How to Inject DUPIXENT® and Instructions for Use. 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. Most do, some don't. Eligible patients will receive their cards by email. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. Biologic Drug: Biologic drugs are made from living cells and are often expensive. Dupixent MyWay ™ will help eligible patients who are uninsured, lack coverage, or need assistance with their out-of-pocket costs. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. chevron_right. With the Copay Card, You Could Pay as Little as $0 † The majority of DUPIXENT patients with commercial/employer-provided insurance use the DUPIXENT MyWay ® Copay Card. Especially tell your healthcare provider if you. Approval represents the second dermatology indication for Dupixent and fifth disease indication overall in the. how to afford it then - it's been so helpful!! 3 Reactions. Share your form with others. 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. Continuation in the program is conditioned upon timely verification of income. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. PRESCRIBER TO FILL OUT Complete the entire form and submit pages 1-2 to ®DUPIXENT MyWay via fax at 1-844-387-9370 or Document Drop at (code: 8443879370) Complete the entire form and submit pages 1-3 to DUPIXENT MyWay® via fax at 1-844-387-9370 or Document Drop at (code: 8443879370) For assistance, call 1-844-DUPIXEN(T) (1-844-387-4936) Option 1, Monday–Friday, 8 am–9 pm ET Enrollment Form FOR ALLERGISTS Using a mail-order specialty pharmacy might help lower the monthly cost of Dupixent. Each time you fill your DUPIXENT prescription, please ensure your. So, even with a "prior authorization" and a "formulary override", the cost to me is $2900 per month, or about $1450. Call 1-844-387-4936 SUMIT COMPLETED PAGES 1 2 Fax: 1-844-387-9370 MF, 8am9pm ET Document Drop: (code: 8443879370) Patient Name DO / / Prescriber Name Prescriber AddressDupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. I’ve been with DUPIXENT MyWay since the very beginning. The DUPIXENT MyWay team can research each patient’s situation and determine eligibility. QUEST (12+ years) DUPIXENT offers rapid breathing relief patients can feel as early as Week 2. Since 2017, Dupixent has increased in price by 13%. United Healthcare covers it but I get insurance through my employer and it was a huge pain to get approved. 28. For more information and to find out if you’re eligible for support, call 844-DUPIXENT (844-387-4936) or visit the program website. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. Injection site reactions and eye conditions are the most common side effects reported and, unlike several other biologics, the risk of infection is low. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. For more information, call 1-844-DUPIXENT ( 1-844-387-4936) option 1. ) Please refer to Section 8, Patient Certifications, for. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. 23. Susie16 Oct 15, 2023 • 9:37 PM. Patients will need on hit the eligibility benchmark, including household income, to qualify. Nationally are Covered for DUPIXENT. Dupixent is indicated for the following type 2 inflammatory diseases:,Atopic Dermatitis,Adults and adolescents,Dupixent is indicated for the treatment of moderate to severe atopic dermatitis in patients aged 12 years and older who are candidates for chronic systemic therapy. a FDA approved since 2017 for adults, 2019 for adolescents (aged 12‑17 years), 2020 for children (aged 6-11 years), and 2022 for infants to preschoolers (aged 6 months-5 years) with uncontrolled moderate‑to‑severe atopic dermatitis. 1-844-DUPIXENT 1-844-387-4936. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of. I pay for it with my insurance and the myway copayment program. DUPIXENT MyWay® A program to provide support to patients starting DUPIXENT. ENROLLMENT FORMDUPIXENT is a form of medicine called a biologic that targets Type 2 inflammation, an underlying cause of nasal polyps. 67 mL, 200 mg/1. 14 mL, or 300 mg/2 mL) Call 1-844-387-4936, Option 1 to contact DUPIXENT MyWay ®. For pediatric patients aged 6 to 11 years, Dupixent dosing is based on weight (100 mg every two weeks or 300 mg every four weeks for children ≥15 to <30 kg, and 200 mg every two weeks for children ≥30 kg) and is supplied as a pre-filled syringe. And, if you're eligible, you can sign up and receive your card today. The patient would prefer not to try. The $500 payment counts towards the member’s deductible and out-of-pocket maximum. It should only be given by an adult caregiver in children 6 to 11 years of age. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. Prior authorization and appeals. It was a process to get into the patient assist program. chevron_right. This DUPIXENT Pre-filled Pen is a single-dose device. S. 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. Especially tell your healthcare provider if you. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will notDUPIXENT MyWay may ask for proof of income at any time for the purpose of audit/verification. LEARN ABOUT OUR PATIENT SUPPORT PROGRAM. _____ What is your total annual household income? _____ (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. 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. Appears that my out of pocket maximum will be $8000 through insurance. How much does Dupixent cost without insurance? The average monthly retail price of Dupixent is $4,910 per 2, 2 mL of 300 mg/2 mL prefilled syringes. It may be covered by your Medicare or insurance plan. SINCE 2017, ≈253,000 PATIENTS HAVE FILLED AT LEAST 1 DUPIXENT PRESCRIPTION b,c. DUPIXENT MyWay®. For patients with commercial insurance who are new to DUPIXENT and experiencing a. Patient Assistance Program. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. 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. Regeneron and Sanofi are committed to helping patients in the U. If you have any additional questions about this pricing information, please call DUPIXENT MyWay at 1-844-DUPIXENT (1-844-387-4936). At one point, I was getting cold sores every 2 to 3 weeks consistently. 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. With MyWay, I get the year for free. DUP. It still covers the same amount. VO: DUPIXENT is a prescription medicine used: to treat people aged 6 years and older with moderate-to-severe atopic dermatitis (eczema) that is not well controlled with prescription therapies used on the skin (topical), or who cannot use topical therapies. 03. Tell your healthcare provider about any new or worsening joint symptoms. Section 5a. DUPIXENT® (dupilumab) Prescription Information Quick Start may be able to provide DUPIXENT at no cost to help bridge patients to therapy if there is a coverage delay. Each time you fill your DUPIXENT prescription, please ensure your. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not affect any disclosure of My Information based on this Authorization made before my request is received and processed by my Healthcare Providers, Health Insurers, The DUPIXENT MyWay Copay Card Program includes the Copay Card, the Debit Card, and any direct patient rebate, and has a combined annual maximum benefit of $13,000 per patient per calendar year. S. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will notEnrollment 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. 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). living with prurigo nodularis. Sign up for the DUPIXENT MyWay® mentor program for adults with uncontrolled chronic rhinosinusitis with nasal polyposis that is associated with type 2 inflammation. In an open-label extension study, the long-term safety profile of DUPIXENT ± TCS in pediatric patients observed through Week 52 was consistent with that seen in adults with. Monday-Friday, 8 am-9 pm ET. 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 significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3 program consisting of two pivotal trials. In order to meet the financial eligibility criteria for receiving Sanofi medication at no cost, you must have an annual household income of ≤ 400% of the current Federal Poverty Level. $0 is the amount you pay. I just spoke to someone through the MyWay Program. If I am completing Section 5b, I authorize for my commercially insured patient one. DUPIXENT MyWay team will research each patient’s situation and determine eligibility. If this is the case, write the preferred specialty pharmacy. 23. • DUPIXENT can be stored at room temperature up to 77°F (25°C) up to 14 days. Please see Important Safety Information and Prescribing Information and Patient Information on website. 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 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. will need to meet the eligibility criteria, including household income, to qualify. Complete the entire form and submit pages 1-3 to ®DUPIXENT MyWay via fax at 1-844-387-9370 or Document Drop at (code: 8443879370) For assistance, call 1-844-DUPIXEN(T) (1-844-387-4936) Option 1, Monday–Friday, 8 am–9 pm ET Enrollment Form FOR ALLERGISTSyou are supposed to get a copay savings card from dupixent myway. 6 Submitting a PA request The appeal. THE DUPIXENT MyWay PROGRAM. After removal from the refrigerator, DUPIXENT must be used within 14 days or discarded. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. . Throw away (dispose of) any DUPIXENT that has been left at room temperature for longer than 14 days. com. Income at or below: Not Published: Medical expenses can be. It may be covered by your Medicare or insurance plan. 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 other 4 ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pm This will allow the specialty pharmacy to conduct the benefits investigation, and DUPIXENT MyWay will provide additional support to the patient. Eligible patients covered by commercial health insurance may pay as little as a $0 p copay per fill of DUPIXENT. 0185 Last Update: November 2022 DUP. 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). 14 mL Dupixent subcutaneous solution from $3,787. There is currently no generic alternative to Dupixent. DUPIXENT® (dupilumab) is a. I understand the disclosure to the Alliance will be for the purposes of enrolling me in, and providing certain services through the DUPIXENT MyWay Program, including • to determine if I am eligible to participate in DUPIXENT MyWay coverage assistance programs, patient assistance programs, or otherThis DUPIXENT Pre-filled Pen is only for use in adults and children aged 2 years and older. The Dupixent MyWay program is not available to medicare patients. It temporarily provides eligible patients DUPIXENT at no cost, subject to program terms and conditions. BIN: 020750 RX PCN: NMeds RX GRP: PDFPDF ID: NMNA019309901930 This is a drug discount program, not an insurance plan. Fill out sections 5a and 5b completely to determine patient eligibility. 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. Serious adverse reactions may occur. DUPIXENT® is indicated as an add-on maintenance treatment of adult and pediatric patients 6 years and older with moderate-to-severe asthma characterized by an eosinophilic phenotype or with oral corticosteroid. Sign it in a few clicks. 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. With of DUPIXENT MyWay Copay Card, right, commercially insured patients might pay as little as $0* copay per fill of DUPIXENT. dupixent myway income guidelinesstellaris unbidden and war in heaven. For more information, call 1-844-DUPIXENT. DUP. 06 and -1. Please see Important Safety Information and full PI on website. g. How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. any time by mailing or faxing a written request to DUPIXENT MyWay at 1800 Innovation Point, Fort Mill, SC 29715; Fax: 1-844-387-9370. Program Website : Patient Assistance Applicationsfor DUPIXENT® dupilumab therapy My Information. Patients in each age group saw improved lung function in as little as 2 weeks. 2. 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. After that, we will have met our family deductible. 50 for a single person. 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. 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. Ways to save on Dupixent. 78 L) was seen at Week 2 in patients taking DUPIXENT 200 mg Q2W + SOC (n=264) (baseline blood EOS ≥300 cells/μL, QUEST, secondary endpoint). Please see. Fill a 90-Day Supply to Save. The increase was approved by the Minnesota Legislature and will help expand SNAP eligibility to families who may have previously been ineligible for the. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Depends if your insurance cares that Dupixent myway is paying your deductible. financial assistance for eligible patients, provide one-on-one nursing support, and more. DUPIXENT can cause serious side effects, including: The most common side effects in patients with eczema include. Eligible patients will receive they cards by e-mail. Coverage varies by. 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. For more information and to find out if you’re eligible for support, call 844-DUPIXENT (844-387-4936) or visit the program website. LEARN ABOUT OUR PATIENT SUPPORT PROGRAM. Does anyone know of any assistance programs I can use to help assist in the copay after dupixent my way limit is reached?33% and 27% reduction in their nasal polyps score compared to a 7% and 4% increase with placebo in SINUS-24 and SINUS-52, respectively (LS mean change from baseline of -1. 80). The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Expert perspectives on management of moderate-to-severe atopic dermatitis: a multidisciplinary consensus addressing current and emerging therapies. with household income, to qualify. 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. Over 80% of insurance plans cover Dupixent, but many have restrictions. 2 Eligible US residents with an FDA-approved. Box 5925 Mailstop 55A-220A Bridgewater, NJ 08807. Financial criteria for patient assistance. 3. Fill out sections 5a and 5b completely to determine patient eligibility. Governed and delivered by Service Canada. 23. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. If you are a New York prescriber, please use an original New York State prescription form. Sign up to connect with a DUPIXENT MyWay® mentor to help patients with Nasal Polyps through their DUPIXENT. - Rachel, DUPIXENT Patient Mentor, living with asthma. 01. I’m Laurie. 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 refer to Section 8, Patient Certifications, for. you offering to give them $170 they assumed you didn’t want to bother contacting dupixent myway. Some Medicare plans may help cover the cost of mail-order drugs. A program called Dupixent MyWay is available for this drug. 8K subscribers in the eczeMABs community. 00 per injection. 02. The formulary status tool below can help check DUPIXENT coverage for various plans. So, even with a "prior authorization" and a "formulary override", the cost to me is $2900 per month, or about $1450.