Injection Support Center Injection Reminders and Tips FREQUENTLY ASKED QUESTIONS; Español. DUPIXENT® (dupilumab) is a. living with prurigo nodularis are most in need of new treatment options . Your healthcare provider may stop DUPIXENT if you develop joint symptoms. 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. Check your eligibility for the DUPIXENT MyWay® Copay Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. 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. Patients will need on hit the eligibility benchmark, including household income, to qualify. 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. How to fill out dupixent reimbursement: 01. 67 mL; 200 mg per 1. 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. They pay the first $13K (in a year) then when that is exhausted I will have to pay around $250 per month and the $13K starts over in January 2019. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not affect any disclosure of My Information based on this Authorization made before my request is received and. DUPIXENT® (dupilumab) Prescription Information Quick Start may be able to provide DUPIXENT at no cost to help bridge patients to therapy if there is a coverage delay. Effective Sept. If necessary, DUPIXENT may be kept at room temperature up to 77 °F (25 °C) for a maximum of 14 days. -The original form (from the first guy) was still in the system and the folks at MyWay were “confused” by it. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. From my understanding, the Dupixent MyWay Program pays the $125 since your insurance is covering the rest. How many people live in your household? _____ Please refer to. 00. For patients with commercial insurance who are new to DUPIXENT and experiencing a. For children aged 6 months to 5 years, it is taken as 1 injection every 4 weeks. It may be covered by your Medicare or insurance plan. 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. 0156 Last Update: March 2023 DUP. Dupixent may cause serious side effects. 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. And, if you're eligible, you can sign up and receive your card today. LEARN ABOUT OUR PATIENT SUPPORT PROGRAM. 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. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will notFor 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. This copay card may be for you if you. b New adult and pediatric patients aged 6 years and older with moderate-to-severeSection 5a. Robocalls increase diabetic retinopathy screenings in low-income patients. ®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. Over 80% of insurance plans cover Dupixent, but many have restrictions. Using the drop. At that point we will owe 20% of the cost of the medication, which adds up to just under $700/month. Advertisement. For more information, dial 1-844-DUPIXENT 1-844-387-4936 ), option 5, Monday-Friday, 9 am – 9 pm ET. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3 program consisting of two pivotal trials About 75,000 adults in the U. 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. With of DUPIXENT MyWay Copay Card, right, commercially insured patients might pay as little as $0* copay per fill of DUPIXENT. So, let's just pretend the total cost is $1,000/month. It’s a change in how copay assistance and coupons are counted toward your. Fill out sections 5a and 5b completely to determine patient eligibility. 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. It may be covered by your Medicare or insurance plan. A program called Dupixent MyWay is available for this drug. 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. Support. 2022;400 (10356):908-919. DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older, with uncontrolled, moderate-to-severe eczema (atopic dermatitis). 00. , chart notes, laboratory values) and use of claims history documenting the following: 1. 14 mL, or 300 mg/2 mL)The Dupixent MyWay program is not available to medicare patients. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. LASTING CHANGE IS ACHIEVABLE. The DUPIXENT MyWay team can research each patient’s situation and determine eligibility. including household income, to qualify. Fill out sections 5a and 5b completely to determine patient eligibility. 0254 Last Update: February 2023 DUP. Serious side effects can occur. Option 1- you have to meet your deductible without Dupixent myway. There is currently no generic alternative to Dupixent. 71 for Dupixent compared to 0. 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 . Hear real patients stories of life with uncontrolled moderate-to-severe asthma and how discovering DUPIXENT® (dupilumab) impacted their journey. 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. 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). 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. It's like $35k-$40k. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may payable as little while $0* copay per fill by DUPIXENT. Dupixent will run about $3000 per month with my insurance until my maximum is met. ) 2 Prescription InformationDupixent® (dupilumab) approved by FDA as the first and only treatment indicated for prurigo nodularis. DUPIXENT can be used with or without topical corticosteroids. Option 1- you have to meet your deductible without Dupixent myway. DUPIXENT® is a prescription medicine used as an add-on maintenance treatment for uncontrolled moderate-to-severe eosinophilic or oral steroid dependent asthma in people aged 6 years and older. 2 cartons. ago. DUPIXENT is a prescription medicine used as an add-on maintenance treatment for adults and children 6 years of age and older who have moderate-to-severe eosinophilic or oral steroid dependent asthma that is not controlled with their current asthma medicines. The language of the MyWay program back then never mentioned the $13,000 limit: they simply asked for income requirements, etc. The most common side effects include: DUPIXENT MyWay. Since MyWay covers 13,000 a year, that will count towards your deductible. There is another biologic very similar to Dupixent called Adbry. Required if enrolling in the DUPIXENT MyWay. DUPIXENT should not be stored above 77 °F (25 °C). Section 5a. I suppose it doesn't really matter now. For more informational, page 1‑844‑DUPIXENT (1-844-387-4936), option. Eligible patients will receive their cards by email. DUPIXENT (dupilumab) Dupixent FEP Clinical Criteria AND submission of medical records (e. Serious side effects can occur. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3 program consisting of two pivotal trials About 75,000 adults in the U. Since 2018, DUPIXENT has been prescribed to over 100,000 asthma patients in the US. 23. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. Financial criteria for patient assistance. 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. 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. Deductible is at $3k out of pocket insurance pays 80% and at $6k insurance pays 100%. The Dupixent pre-filled syringe is available in the following strengths: 100 mg per 0. At one point, I was getting cold sores every 2 to 3 weeks consistently. Please see Important Safety Information and Patient Information on website. ) I agree that Regeneron Pharmaceuticals, Inc. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. I've been on Dupixent for over 2 years now and it has been such a great experience keeping my eczema under control. You must also meet certain household income eligibility requirements as outlined below: 48 States and DC. DUPIXENT® and DUPIXENT MyWay® are entered commercial of Sanofi Biotechnological. Coverage varies by type and plan. 14 mL, or 300 mg/2 mL)Call 1-844-387-4936, Option 1 to contact DUPIXENT MyWay ®. 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. But either way, after you or Dupixent myway meets your deductible, it should be free to you. Susie16 Oct 15, 2023 • 9:37 PM. Get emergency medical help if you have signs of an allergic reaction to Dupixent: hives, rash, itching; fever, swollen glands, joint pain; feeling light-headed, difficult breathing; swelling of your face, lips, tongue, or throat. Serious adverse reactions may. I wanted to go out and make a difference and help people. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not ENROLL. 67 mL, 200 mg/1. Injection site reactions and eye conditions are the most common side effects reported and, unlike several other biologics, the risk of infection is low. $125 is the amount Dupixent assistance pays. It will also depend on how much you have. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3 program consisting of two pivotal trials. chevron_right. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. 18, 0. In this case Dupixent myway will cover the first 13k, which is probably like 5 months. any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. 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). 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. 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. who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay ® program. ®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. 1-844-DUPIXENT 1-844-387-4936. It still covers the same amount. Box 5925 Mailstop 55A-220A Bridgewater, NJ 08807. 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). Lancet. 0252 Last Update: Feb 2023 DUP. Learn how DUPIXENT® (dupilumab) works as the first and only FDA-approved treatment for prurigo nodularis (PN) in adults aged 18 years and older. That is what I am in the middle of. 17 and 0. Well at a cost of roughly $3,500/dose which lasts a month, that will all be used up in four months. 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. In this case Dupixent myway will cover the first 13k, which is probably like 5 months. who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay ® program. Access the dupixent reimbursement form either online or through your healthcare provider. 01. Even when using the Copay Card, that would cover only cover 4 months worth, and would not go towards my deductible, totaling about. · If the insurer does have a copay accumulator in place: the insurer pays the entire cost of the refill except for $500. Continuation in the DUPIXENT MyWay Patient Assistance Program is conditioned upon timely verification of income. Form more information phone: 844-387-4936 or Visit website Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. DUPIXENT has been FDA approved for use in adults with uncontrolled moderate-to-severe eczema since 2017. If you are a New York prescriber, please use an original New York State prescription form. a $85. The doctor's office called to say I need to call to talk about my income and expenses. Declining androgen levels correlated with increased frailty. - Rachel, DUPIXENT Patient Mentor, living with asthma. DUPIXENT MyWay coordinators are available Monday-Friday 8 am to 9 pm ET. Ways to save on Dupixent. Please see Important Safety Information and Patient Information on. 00 per injection. 0185 Last Update: November 2022 DUP. The formulary status tool below can help check DUPIXENT coverage for various plans. 98% of Commercially Insured Patients. After that, we will have met our family deductible. Im so stressed out about. Monday-Friday, 8 am-9 pm ET. 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. Compare . The formulary status tool below can help check DUPIXENT coverage for various plans. 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. It temporarily provides eligible patients DUPIXENT at no cost, subject to program terms and conditions. 14 mL, or 300 mg/2 mL)My insurance provider covers 85% and our Canadian version of 'MyWay' pays the remainder. It temporarily provides eligible patients DUPIXENT at no cost, subject to program terms and conditions. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. 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. Your doctor will tell you how much DUPIXENT to inject and how often to inject it. Sign it in a few clicks. 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. Experience: Been on Dupixent since May 15, 2017. 01. THE DUPIXENT MyWay PROGRAM. You have to game the system instead of trying to get full coverage. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. If you don't have insurance at all, the only realistic option is to qualify for income-based help from Dupixent directly. Depends if your insurance cares that Dupixent myway is paying your deductible. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. 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. 09. 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. 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. any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. You can email or print the enrollment forms below. 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. For more information, dial 1‑844‑DUPIXENT ( 1-844-387-4936 ), option 1 Monday-Friday, 8 am - 9 pm ET. The DUPIXENT MyWay team will research each patient’s situation and determine eligibility. THIS IS NOT INSURANCE. For more information, call 1. Eligible patients will receive their cards by email. 2 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). SINCE 2017, ≈253,000 PATIENTS HAVE FILLED AT LEAST 1 DUPIXENT PRESCRIPTION b,c. (2 of 3) Patient signature/Legal representative if patient is <18 years Date Section 2. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. ) 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. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. To contact DUPIXENT MyWay, please call 1-844-DUPIXENT (1-844-387-4936). For assistance, please call 1-844-468-2252 Monday Friday, 8AM to 8PM ET. 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. In patients aged 6 months to 5 years, Dupixent is administered with a pre-filled syringe every four weeks based on weight (200 mg for children ≥5 to <15 kg and 300 mg for children ≥15 to <30 kg). 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. Continuation in the program is conditioned upon timely verification of income. 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. The $500 payment counts towards the member’s deductible and out-of-pocket maximum. DUPIXENT MyWay. Quantity Limits: Dupixent: 200 mg/1. DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older with uncontrolled, moderate-to-severe. 1-844-DUPIXENT (1-844-387-4936) Topicort (desoximetasone spray 0. Follow these tips to take DUPIXENT while traveling: Store DUPIXENT in the original carton to protect it from light. Dupixent MyWay pays the $500 copay. Your office may choose to use a preferred specialty pharmacy to start the benefits investigation. DUPIXENT is not a steroid or immunosuppressant; it is a prescription biologic medicine given under the skin (subcutaneous injection). Have commercial insurance, including health insurance. March 27, 2018. For more information, call 1-844-DUPIXENT. Dupixent is not intended for episodic use. Connect with someone, ask questions, and learn about their experience with DUPIXENT® (dupilumab) treatment. Rx: DUPIXENT® (dupilumab) (100 mg/0. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. Gather all necessary information and documents, such as your insurance information, prescription details, and any supporting documentation. 80). If your office does not use a preferred specialty pharmacy, leave the box unchecked to indicate that you would like DUPIXENT MyWay to conduct the benefits investigation on the patient’s behalf. Not valid for prescriptions paid, in whole or in part, by Medicaid, Medicare, VA, DOD, TRICARE, or. Support. . And I would experience blurry vision, red and itchy eyes. Do NOT shakeConoce las dos opciones de administración disponibles: jeringa precargada de 200 mg y 300 mg, y pluma precargada de 200 mg y 300 mg (para edades de 12 años o más), y revisa cómo inyectar DUPIXENT® (dupilumab), un medicamento para inyección subcutánea, de venta con receta, para el eczema moderado a grave en adultos y niños de 6 meses o más. If I am completing Section 5b, I authorize for my commercially insured patient one. With the DUPIXENT MyWay Copay Card, eligible,. DUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process. Pay as little as $0 per month. 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. Please complete the form, sign, and FA to 1-844-23-312. Approval represents the second dermatology indication for Dupixent and fifth disease indication overall in the. Complete the entire form and submit pages 1-2 to ®DUPIXENT MyWay via fax at 1-844-387-9370 or Document Drop at (code: 8443879370) For assistance, call 1-844-DUPIXEN(T) (1-844-387-4936) Option 1, Monday–Friday, 8. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Although you are not eligible, you can sign up DUPIXENT MyWay. 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. Check your eligibility for the DUPIXENT MyWay® Copay Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients. chevron_right. will need to meet the eligibility criteria, including household income, to qualify. 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. 99% of commercial patients (6+ months of age) nationally are covered for DUPIXENT. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. If you are a New York prescriber, please use an original New York State prescription form. 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. Hear from DUPIXENT® (dupilumab) patients & caregivers of patients 6 years and older with uncontrolled moderate-to-severe atopic dermatitis & healthcare professionals who treat atopic dermatitis, download helpful resources & explore future events. Página de inicio de franquicias ; Eczema moderado a grave (6 meses de edad o más) Asma moderada a grave (6 años de edad o más) DUPIXENT Pricing Information For Healthcare Professionals. . I have a $40 copay but I got the dupixent my way copay card its free for me. ®DUPIXENT (dupilumab) Prescription Information Prescriber Certification: My signature certifies that the person named on this form is my patient; the information provided on this application, to the best of my knowledge, is complete and accurate; that therapy with DUPIXENT is medically necessary; and that I. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. DUPIXENT is available as a single dose in a pre-filled syringe (200 mg or 300 mg) with needle shield, or single-dose pre-filled pen (200 mg or 300 mg) for ages 2+ years. PRESCRIBER TO FILL OUT Section 6a. Each time you fill your DUPIXENT prescription, please ensure your. 01. com. But either way, after you or Dupixent myway meets your deductible, it should be free to you. Income at or below: Not Published: Medical expenses can be deducted from reported income:. Be sure to fill out your enrollment form completely and accurately. Ready to connect with actual patients and caregivers being treated with DUPIXENT? The DUPIXENT MyWay Mentor Program helps put current and prospective moderate-to-severe eczema (atopic dermatitis or AD) DUPIXENT patients in contact with people going through similar. Expert perspectives on management of moderate-to-severe atopic dermatitis: a multidisciplinary consensus addressing current and emerging therapies. 6 Submitting a PA request The appeal. The patient must then take the following actions:I just got approved for dupixent this week however the copay is 3,000$ a month! The dupixent my way program only covers up to 13k or something like that. Especially tell your healthcare provider if you. That is good, because I was quoted 1400+ a month by my Medicare D provider. Dupixent changed my life completely. They are a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI. Use DUPIXENT exactly as prescribed by your doctor. $3,645. I’ve been with DUPIXENT MyWay since the very beginning. 1. And I would experience blurry vision, red and itchy eyes. 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. 02. Subcutaneous Solution 100 mg/0. Serious side. DUPIXENT is taken by injection under the skin (subcutaneous injection) once every two weeks. If this is the case, write the preferred specialty pharmacy name and then check the box indicating that you have sent the prescription to the specialty pharmacy, which will. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. 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. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. Click Tap to Learn More In an open-label extension study, the long-term safety profile of DUPIXENT ± TCS in pediatric patients observed through Week 52 was consistent with that seen in adults with atopic dermatitis, with hand-foot-and-mouth disease and skin papilloma (incidence ≥2%) reported in patients 6 months to 5 years of age. DUPIXENT MyWay® A program to provide support to patients starting DUPIXENT. 23. Program Website : Program Applications and FormsView the possible side effects of DUPIXENT in patients with uncontrolled chronic rhinosinusitis with nasal polyposis. 17 and 0. Program possessed one annual maximum from $13,000. 2. Lancet. For more information, call 1-844-DUPIXENT ( 1-844-387-4936) option 1. for reimbursement to any payer, including Medicare and Medicaid; and no free product may be sold, traded, or distributed for sale. “Eczema otherwise unspecified” is not indicated for Dupixent. The fax number is 1. 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. If you are a New York prescriber, please use an original New York. DUPIXENT MyWay Ambassador. Enroll now to receive emails and resources designed to help patients, caregivers and information seekers through the DUPIXENT® (dupilumab) treatment journey. 2 pens of 300mg/2ml. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not 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) Section 5a. I also have the dupixent myway card that covers a total of $13,000 for the year. if speciality. Manufacturer Coupon. DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. Prurigo Nodularis: The most common adverse reactions (incidence ≥2%) are nasopharyngitis, conjunctivitis, herpes infection, dizziness, myalgia, and diarrhea. 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. Regeneron and Sanofi are committed to helping patients in the U. Appears that my out of pocket maximum will be $8000 through insurance. 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. 23. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. Guam or the USVI, and demonstrate a financial need with a total annual adjusted gross income of $100,000 or less. 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. Upon receipt of the completed Enrollment Form, DUPIXENT MyWay will: Conduct a benefits investigation to confirm commercial coverage Assess if the patient meets the eligibility criteria for the Quick Start Program 1 2 Approve the patient (if they are eligible). DUPIXENT 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. I know people who make six figures on a joint income and still use MyWay. 1‑844‑DUPIXENT 1-844-387-4936. 67 mL, 200 mg/1. Insurance Information Insurance? Yes No If yes, is it Medicare Part D? Primary insurance name Secondary insurance nameDupixent myway income limits 2022; where to buy authentic kf94 masks;. Serious side effects can occur. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. For Healthcare Professionals. I. I just spoke to someone through the MyWay Program. 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). 67 mL, 200 mg/1. 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. 89 and -1. Type text, add images, blackout confidential details, add comments, highlights and more. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. DUPIXENT ® is a fully human monoclonal antibody that inhibits the signaling of the interleukin-4 (IL-4) and interleukin-13 (IL-13) proteins 3 and is not an immunosuppressant. In clinical trials, DUPIXENT reduced the. The most common side effects include: DUPIXENT MyWay. Watch videos from experts [,download materials,] and explore future events to further understand DUPIXENT® (dupilumab). 23. Sign up or activate your card here. Eligible patients covered by commercial health insurance may pay as little as a $0 p copay per fill of DUPIXENT. 98% of Commercially Insured Patients. How much does Dupixent cost without insurance? The average monthly retail price of Dupixent is $4,910 per 2, 2 mL of 300 mg/2 mL prefilled syringes. Dupixent will run about $3000 per month with my insurance until my maximum is met. I’m Laurie. The majority of DUPIXENT patients with commercial/employer-provided insurance use the DUPIXENT MyWay ® Copay Card. 22. 03. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. S. I give supplemental injection training to the patient and the patient’s caregiver. Fill a 90-Day Supply to Save. 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. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. 22. Clip the card and save • Save up to 80% on medications*Tell your healthcare provider about any new or worsening joint symptoms. chevron_right. Base amount is $558. Sanofi and Regeneron are committed to helping patients in the U. There is currently no generic alternative to Dupixent. - Rachel, DUPIXENT Patient Mentor, living with asthma. 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. Program has an annual maximum of $13,000. S. 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. 3. Section 5a. Sign it in a few clicks. Support. I suppose it doesn't really matter now. I give supplemental injection training to the patient and the patient’s caregiver. It took the price from 2K to 1K. Get a Quick Start. *For patients on DUPIXENT 300 mg in a 24-week and a 52-week clinical trial vs 17% for placebo group. If you’re the spouse or.