) I agree that Regeneron Pharmaceuticals, Inc. Dupixent Myway . ago It is actually not a change in the myway program. 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. Do not store DUPIXENT pre-filled syringes at room temperatures more than 77°F (25°C) Do not keep DUPIXENT at room temperature. I’m Laurie. Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. 01. It may be covered by your Medicare or insurance plan. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. 80). 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. With of DUPIXENT MyWay Copay Card, right, commercially insured patients might pay as little as $0* copay per fill of DUPIXENT. A 68-year-old woman developed generalized joint pain 6 weeks after starting Dupixent. DUPIXENT® (dupilumab) is indicated as an add-on maintenance treatment in adult patients with inadequately controlled chronic rhinosinusitis with nasal polyposis (CRSwNP). 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® (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). How to fill out dupixent reimbursement: 01. Fill out sections 5a and 5b completely to determine patient eligibility. 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. Effective Sept. Got off of it as soon as I realized it was getting worse with every shot after spacing them out every other month. 1-844-DUPIXENT (1-844-387-4936) Topicort (desoximetasone spray 0. So the nurse told me to fax receipts for year to date prescriptions and last year's income forms (W2, 1099, etc). I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. Share your form with others. ®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. SINCE 2017, ≈253,000 PATIENTS HAVE FILLED AT LEAST 1 DUPIXENT PRESCRIPTION b,c. I just got approved thru Dupixent my way for a year of free medication. Section 5a. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. I also have the dupixent myway card that covers a total of $13,000 for the year. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. Program Website : Program Applications and FormsView the possible side effects of DUPIXENT in patients with uncontrolled chronic rhinosinusitis with nasal polyposis. 01. Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. Learn how DUPIXENT helped treat children 6 to 11 years old with their moderate-to-severe asthma. 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. 14 mL, or 300 mg/2 mL)The average cash price for a 30-day supply of Dupixent is $5,298. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. If you are moderate to low-income person with eczema or just need help paying for your health care or prescription costs, you’ve come to the right place. DUPIXENT MyWay team will research each patient’s situation and determine eligibility. 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 otherDUPIXENT . It took the price from 2K to 1K. 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. PRESCRIBER TO FILL OUT Section 6a. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. 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. Edit your dupixent myway enrollment form online. 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. ENROLLMENT FORMDUPIXENT is a form of medicine called a biologic that targets Type 2 inflammation, an underlying cause of nasal polyps. 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). According to the manufacturers, Dupixent can be dosed to a maximum daily dose as indicated below. The average cash price for a 30-day supply of Dupixent is $5,298. The majority of DUPIXENT patients with commercial/employer-provided insurance use the DUPIXENT MyWay ® Copay Card. I’ve been with DUPIXENT MyWay since the very beginning. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. We are finding the Dupixent MyWay program to be quite challenging to understand; we don't know whether that might be an option, and we are looking at other options, even expensive ones. Patients in each age group saw improved lung function in as little as 2 weeks. Prior authorization and appeals. Human IgG antibodies are known to cross the placental barrier; therefore, DUPIXENT may be transmitted from the mother to the developing fetus. ®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. I’ve been with DUPIXENT MyWay since the very beginning. How many people live in your household? _____ Please refer to. When I was very young, I knew that I wanted to be a nurse. 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. ) 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). Since 2017, Dupixent has increased in price by 13%. The U. If requested, I agree to provide proof of income within thirty (30) days of the request. Data from DUPIXENT ® clinical trials have shown that IL-4 and IL-13 are key drivers of the type 2 inflammation that plays a major role in asthma, atopic. If you don’t have health insurance, talk. Serious adverse reactions may. Based on the questions answered above, you are not eligible to register for a new copay card or to activate a copay card. DUPIXENT MyWay®. For more information, call 1-844-DUPIXEN (T) (1-844-387-4936. I suppose it doesn't really matter now. Financial criteria for patient assistance. After removal from the refrigerator, DUPIXENT must be used within 14 days or discarded. • Store DUPIXENT in the refrigerator at 36°F to 46°F (2°C to 8°C). 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. DUPIXENT MyWay coordinators are available Monday-Friday 8 am to 9 pm ET. Hello! Switching insurance this year and need to prepare for increasing costs of dupixent with my new insurance. The fax number is 1. I found the carnivore diet helps immensely for autoimmune issues. I’m Laurie. 98% of Commercially Insured Patients. a Coverage varies by type and plan. Access the dupixent reimbursement form either online or through your healthcare provider. Decreased exacerbations and/or improvement in symptoms 2. 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 Enrollment FormYes, it does appear that Dupixent can cause weight gain, although this is not listed as a side effect in the product information. S. DUPIXENT . _____ What is your total annual household income? _____ (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. 67 mL; 200 mg per 1. Oct 26, 2022 · Dupixent MyWay Program Enrollment Form for Allergists (AD, Asthma, CRSwNP). Dupixent. In this case Dupixent myway will cover the first 13k, which is probably like 5 months. For children aged 6 months to 5 years, it is taken as 1 injection every 4 weeks. 12. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. Manufacturer Coupon. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. S. Financial criteria for patient assistance. Serious side effects can occur. Please note that you will receive a confirmation fax after sending the form. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. Learn more about programs for eligible patients who are insured, underinsured, and uninsured. 0156 Last Update: March 2023 DUP. 14 mL, or 300 mg/2 mL) Call 1-844-387-4936, Option 1 to contact DUPIXENT MyWay ®. Serious side. They are a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI. DUPIXENT (dupilumab) Dupixent FEP Clinical Criteria AND submission of medical records (e. Clip the card and save • Save up to 80% on medications*Tell your healthcare provider about any new or worsening joint symptoms. 17 and 0. Learn how DUPIXENT® (dupilumab) works as the first and only FDA-approved treatment for prurigo nodularis (PN) in adults aged 18 years and older. THIS IS NOT INSURANCE. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. If you are a New York prescriber, please use an original New York. 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 me, the side effects didn’t really bother me or have me second guess my decision with Dupixent because my skin was. DUPIXENT is a biologic and can help reduce your patients' use of systemic corticosteroids. Eligible patients covered by commercial health insurance may pay as little as a $0 p copay per fill of DUPIXENT. DUPIXENT has been FDA approved for use in adults with uncontrolled moderate-to-severe eczema since 2017. For more information, dial 1‑844‑DUPIXENT( 1-844-387-4936 ), option 1. Just got off the phone with Dupixent My Way. 14 mL, or 300 mg/2 mL)Call 1-844-387-4936, Option 1 to contact DUPIXENT MyWay ®. If you are a New York prescriber, please use an original New York State prescription form. 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. 4. 2 cartons. Household Size. For more information and to find out if you’re eligible for support, call 844-DUPIXENT (844-387-4936) or visit the program website. 22. Eligible patients will receive their cards by email. They are a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI. For more informational, page 1‑844‑DUPIXENT (1-844-387-4936), option. At one point, I was getting cold sores every 2 to 3 weeks consistently. 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. 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. 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. Sign up to connect with a DUPIXENT MyWay® mentor to help patients with Nasal Polyps through their DUPIXENT. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. Support. 01. 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. March 27, 2018. You can email or print the enrollment forms below. Additionally, Dupixent MyWay ™ offers personalized support from registered nurses and other specialists who are available 24/7 to speak with patients and help them navigate the complex insurance. First few months into taking Dupixent, I got laid off and worked w my doctors/Dupixent to get assistance. ) I agree that Regeneron Pharmaceuticals, Inc. Patient and Co-pay Assistance: DUPIXENT MyWay helps eligible patients get access to therapy whether they are uninsured, lack. Compare . dupixent myway income guidelinesstellaris unbidden and war in heaven. THE DUPIXENT MyWay COPAY CARD. That is good, because I was quoted 1400+ a month by my Medicare D provider. Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. com. 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;. Enroll now to receive emails and resources designed to help patients, caregivers and information seekers through the DUPIXENT® (dupilumab) treatment journey. Eczema. 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. 8K subscribers in the eczeMABs community. Your doctor will tell you how much DUPIXENT to inject and how often to inject it. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. 1-844-387-4936 (toll free) Monday - Friday, 8AM - 9PM (ET) Multilingual options available. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. *For patients on DUPIXENT 300 mg in a 24-week and a 52-week clinical trial vs 17% for placebo group. 2 pens of 300mg/2ml. Be sure to fill out your enrollment form completely and accurately. It’s a change in how copay assistance and coupons are counted toward your. For more information and to find out if you’re eligible for support, call 844-DUPIXENT (844-387-4936) or visit the program website. For children aged 6 months to 5 years, it is taken as 1 injection every 4 weeks. Have commercial insurance, including health insurance. 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. Also if your insurance does cover,Dupixent offers a co-pay card that. 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). 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 is not used to treat sudden breathing problems. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. Governed and delivered by Service Canada. 1-844-387-4936 (toll free) Monday - Friday, 8AM - 9PM (ET) Multilingual options available. DUPIXENT® (dupilumab) is a. In clinical trials, DUPIXENT reduced the. (DUPIXENT + Topical Corticosteroids (TCS) vs TCS only): CLEAR OR ALMOST CLEAR SKIN AT 16 Weeks 39% taking DUPIXENT + TCS vs 12% using TCS only. The language of the MyWay program back then never mentioned the $13,000 limit: they simply asked for income requirements, etc. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not ENROLL. 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. Sign up or activate your card here. Patient assistance program. 2 cartons. 22. If you still have questions, you can speak with a DUPIXENT MyWay representative or request to join the program over the phone. Please see accompanying full Prescribing Information. 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. Patient Signature _____ If you have questions about the . THE DUPIXENT MyWay PROGRAM. Patient is responsible for any out-of-pocket amounts that exceed the program limit. $3,645. 67 mL, 200 mg/1. This DUPIXENT Pre-filled Pen is a single-dose device. Refrigerate it at 36 °F to 46 °F. was not paid in whole or in part by Medicare, Medicaid, or any federal or state programs. 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. DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. DUPIXENT® (dupilumab) is a. Section 5a. 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. So, even with a "prior authorization" and a "formulary override", the cost to me is $2900 per month, or about $1450. 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. S. Please see Important Safety Information and full PI on website. Dupixent MyWay pays the $500 copay. Subcutaneous Solution 100 mg/0. 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. Pregnancy: A pregnancy exposure registry monitors pregnancy outcomes in women exposed to DUPIXENT during pregnancy. Social Security income, unemployment insurance benefits, disability income, any other income for the household. With and DUPIXENT MyWay Copay Card, eligible, commercially insured care may pay when little as $0* copay by fill the DUPIXENT. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. The DUPIXENT MyWay team can research each patient’s situation and determine eligibility. 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. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. DUPIXENT should not be stored above 77 °F (25 °C). Please see Important Safety Information and Patient Information on website. At one point, I was getting cold sores every 2 to 3 weeks consistently. Appears that my out of pocket maximum will be $8000 through insurance. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. 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. Johns Hopkins EHP i think goes with cigna and CVS Specialty pharmacy covers. 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. Fill out sections 5a and 5b completely to determine patient eligibility. As far as choosing a better plan with a lower deductible, I don't really have much of a choice. “It’s an incredible feeling to be validated and. if speciality. 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. 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. 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. For patients with commercial insurance who are new to DUPIXENT and experiencing a. Please see Dosage Regimens, How to Inject DUPIXENT® and Instructions for Use. For patients with commercial insurance who are new to DUPIXENT and experiencing a. Robocalls increase diabetic retinopathy screenings in low-income patients. financial assistance for eligible patients, provide one-on-one nursing. 67 mL, 200 mg/1. 01. 74 (2023), plus an amount based on how much you. Dupixent is an injection under the skin (subcutaneous injection) at different injection sites. 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. Over 80% of insurance plans cover Dupixent, but many have restrictions. DUPIXENT® (dupilumab) is taken as an injection by a pre-filled syringe or pre-filled pen. , chart notes, laboratory values) and use of claims history documenting the following: 1. 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. ago. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. DUPIXENT can be used with or without topical corticosteroids. -The MyWay forms themselves changed to a new revision and had to be resubmitted by my doctor -The revised new form needed me to resign then over the phone. Once you’ve been prescribed DUPIXENT, your healthcare provider can download the enrollment form, help you fill it out, and fax it back to DUPIXENT MyWay at 1-844-387-9370. Eligible clients will receive their cards by email. Want to be a part of the DUPIXENT MyWay® Ambassador Program? Fill out this self-nomination form to see if you qualify. LEARN ABOUT OUR PATIENT SUPPORT PROGRAM. 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. 09. 1‑844‑DUPIXENT 1-844-387-4936. Injection site reactions and eye conditions are the most common side effects reported and, unlike several other biologics, the risk of infection is low. I understand that. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. 23. DUPIXENT® ® 1-844-387-9370 or Document Drop at (code: 8443879370) In adults and children 6 years and older, your initial dose of DUPIXENT is 2 injections under the skin (subcutaneous injection) at different injection sites. DUPIXENT MyWay. I wanted to go out and make a difference and help people. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. - Rachel, DUPIXENT Patient Mentor, living with asthma. 23. 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. If you still have questions, you can speak with a DUPIXENT MyWay or request to join the program over the phone. · If the insurer does have a copay accumulator in place: the insurer pays the entire cost of the refill except for $500. Especially tell your healthcare provider if you. If you are a New York prescriber, please use an original New York State prescription form. 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. 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. r/eczema • I wish there was an eczema simulator so others could feel what we do when they say “don’t. Dupixent will run about $3000 per month with my insurance until my maximum is met. 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. 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). living with prurigo nodularis. The $500 payment counts towards the member’s deductible and out-of-pocket maximum. 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. Each time you fill your DUPIXENT prescription, please ensure your. 2 Eligible US residents with an FDA-approved. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will notOnce you’ve been prescribed DUPIXENT, your healthcare provider can download the enrollment form, help you fill it out, and fax it back to DUPIXENT MyWay at 1-844-387-9370. Rx: DUPIXENT® (dupilumab) (100 mg/0. If I am completing Section 5b, I authorize for my commercially insured patient one. The most common side effects include: DUPIXENT MyWay. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. If you are a New York prescriber, please use an original New York State prescription form. financial assistance for eligible patients, provide one-on-one nursing support, and more. 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). 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. 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. S. financial assistance for eligible patients, provide one-on-one nursing support, and more. , 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. It should only be given by an adult caregiver in children 6 to 11 years of age. 26 [95% CI: 0. So, how can you save? Manufacturer Sanofi offers Dupixent MyWay, a patient support program. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. Browse the DUPIXENT® (dupilumab) sitemap to help you learn more about uncontrolled moderate- to-severe eczema in adults and children aged 6 months & older and navigate DUPIXENT. 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. Monday-Friday, 8 am-9 pm ET. It's like $35k-$40k. Since 2018, DUPIXENT has been prescribed to over 100,000 asthma patients in the US. Box 5925 Mailstop 55A-220A Bridgewater, NJ 08807. 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). DUPIXENT can cause serious side effects, including: The most common side effects in patients with eczema include. 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. 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. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. Some people do injections every 3 weeks, which could stretch that copay card out longer. It still covers the same amount. Program has an annual maximum of $13,000. O. For more information, call 1. And I would experience blurry vision, red and itchy eyes. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. 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. For more information, call 1-844-DUPIXENT ( 1-844-387-4936) option 1. 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. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. 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. Support. Does anyone know the eligibility process for the dupixent copay assistance? Do they ask for tax forms? Is there an income limit? comments sorted by Best Top New Controversial Q&A Add a Comment More posts you may like. Select Condition Indication Moderate-to-Severe Eczema (Ages 6+ Months) Moderate-to-Severe Asthma (Ages 6+ Years) Chronic Rhinosinusitis with Nasal Polyposis (Ages 18+. Income at or below: Not Published: Medical expenses can be. DUPIXENT is taken by injection under the skin (subcutaneous injection) once every two weeks. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. You don’t have to put your life on hold to fit your dosing schedule. For Healthcare Professionals. Maximum benefit (2023) = $1,483. A program called Dupixent MyWay is available for this drug. 0252 Last Update: Feb 2023 DUP. We just need you to answer a few questions to verify your eligibility and contact information. Complete the entire form and submit pages 1-2 to ®DUPIXENT MyWay via fax at 1-844-387-9370 or Document Drop at (code: 8443879370) For assistance, call 1-844-DUPIXEN(T) (1-844-387-4936) Option 1, Monday–Friday, 8. 00. - Rachel, DUPIXENT Patient Mentor, living with asthma. Assistance may be available for patients who do not have insurance. Eligible patients will receive they cards by e-mail. For more information, call 1-844-DUPIXENT. 78 L) was seen at Week 2 in patients taking DUPIXENT 200 mg Q2W + SOC (n=264) (baseline blood EOS ≥300 cells/μL, QUEST, secondary endpoint). By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. The patient must then take the following actions:I just got approved for dupixent this week however the copay is 3,000$ a month! The dupixent my way program only covers up to 13k or something like that. 03. Even when using the Copay Card, that would cover only cover 4 months worth, and would not go towards my deductible, totaling about. What it is used for. S. Those who may qualify must be at least 18 years of age or older, a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI, and demonstrate a. Decreased utilization of rescue medications 3. For more information, dial 1‑844‑DUPIXENT ( 1-844-387-4936 ), option 1 Monday-Friday, 8 am - 9 pm ET. 18, 0. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. 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). DUPIXENT® and DUPIXENT MyWay® are entered commercial of Sanofi Biotechnological. ) 2 Prescription InformationDUPIXENT is not a steroid. Please see accompanying full Prescribing Information. 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. LONG-LASTING CLEARER SKIN AT 16 and 52 Weeks 22% taking. I just spoke to someone through the MyWay Program. For more information, dial 1‑844‑DUPIXENT 1-844-387-4936 Monday-Friday, 8 am-9 pm ET. 02. 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. Dupixent is not intended for episodic use. Dupixent inhibits the overactive signaling of interleukin-4 (IL-4) and. Eligible commercially insured patients may pay $0 per prescription with a maximum savings of $13,000 per year; for additional information contact the program at 844-387-4936. (The patient is lucky / unlucky enough to have an income that would rule out the Patient Assistance Program. LEARN ABOUT OUR PATIENT SUPPORT PROGRAM. Serious side effects can occur. I also have the dupixent myway card that covers a total of $13,000 for the year. Nationally are Covered for DUPIXENT. With the DUPIXENT MyWay Copay Card, eligible,. Throw away (dispose of) any DUPIXENT that has been left at room temperature for longer than 14 days. 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). Patient and Co-pay Assistance: DUPIXENT MyWay helps eligible patients get access to therapy whether they are uninsured, lack coverage, or need assistance with their out-of. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. 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. The most common side effects include: DUPIXENT MyWay. 00. DUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process.