You can email or print the enrollment forms below. LONG-LASTING CLEARER SKIN AT 16 and 52 Weeks 22% taking. 23. Dupixent has been studied in more than 8,000 patients ages 6 years and older across more than 40 clinical trials. For more information, please call 1-844-DUPIXENT (1-844-387-4936) or visit . DUPIXENT MyWay® is a patient support program designed to help you get access to DUPIXENT and help eligible patients cover the out-of-pocket costs of DUPIXENT. any time by mailing or faxing a written request to DUPIXENT MyWay at 1800 Innovation Point, Fort Mill, SC 29715; Fax: 1-844-387-9370. dupixent myway income guidelinesstellaris unbidden and war in heaven. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. If I am completing Section 5b, I authorize for my commercially insured patient one. 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). Do you think that will hurt my chances of qualifying? I know my prescription drug costs are high enough. 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. 0129 Last Update:. 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 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. The average cash price for a 30-day supply of Dupixent is $5,298. Program has an annual maximum of $13,000. 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. “Eczema otherwise unspecified” is not indicated for Dupixent. 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. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. Your insurance has to deny twice and then you can apply for patient assistance. 1kg over one year – the amount of weight gained ranged from 0. If I am completing Section 5b, I authorize for my commercially insured patient one. ago It is actually not a change in the myway program. Injection Support Center Injection Reminders and Tips FREQUENTLY ASKED QUESTIONS; Español. Learn how DUPIXENT® (dupilumab) works as the first and only FDA-approved treatment for prurigo nodularis (PN) in adults aged 18 years and older. 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. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. Program possessed one annual maximum from $13,000. 67 mL, 200 mg/1. 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. 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. I suppose it doesn't really matter now. Follow these tips to take DUPIXENT while traveling: Store DUPIXENT in the original carton to protect it from light. 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. Pay as little as $0 per month. Connect with someone, ask questions, and learn about their experience with DUPIXENT® (dupilumab) treatment. 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. If you still have questions, you can speak with a DUPIXENT MyWay or request to join the program over the phone. Please see accompanying full Prescribing Information. Lot EXP Mfd. You or your patients can contact DUPIXENT MyWay® at 1-844-DUPIXEN(T) (1-844-387-4936) 1-844-DUPIXEN(T) (1-844-387-4936) to learn more. DUPIXENT® (dupilumab) is a. How many people live in your household? _____ Please refer to. 14 mL; and 300 mg per 2 mL. See All. To contact DUPIXENT MyWay, please call 1-844-DUPIXENT (1-844-387-4936). , 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. Coverage varies by. Deductible is at $3k out of pocket insurance pays 80% and at $6k insurance pays 100%. 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. You may be eligible for the DUPIXENT MyWayDUPIXENT MyWayAbout Dupixent Dupixent is administered as an injection under the skin (subcutaneous injection) at different injection sites. DUPIXENT MyWay coordinators are available Monday-Friday 8 am to 9 pm ET. Serious side effects can occur. Dupixent® should be given by or under the supervision of an adult in children 12 years of age and older. For more information or to enroll in the patient support program, contact us at: 1‑844‑DUPIXENT. ) Please refer to Section 8, Patient Certifications, for. DUPIXENT MyWay®. 14 mL, or 300 mg/2 mL)I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. I give supplemental injection training to the patient and the patient’s caregiver. 67 mL, 200 mg/1. DUPIXENT MyWay. 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 . 1-844-387-4936 (toll free) Monday - Friday, 8AM - 9PM (ET) Multilingual options available. Note: All information is required unless otherwise indicated. 22. S. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Sign it in a few clicks. There is currently no generic alternative to Dupixent. 1-844-DUPIXENT 1-844-387-4936. 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. I knocked out the first copay out of pocket and went on the manufacturer website and applied for the dupixent my way card. 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. Dupixent changed my life completely. It was a process to get into the patient assist program. I’m a registered nurse with DUPIXENT MyWay. 2017;5 (6):1519-1531. 01. You may be eligibility on the DUPIXENT MyWay Copay Card if you:DUPIXENT MyWay Copay Card if you:Dupixent® should be given by or under the supervision of an adult in children 12 years of age and older. Sign up or activate your card here. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. any time by mailing or faxing a written request to DUPIXENT MyWay at 1800 Innovation Point, Fort Mill, SC 29715; Fax: 1-844-387-9370. . With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. Want to be a part of the DUPIXENT MyWay® Ambassador Program? Fill out this self-nomination form to see if you qualify. • Store DUPIXENT in the refrigerator at 36°F to 46°F (2°C to 8°C). For assistance, please call 1-844-468-2252 Monday Friday, 8AM to 8PM ET. SINCE 2017, ≈253,000 PATIENTS HAVE FILLED AT LEAST 1 DUPIXENT PRESCRIPTION b,c. Just got off the phone with Dupixent My Way. Hello! Switching insurance this year and need to prepare for increasing costs of dupixent with my new insurance. Fill out sections 5a and 5b completely to determine patient eligibility. This copay card may be for you if you. 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. Get a Quick Start. DUPIXENT MyWay ENROLLMENT FORMS; English Enrollment Form. I'm "only" 61 now though on Dupixent MyWay copay help. Dupixent Myway . The specialty pharmacy is responsible for securing coverage on my patient’s behalf. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. DUP. 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. The DUPIXENT MyWay nurse connects patients to a variety of considerate resources, including one-on-one nursing product, financial assistance for right patients, and helpful refill and injection reminders. ) 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. Sign it in a few clicks. 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. They are a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI. S. DUPIXENT MyWay Ambassador. Program Website : Program Applications and Forms will need to meet the eligibility criteria, including household income, to qualify. The U. who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay ® program. So, let's just pretend the total cost is $1,000/month. Support. BIN: 020750 RX PCN: NMeds RX GRP: PDFPDF ID: NMNA019309901930 This is a drug discount program, not an insurance plan. Dupilumab. for DUPIXENT® dupilumab therapy My Information. If requested, I agree to provide proof of income within thirty (30) days of the request. 00 per injection. -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. ) 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). I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. 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. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. With of DUPIXENT MyWay Copay Card, right, commercially insured patients might pay as little as $0* copay per fill of DUPIXENT. 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. LASTING CHANGE IS ACHIEVABLE. 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. Continuation in the program is conditioned upon timely verification of income. 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. To enroll or obtain information call 1-877-311. My wife is on Dupixent, and has the MyWay card which allows up to $13,000/year. Clip the card and save • Save up to 80% on medications* Tell your healthcare provider about any new or worsening joint symptoms. Continuation in the DUPIXENT MyWay Patient Assistance Program is conditioned upon timely verification of income. Monday-Friday, 8 am - 9 pm ETto DUPIXENT MyWay at 1-844-387-9370. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. It was granted and I pay $0. S. Patient Assistance Program. 1. I understand that. Regeneron and Sanofi are committed to helping patients in the U. 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. chevron_right. 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 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. Please see Dosage Regimens, How to Inject DUPIXENT® and Instructions for Use. 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. For more information, dial 1. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. 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. Depends if your insurance cares that Dupixent myway is paying your deductible. What it is used for. Each time you fill your DUPIXENT prescription, please ensure your. Dupixent MyWay pays the $500 copay. 0254 Last Update: February 2023 DUP. 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. Serious side effects can occur. S. Got off of it as soon as I realized it was getting worse with every shot after spacing them out every other month. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. Caring. And, if you're eligible, you can sign up and receive your card today. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. Even when using the Copay Card, that would cover only cover 4 months worth, and would not go towards my deductible, totaling about. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. DUPIXENT is a biologic and can help reduce your patients' use of systemic corticosteroids. For more information, dial 1‑844‑DUPIXENT 1-844-387-4936 Monday-Friday, 8 am-9 pm ET. Section 5a. It's like $35k-$40k. 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. PRESCRIBER TO FILL OUT Section 6a. How many people live in your household? _____ Please refer to Section 8, Patient Certifications , for. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. 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. Self-nominate to become DUPIXENT MyWay® Ambassador, and if selected, you may have opportunities to share your story and offer encouragement to patients and their family members. I understand the disclosure to the Alliance will be for the purposes of enrolling me in, and providing certain services through the DUPIXENT MyWay Program, including • to determine if I am eligible to participate in DUPIXENT MyWay coverage assistance programs, patient assistance programs, or otherI experienced cold sores and eye issues for about the first 6 months of being on Dupixent. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. Watch videos from experts [,download materials,] and explore future events to further understand DUPIXENT® (dupilumab). I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. After that, it is taken as 1 injection every 2 weeks or every 4 weeks, depending on your age and weight. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. 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. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Compare . · If the insurer does have a copay accumulator in place: the insurer pays the entire cost of the refill except for $500. 02. 02. will not conduct a benefits verification. 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. . 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). TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. 23. Dupixent may cause serious side effects. 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. 01. 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. 1kg to 18. any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. 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. For more information, call 1-844-DUPIXENT ( 1-844-387-4936) option 1. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. DUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process. 4 ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pm01. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. Check your eligibility for the DUPIXENT MyWay® Copay Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. Well at a cost of roughly $3,500/dose which lasts a month, that will all be used up in four months. At one point, I was getting cold sores every 2 to 3 weeks consistently. Please see Important Safety Information and full PI on website. For Healthcare Professionals. Rx: DUPIXENT® (dupilumab) (100 mg/0. When I was very young, I knew that I wanted to be a nurse. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not affect any disclosure of My Information based on this Authorization made before my request is received and processed by my Healthcare Providers, Health Insurers,DUPIXENT has been prescribed to over 50,000 uncontrolled nasal polyp patients and counting! DUPIXENT is the first biologic nasal polyp treatment that’s an alternative to nasal polyp surgery. Children 6 to 11 years of age . Household Income. Im so stressed out about. DUPIXENT can cause serious side effects, including: The most common side effects in patients with eczema include. If you don’t have health insurance, talk. 5. how to afford it then - it's been so helpful!! 3 Reactions. Be sure to fill out your enrollment form completely and accurately. Dupixent. 67 mL Dupixent subcutaneous solution from $3,787. Monday-Friday, 8 am-9 pm ET. 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. They never mentioned only covering a. 2 Eligible US residents with an FDA-approved. At one point, I was getting cold sores every 2 to 3 weeks consistently. I’ve been with DUPIXENT MyWay since the very beginning. If you are a New York prescriber, please use an original New York State prescription form. Have commercial insurance, including health insurance. DUPIXENT can be used with or without topical corticosteroids. DUP. United Healthcare covers it but I get insurance through my employer and it was a huge pain to get approved. 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. com. 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. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. 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. 17 and 0. S. 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. Guam or the USVI, and demonstrate a financial need with a total annual adjusted gross income of $100,000 or less. 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. living with prurigo nodularis are most in need of new treatment options . ) Please refer to Section 8, Patient Certifications, for. will need to meet the eligibility criteria, including household income, to qualify. 3. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. DUPIXENT MyWay is a patient support program that can help enable access to DUPIXENT and offers financial assistance for eligible patients, one-on-one nursing support, and more. I just got approved thru Dupixent my way for a year of free medication. 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. For more information and to find out if you’re eligible for support, call 844-DUPIXENT (844-387-4936) or visit the program website. Option 1- you have to meet your deductible without Dupixent myway. Please see accompanying full Prescribing InformationTell us about yourself. The patient would prefer not to try. 5011 XXX X < M A T > 00000 0 300 mg/ 2 m L Look at theFull Prescribing Information: Patient Information: Learn more about DUPIXENT: Thanks for c. For more information, please call 1-844-DUPIXENT (1-844-387-4936) or visit . 8K subscribers in the eczeMABs community. $125 is the amount Dupixent assistance pays. DUPIXENT MyWay team will research each patient’s situation and determine eligibility. Step One - let's gather our materials. Check the liquid in the prefilled pen or syringe. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. DUPIXENT should not be stored above 77 °F (25 °C). How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. You must also meet certain household income eligibility requirements as outlined below: 48 States and DC. Expert perspectives on management of moderate-to-severe atopic dermatitis: a multidisciplinary consensus addressing current and emerging therapies. I also have the dupixent myway card that covers a total of $13,000 for the year. Some Medicare plans may help cover the cost of mail-order drugs. Serious side effects can occur. Most do, some don't. March 27, 2018. 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. Assistance may be available for patients who do not have insurance. 23. 12. 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 ALLERGISTSThe price you pay for Dupixent can vary. DUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process. If you are a New York prescriber, please use an original New York. DUPIXENT® (dupilumab) is a prescription medicine FDA-approved to treat five conditions. 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. 80). (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. 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. 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. For more information and to find out if you’re eligible for support, call 844-DUPIXENT (844-387-4936) or visit the program website. Approval represents the second dermatology indication for Dupixent and fifth disease indication overall in the. Serious side effects can occur. 1-844-DUPIXENT 1-844-387-4936. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. 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). financial assistance for eligible patients, provide one-on-one nursing support, and more. 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. a ®® ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pm600 mg (two 300 mg injections) 300 mg Q4W : 30 to less than 60 kg ; 400 mg (two 200 mg injections) 200 mg Q2W : 60 kg or more : 600 mg (two 300 mg injections)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. a ®® ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pmAdditionally, Dupixent MyWay TM 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 process. 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. Data on file, Regeneron Pharmaceuticals, Inc. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. Eligible clients will receive their cards by email. 01. In this case Dupixent myway will cover the first 13k, which is probably like 5 months. It temporarily provides eligible patients DUPIXENT at no cost, subject to program terms and conditions. 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. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. Check your eligibility for the DUPIXENT MyWay® Copay Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients. Enroll now to receive emails and resources designed to help patients, caregivers and information seekers through the DUPIXENT® (dupilumab) treatment journey. Serious side effects can occur. Sanofi offers a Dupixent MyWay copay card to some patients with commercial insurance, but it has eligibility requirements and a yearly maximum of $13,000. DUPIXENT® is 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. Please see. Appears that my out of pocket maximum will be $8000 through insurance. Robocalls increase diabetic retinopathy screenings in low-income patients. Patient is responsible for any out-of-pocket amounts that exceed the program limit. 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. Get a Quick Start. DUPIXENT (dupilumab) Dupixent FEP Clinical Criteria AND submission of medical records (e. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. I suppose it doesn't really matter now. 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). After removal from the refrigerator, DUPIXENT must be used within 14 days or discarded. Tips. It will also depend on how much you have. Partner with a specialist near you to see if DUPIXENT® (dupilumab) is an option for you for uncontrolled moderate-to-severe eczema in adults and children aged 6 months & older. The DUPIXENT MyWay program also provides useful tools and resources to help you stay on track with your treatment. r/eczema • I wish there was an eczema simulator so others could feel what we do when they say “don’t. Most do, some don't. Serious side effects can occur. Especially tell your healthcare provider if you. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. With MyWay, I get the year for free. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. THE DUPIXENT MyWay PROGRAM. 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. Base amount is $558. DUPIXENT MyWay®. 01. 2 cartons. 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. Guam or the USVI, and demonstrate a financial need with a total annual adjusted gross income of $100,000 or less. 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. Nationally are Covered for DUPIXENT. Maximum Monthly Gross Income. Self-nominate to become DUPIXENT MyWay® Ambassador, and if selected, you may have opportunities to share your story and offer encouragement to patients and their family members. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. Hear real patients stories of life with uncontrolled moderate-to-severe asthma and how discovering DUPIXENT® (dupilumab) impacted their journey. including household income, to qualify. Eosinophilic Esophagitis: DUPIXENT is indicated for the treatment of adult and pediatric patients aged 12 years and older, weighing at least 40 kg, with eosinophilic esophagitis (EoE). Dupixent (dupilamab) Dupixent MyWay patient support program. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as a $0* copay per fill of DUPIXENT, maximum of $13,000 per patient per calendar year. It may be covered by your Medicare or insurance plan. Nationally are Covered for DUPIXENT. Pay as little as $0 per month. Ways to save on Dupixent. Patients in each age group saw improved lung function in as little as 2 weeks. ) 2 Prescription InformationDUPIXENT is not a steroid. 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. DUPIXENT use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. This DUPIXENT Pre-filled Pen is a single-dose device. Support. Nurse Educators Nurse Educators offer one-on-one support to help patients start and stay on track with therapy. 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 is an injection under the skin (subcutaneous injection) at different injection sites. for DUPIXENT® dupilumab therapy My Information. For more informational, page 1‑844‑DUPIXENT (1-844-387-4936), option. Income at or below: Not Published: Medical expenses can be deducted from reported income:. SINCE 2017, ≈253,000 PATIENTS HAVE FILLED AT LEAST 1 DUPIXENT PRESCRIPTION b,c. When I was very young, I knew that I wanted to be a nurse. Biologic Drug: Biologic drugs are made from living cells and are often expensive. Learn more about programs for eligible patients who are insured, underinsured, and uninsured. 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. 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. 71 for Dupixent compared to 0. 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. 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. Although you are not eligible, you can sign up DUPIXENT MyWay. DUPIXENT® (dupilumab) is a. 01. DUPIXENT® (dupilumab) is a. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. 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. Eligible patients will receive they cards by e-mail. Eligible patients covered by commercial health insurance may pay as little as a $0 p copay per fill of DUPIXENT. 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.