You may be able to get a 90-day supply of Dupixent. I suppose it doesn't really matter now. 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. Dupixent is an injection that is usually given under the skin every other week for the treatment of asthma, eczema, and some other inflammatory conditions. DUPIXENT MyWay ENROLLMENT FORMS; English Enrollment Form. · If the insurer does have a copay accumulator in place: the insurer pays the entire cost of the refill except for $500. 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. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. There is currently no generic alternative to Dupixent. 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. In addition, I agree to notify DUPIXENT MyWay if my insurance situation changes. 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. Appears that my out of pocket maximum will be $8000 through insurance. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3 program consisting of two pivotal trials. Compare monoclonal antibodies. For children aged 6 months to 5 years, it is taken as 1 injection every 4 weeks. 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. Coverage varies by. 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. 22. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not affect any disclosure of My Information based on this Authorization made before my request is received and processed by 1‑844‑DUPIXENT 1-844-387-4936. It's like $35k-$40k. 99% of commercial patients (6+ months of age) nationally are covered for DUPIXENT. Denied because of 2022 income threshold for household of two. Your insurance has to deny twice and then you can apply for patient assistance. 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. 23. Depends if your insurance cares that Dupixent myway is paying your deductible. 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. At this rate, I will no longer be able to afford the medication very soon. To enroll or obtain information call 1-877-311. With MyWay, I get the year for free. Advertisement. 01. 14 mL, or 300 mg/2 mL)Section 5a. For more information, call 1-844-DUPIXENT. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Learn more about programs for eligible patients who are insured, underinsured, and uninsured. A case series of 12 people prescribed Dupixent reported an average weight gain of 6. 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). including household income, to qualify. If this is the case, write the preferred specialty pharmacy. If you are a New York prescriber, please use an original New York State prescription form. 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. I just started this week so I look forward to seeing the results. Im so stressed out about. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. 09. Assistance may be available for patients who do not have insurance. Gather all necessary information and documents, such as your insurance information, prescription details, and any supporting documentation. As far as choosing a better plan with a lower deductible, I don't really have much of a choice. Manufacturer Coupon. THIS IS NOT INSURANCE. Serious side effects can occur. . Eligible patients will receive their cards by email. b New adult and pediatric patients aged 6 years and older with moderate-to-severeSection 5a. I’m a registered nurse with DUPIXENT MyWay. Program Website : Program Applications and Forms will need to meet the eligibility criteria, including household income, to qualify. After that, it is taken as 1 injection every 2 weeks or every 4 weeks, depending on your age and weight. 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). 8K subscribers in the eczeMABs community. Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. PRESCRIBER TO FILL OUT Section 6a. 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. Nurse Educators Nurse Educators offer one-on-one support to help patients start and stay on track with therapy. The most common side effects include: DUPIXENT MyWay. 0185 Last Update: November 2022 DUP. ) 2 Prescription InformationDupixent® (dupilumab) approved by FDA as the first and only treatment indicated for prurigo nodularis. Throw away (dispose of) any DUPIXENT that has been left at room temperature for longer than 14 days. DUPIXENT has been FDA approved for use in adults with uncontrolled moderate-to-severe eczema since 2017. Fill a 90-Day Supply to Save. 03. Patient is responsible for any out-of-pocket amounts that exceed the program limit. This copay card may be for you if you. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. $3,645. And, if you're eligible, you can sign up and receive your card today. They are a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI. 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. If you’re the spouse or. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. Decreased exacerbations and/or improvement in symptoms 2. ) Please refer to Section 8, Patient Certifications, for. 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. who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay ® program. Patients will need on hit the eligibility benchmark, including household income, to qualify. Fax the Enrollment Form to DUPIXENT MyWay. 23. TEL: 844. form on DUPIXENT. chevron_right. O. 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. . 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. THE DUPIXENT MyWay PROGRAM. was not paid in whole or in part by Medicare, Medicaid, or any federal or state programs. Data on file, Regeneron Pharmaceuticals, Inc. Note: All information is required unless otherwise indicated. If I am completing Section 5b, I authorize for my commercially insured patient one. 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. Maximum Monthly Gross Income. 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 a prescription medicine FDA-approved to treat five conditions. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not affect any disclosure of My Information based onto DUPIXENT MyWay at 1-844-387-9370. And very recently got laid off due to Covid-19. 23. Learn how DUPIXENT helped treat children 6 to 11 years old with their moderate-to-severe asthma. Copay Card or you wish to discontinue your participation, please contact us. 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. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. 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. Serious side. Susie16 Oct 15, 2023 • 9:37 PM. 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. And I would experience blurry vision, red and itchy eyes. According to the manufacturers, Dupixent can be dosed to a maximum daily dose as indicated below. DUPIXENT is a biologic and can help reduce your patients' use of systemic corticosteroids. Monday-Friday, 8 am-9 pm ET. will need to meet the eligibility criteria, including household income, to qualify. S. 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) Education and Nurse Support: One-on-one nursing support is available to educate and empower patients to use DUPIXENT as prescribed. 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. comfysnail • 1 yr. LH Patient View; data through June 16, 2023. I'm guessing this will not be allowed once I'm on Medicare. Do you think that will hurt my chances of qualifying? I know my prescription drug costs are high enough. 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. If you are a New York prescriber, please use an original New York. I have a $40 copay but I got the dupixent my way copay card its free for me. $0!!!!! On April 6 I sent them income paperwork and my year to date prescription invoices. Tell your healthcare provider about any new or worsening joint symptoms. Children 6 to 11 years of age . _____ What is your total annual household income? _____ (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. A 48-year-old man developed left thumb tenderness and bilateral Achilles tendinopathy after 6 weeks of Dupixent. Please see Important Safety Information and Patient Information on website. DUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process. Assistance may be available for patients who do not have insurance. How to fill out dupixent reimbursement: 01. 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. Follow these tips to take DUPIXENT while traveling: Store DUPIXENT in the original carton to protect it from light. DUPIXENT can be used with or without topical corticosteroids. 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). Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not ENROLL. Johns Hopkins EHP i think goes with cigna and CVS Specialty pharmacy covers. 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). Section 5a. store above 77 °F (25 °C). If you still have questions, you can speak with a DUPIXENT MyWay or request to join the program over the phone. Not valid for prescriptions paid, in whole or in part, by Medicaid, Medicare, VA, DOD, TRICARE, or. These programs and tips can help make your prescription more affordable. For more information, call 1. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. I have read and agree to the Income Verification included in Section 8 on page 5. Rx: DUPIXENT® (dupilumab) (100 mg/0. Monday-Friday, 8 am-9 pm ET. 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. 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. 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. 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. First few months into taking Dupixent, I got laid off and worked w my doctors/Dupixent to get assistance. 14 mL, or 300 mg/2 mL)The average cash price for a 30-day supply of Dupixent is $5,298. ENROLLMENT FORMDUPIXENT is a form of medicine called a biologic that targets Type 2 inflammation, an underlying cause of nasal polyps. 06 and -1. Patient has been compliant on Dupixent therapy 4. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Dupixent on a High Deductible Health Plan. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. 2 pens of 300mg/2ml. Watch videos for a supplemental demonstration on how to use and dispose of DUPIXENT® (dupilumab), a prescription medicine for subcutaneous injection. Also, make sure to store the DUPIXENT MyWay phone number in your phone’s contacts so you. With the DUPIXENT MyWay Copay Card, eligible,. Does anyone know of any assistance programs I can use to help assist in the copay after dupixent my way limit is reached?33% and 27% reduction in their nasal polyps score compared to a 7% and 4% increase with placebo in SINUS-24 and SINUS-52, respectively (LS mean change from baseline of -1. How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. 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. who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay ® program. Copay Card or you wish to discontinue your participation, please contact us. DUPIXENT® (dupilumab) is a. If you still have questions, you can speak with a DUPIXENT MyWay or request to join the program over the phone. Approval represents the second dermatology indication for Dupixent and fifth disease indication overall in the. The Dupixent pre-filled syringe is available in the following strengths: 100 mg per 0. For Healthcare Professionals. DUPIXENT® (dupilumab) is a. Continuation in the DUPIXENT MyWay Patient Assistance Program is conditioned upon timely verification of income. 18, 0. 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. What it is used for. , chart notes, laboratory values) and use of claims history documenting the following: 1. What it is used for. Lot EXP Mfd. 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. Registered nurses are also available to speak with eligible patients about DUPIXENT. 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. It’s a change in how copay assistance and coupons are counted toward your. Also if your insurance does cover,Dupixent offers a co-pay card that. 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 . 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 $500 payment counts towards the member’s deductible and out-of-pocket maximum. Support. 02. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. I just spoke to someone through the 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. $0 is the amount you pay. ) I agree that Regeneron Pharmaceuticals, Inc. Since 2018, DUPIXENT has been prescribed to over 100,000 asthma patients in the US. 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. Support. 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. 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). To contact DUPIXENT MyWay, please call 1-844-DUPIXENT (1-844-387-4936). With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may payable as little while $0* copay per fill by DUPIXENT. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. · If the insurer does have a copay accumulator in place: the insurer pays the entire cost of the refill except for $500. 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. 71 for Dupixent compared to 0. If you don't have insurance at all, the only realistic option is to qualify for income-based help from Dupixent directly. Learn about the DUPIXENT® (dupilumab) mechanism of action inhibiting IL-4 and IL-13 signaling in appropriate asthma patients. DUPIXENT can be used with or without topical corticosteroids. 25%) Taro Pharma patient access. 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). DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. 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. Especially tell your healthcare provider if you. 0156 Past Update: March 2023 DUP. I'm "only" 61 now though on Dupixent MyWay copay help. 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. 2022;400 (10356):908-919. Dupixent is not intended for episodic use. Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. living with prurigo nodularis are most in need of new treatment options . Program Website : Patient Assistance Applications for DUPIXENT® dupilumab therapy My Information. Dupixent will run about $3000 per month with my insurance until my maximum is met. It was a process to get into the patient assist program. Please see. 09. The DUPIXENT MyWay patient support program is here to help you at every step of your DUPIXENT treatment journey. Find videos and downloadable instructions for the two injection administration options available for DUPIXENT® (dupilumab), pre-filled syringe (200 mg or 300 mg) with needle shield for ages 6 months & older, or pre-filled pen (200 mg or 300 mg) for ages 2+ years. 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. It may be covered by your Medicare or insurance plan. 0252 Last Update: Feb 2023 DUP. 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. For more information, call 1-844-DUPIXENT ( 1-844-387-4936) option 1. Income at or below: Not Published: Medical expenses can be deducted from reported income:. chevron_right. Sign it in a few clicks. Please complete the form, sign, and FA to 1-844-23-312. It may be covered by your Medicare or insurance plan. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. living with prurigo nodularis. You can email or print the enrollment forms below. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. Patient assistance program. They are a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI. 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. LEARN ABOUT OUR PATIENT SUPPORT PROGRAM. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. DUPIXENT can be used with or without topical corticosteroids. com. That is what I am in the middle of. If I am completing Section 5b, I authorize for my commercially insured patient one. was not paid in whole or in part by Medicare, Medicaid, or any federal or state programs. 00, but I do have some money invested. Although you are not eligible, you can sign up DUPIXENT MyWay. There is currently no generic alternative to Dupixent. Eligible patients covered by commercial health insurance may pay as little as a $0 p copay per fill of DUPIXENT. Serious side effects can occur. That is good, because I was quoted 1400+ a month by my Medicare D provider. Type text, add images, blackout confidential details, add comments, highlights and more. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. Base amount is $558. 22. Check the liquid in the prefilled pen or syringe. any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. 1-844-DUPIXENT (1-844-387-4936) Topicort (desoximetasone spray 0. In clinical trials, DUPIXENT reduced the. DUPIXENT can cause serious side effects, including: The most common side effects in patients with eczema include. 23. Tips. PRESCRIBER TO FILL OUT Section 6a. To more financial assistance news, dial 1‑844‑DUPIXENT ( 1-844-387-4936), option 1 Monday-Friday, 8 am - 9 pm ESTPRESCRIBER TO FILL OUT Section 6a. At one point, I was getting cold sores every 2 to 3 weeks consistently. Dupixent® (dupilumab) approved by FDA as the first and only treatment indicated for prurigo nodularis Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3. I knocked out the first copay out of pocket and went on the manufacturer website and applied for the dupixent my way card. DUPIXENT is taken by injection under the skin (subcutaneous injection) once every two weeks. _____ What is your total annual household income? _____ (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. 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. (2 of 3) Patient signature/Legal representative if patient is <18 years Date Section 2. For more information, call 1-844-DUPIXENT ( 1-844-387-4936) option 1. 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. Effective Sept. 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. Needed additional leadership equipped the enrollment process? Contact your section accessories dedicated or call DUPIXENT MyWay. Appears that my out of pocket maximum will be $8000 through insurance. for DUPIXENT® dupilumab therapy My Information. 80). 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;. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay, and that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. For assistance, please call 1-844-468-2252 Monday Friday, 8AM to 8PM ET. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. living with prurigo nodularis. Access the dupixent reimbursement form either online or through your healthcare provider. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. 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. 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. 10 for placebo; difference between Dupixent and placebo: -2. a,b a Data on file, Sanofi and Regeneron, US. The formulary status tool below can help check DUPIXENT coverage for various plans. Learn why DUPIXENT® (dupilumab) may be an. 14 ml, 300 mg/2 ml: Asthma, atopic dermatitis: 3 syringes for the first 28 days. Manufacturer Coupon. I’ve been with DUPIXENT MyWay since the very beginning. DUPIXENT MyWay coordinators are available Monday-Friday 8 am to 9 pm ET. Share your form with others. Edit your dupixent myway enrollment form online. The DUPIXENT MyWay team will research each patient’s situation and determine eligibility. Pay as little as $0 per month. With the Copay Card, You Could Pay as Little as $0 † The majority of DUPIXENT patients with commercial/employer-provided insurance use the DUPIXENT MyWay ® Copay Card. Subcutaneous Solution 100 mg/0. -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. 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. Ways to save on Dupixent. Griffinej5 • 2 yr. Hear real patients stories of life with uncontrolled moderate-to-severe asthma and how discovering DUPIXENT® (dupilumab) impacted their journey. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Check the liquid in the prefilled pen or syringe. 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. 67 mL; 200 mg per 1. Patient and Co-pay Assistance: DUPIXENT MyWay helps eligible patients get access to therapy whether they are uninsured, lack. Susie16 Aug 29, 2023 • 2:03 AM. If you don’t have health insurance, talk. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. DUPIXENT is available as a single dose in a pre-filled syringe (200 mg or 300 mg) with needle shield, or single-dose pre-filled pen (200 mg or 300 mg) for ages 2+ years. DUPIXENT is not a steroid or immunosuppressant; it is a prescription biologic medicine given under the skin (subcutaneous injection). FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. 1-844-DUPIXENT 1-844-387-4936. Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. 14 mL, or 300 mg/2 mL)Call 1-844-387-4936, Option 1 to contact DUPIXENT MyWay ®. 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 patient support program is here to help you at every step of your DUPIXENT treatment journey. 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 . 1,000-125=875 $875 is the amount your health insurance pays. 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 will run about $3000 per month with my insurance until my maximum is met. For more information, dial 1. DUPIXENT MyWay® A program to provide support to patients starting DUPIXENT. A quantity of Dupixent will be considered medically necessary if the above criteria are met, as indicated in the table below:. 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. Patients may be eligible for the DUPIXENT MyWay Copay Card if: They have a DUPIXENT prescription for an FDA-approved condition. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. About 75,000 adults in the U. 71 for Dupixent compared to 0. 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. Ways to save on Dupixent. If you are a New York prescriber, please use an original New York State prescription form. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. Call 1-844-387-4936 SUMIT COMPLETED PAGES 1 2 Fax: 1-844-387-9370 MF, 8am9pm ET Document Drop: (code: 8443879370) Patient Name DO / / Prescriber Name Prescriber AddressDupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. DUPIXENT (dupilumab) Dupixent FEP Clinical Criteria AND submission of medical records (e. For more information, please call 1-844-DUPIXENT (1-844-387-4936) or visit got Dupixent MyWay copay assistance and they never asked one question about my income. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. Serious adverse reactions may occur. Some Medicare plans may help cover the cost of mail-order drugs. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Decreased utilization of rescue medications 3. DUPIXENT MyWay®. 4. Enrolled patients receive: One-on-one support from our DUPIXENT MyWay support team; Help understanding insurance coverage; Financial assistance (for eligible patients only) Help. Regeneron and Sanofi are committed to helping patients in the U. 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. The language of the MyWay program back then never mentioned the $13,000 limit: they simply asked for income requirements, etc. Rx: DUPIXENT® (dupilumab) (100 mg/0. 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. 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. DUPIXENT MyWay® Program Taking Dupixent. 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 significantly reduced itch and skin lesions compared to placebo in direct-to-Phase. 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. 0252 Last Update: Feb 2023 DUP. Patients in each age group saw improved lung function in as little as 2 weeks. 50 for a single person. (The patient is lucky / unlucky enough to have an income that would rule out the Patient Assistance Program. Guam or the USVI, and demonstrate a financial need with a total annual adjusted gross income of $100,000 or less. LEARN ABOUT OUR PATIENT SUPPORT PROGRAM.