DUPIXENT can be used with or without topical corticosteroids. 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 . Dupixent. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not affect any disclosure of My Information based on1-844-DUPIXENT 1-844-387-4936. dupixent myway income guidelinesstellaris unbidden and war in heaven. Im so stressed out about. For Healthcare Professionals. 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. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Your cost may depend on your treatment plan, your insurance coverage (if you have it), and the pharmacy you use. 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. 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. Sign up for the DUPIXENT MyWay® mentor program for adults with uncontrolled chronic rhinosinusitis with nasal polyposis that is associated with type 2 inflammation. 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. SINCE 2017, ≈253,000 PATIENTS HAVE FILLED AT LEAST 1 DUPIXENT PRESCRIPTION b,c. 1-844-387-4936 (toll free) Monday - Friday, 8AM - 9PM (ET) Multilingual options available. 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. Depends if your insurance cares that Dupixent myway is paying your deductible. $0!!!!! On April 6 I sent them income paperwork and my year to date prescription invoices. DUPIXENT® and DUPIXENT MyWay® are entered commercial of Sanofi Biotechnological. Quantity Limits: Dupixent: 200 mg/1. Dupixent side effects. The average cash price for a 30-day supply of Dupixent is $5,298. Serious side effects can occur. 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. They are a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI. 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 may cause serious side effects. (2 of 3) Patient signature/Legal representative if patient is <18 years Date Section 2. Opinions clash over private equity’s effect on dermatology. You have to game the system instead of trying to get full coverage. Dupixent is administered as an injection under the skin (subcutaneous injection) at different injection sites. For assistance, please call 1-844-468-2252 Monday Friday, 8AM to 8PM ET. Fill out sections 5a and 5b completely to determine patient 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. Tips. 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). Throw away (dispose of) any DUPIXENT that has been left at room temperature for longer than 14 days. 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. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Serious adverse reactions may occur. These programs and tips can help make your prescription more affordable. Sanofi and Regeneron are committed to helping patients in the U. The fax number is 1. Appears that my out of pocket maximum will be $8000 through insurance. any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Sign it in a few clicks. The $500 payment counts towards the member’s deductible and out-of-pocket maximum. financial assistance for eligible patients, provide one-on-one nursing. 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. BIN: 020750 RX PCN: NMeds RX GRP: PDFPDF ID: NMNA019309901930 This is a drug discount program, not an insurance plan. Please note that you will receive a confirmation fax after sending the form. ago. If you are a New York prescriber, please use an original New York State prescription form. Gather all necessary information and documents, such as your insurance information, prescription details, and any supporting documentation. ) I agree that Regeneron Pharmaceuticals, Inc. Get ongoing, personalized nursing support; help scheduling monthly prescription refills and deliveries; and in-home, in-office, or online supplemental injection training. Patient Assistance Program. 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. 12. Rx: DUPIXENT® (dupilumab) (100 mg/0. S. 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. 14 mL, or 300 mg/2 mL)My insurance provider covers 85% and our Canadian version of 'MyWay' pays the remainder. 03. Dupixent inhibits the overactive signaling of interleukin-4 (IL-4) and. 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. 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. S. Patients may be eligible for the DUPIXENT MyWay Copay Card if: They have a DUPIXENT prescription for an FDA-approved condition. Susie16 Aug 29, 2023 • 2:03 AM. The majority of DUPIXENT patients with commercial/employer-provided insurance use the DUPIXENT MyWay ® Copay Card. I pay for it with my insurance and the myway copayment 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. _____ What is your total annual household income? _____ (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. 23. See All. 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. the info from that copay savings card you will give to alliance and they process that after insurance (so the $170 copay they’d cover) which would leave you with $0 copay. Support. 09. Rx: DUPIXENT® (dupilumab) (100 mg/0. Data on file, Regeneron Pharmaceuticals, Inc. DUPIXENT® (dupilumab) is a prescription medicine FDA-approved to treat five conditions. Johns Hopkins EHP i think goes with cigna and CVS Specialty pharmacy covers. If you don’t have health insurance, talk. Serious side effects can occur. S. March 27, 2018. 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). THIS IS NOT INSURANCE. 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. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. 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. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. Rx: DUPIXENT® (dupilumab) (100 mg/0. THE DUPIXENT MyWay PROGRAM. form on DUPIXENT. 34 milliliters 200 mg/1. who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay ® program. When I was very young, I knew that I wanted to be a nurse. 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. You don’t have to put your life on hold to fit your dosing schedule. 14 mL, or 300 mg/2 mL) Call 1-844-387-4936, Option 1 to contact DUPIXENT MyWay ®. There is currently no generic alternative to Dupixent. Since MyWay covers 13,000 a year, that will count towards your deductible. If you don't have insurance at all, the only realistic option is to qualify for income-based help from Dupixent directly. Watch videos for a supplemental demonstration on how to use and dispose of DUPIXENT® (dupilumab), a prescription medicine for subcutaneous injection. Enrolled patients receive: One-on-one support from our DUPIXENT MyWay support team; Help understanding insurance coverage; Financial assistance (for eligible patients only) Help. 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. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. 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. 2 cartons. will not conduct a benefits verification. Section 5a. Learn why DUPIXENT® (dupilumab) may be an. How to fill out dupixent reimbursement: 01. And, if you're eligible, you can sign up and receive your card today. In addition, I agree to notify DUPIXENT MyWay if my insurance situation changes. living with prurigo nodularis. Household Income. ) 2 Prescription InformationIn adults and children 6 years and older, your initial dose of DUPIXENT is 2 injections under the skin (subcutaneous injection) at different injection sites. Enrolled patients receive: One-on-one support from our DUPIXENT MyWay support team; Help understanding insurance coverage; Financial assistance (for eligible patients only) Help scheduling deliveries any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. 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. A program called Dupixent MyWay is available for this drug. Rx: DUPIXENT® (dupilumab) (100 mg/0. for DUPIXENT® dupilumab therapy My Information. BIN: 020750 RX PCN: NMeds RX GRP: PDFPDF ID: NMNA019309901930 This is a drug discount program, not an insurance plan. 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. 0129 Last Update:. Caring. If you still have questions, you can speak with a DUPIXENT MyWay representative or request to join the program over the phone. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. 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. I'm "only" 61 now though on Dupixent MyWay copay help. With MyWay, I get the year for free. Susie16 Oct 15, 2023 • 9:37 PM. 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. 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. 67 mL Dupixent subcutaneous solution from $3,787. DUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process. The patient must then take the following actions:I just got approved for dupixent this week however the copay is 3,000$ a month! The dupixent my way program only covers up to 13k or something like that. Note: All information is required unless otherwise indicated. 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 consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. 67 mL, 200 mg/1. For more information or to enroll in the patient support program, contact us at: 1‑844‑DUPIXENT. Dupixent changed my life completely. Injection Support Center Injection Reminders and Tips FREQUENTLY ASKED QUESTIONS; Español. Fill out the form accurately and completely, providing all. For children aged 6 months to 5 years, it is taken as 1 injection every 4 weeks. 0185 Last Update: November 2022 DUP. Needed additional leadership equipped the enrollment process? Contact your section accessories dedicated or call DUPIXENT MyWay. Check the liquid in the prefilled pen or syringe. 1kg to 18. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. For patients with commercial insurance who are new to DUPIXENT and experiencing a. I. The language of the MyWay program back then never mentioned the $13,000 limit: they simply asked for income requirements, etc. SIGN UP TO SPEAK WITH A DUPIXENT MyWay ® MENTOR . a $85. Dupixent is not intended for episodic use. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. We just need you to answer a few questions to verify your eligibility and contact information. It may be covered by your Medicare or insurance plan. Social Security income, unemployment insurance benefits, disability income, any other income for the household. Eligible patients will receive their cards by email. How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. $3,645. Patient assistance program. Pay as little as $0 per month. Learn how DUPIXENT® (dupilumab) works as the first and only FDA-approved treatment for prurigo nodularis (PN) in adults aged 18 years and older. Have commercial insurance, including health insurance. For more information and to find out if you’re eligible for support, call 844-DUPIXENT (844-387-4936) or visit the program website. “Eczema otherwise unspecified” is not indicated for 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. Approximately 72% of the total FEV 1 improvement (470 mL improvement at Week 52 from baseline FEV 1 of 1. 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. Dupixent MyWay Copay Card. DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. 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. Sign up or activate your card here. Check the liquid in the prefilled pen or syringe. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. My doctor gave me a copay card to cover mine. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. 23. Use DUPIXENT exactly as prescribed by your doctor. Just got the fun news that I will need to pay $2,700 for a monthly dose of Dupixent. I also enrolled in the dupixent my way program and my ambassador told me that as long as you don’t make $100,000 a year you qualify for the program to get dupixent free for a year. 67 mL, 200 mg/1. 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. Serious side. ) I agree that Regeneron Pharmaceuticals, Inc. Enroll now to receive emails and resources designed to help patients, caregivers and information seekers through the DUPIXENT® (dupilumab) treatment journey. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay ® program. 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. 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. DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. I’m a registered nurse with DUPIXENT MyWay. 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. DUPIXENT use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. 4. 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. 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. LEARN ABOUT OUR PATIENT SUPPORT PROGRAM. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. Serious adverse reactions may occur. 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). Decreased exacerbations and/or improvement in symptoms 2. Hear real patients stories of life with uncontrolled moderate-to-severe asthma and how discovering DUPIXENT® (dupilumab) impacted their journey. I just started this week so I look forward to seeing the results. ithdrawal of this Authoriation will end my participation in the DUPIXENT MyWay Program and will not aect any disclosure of My Information ased on this Authoriation made efore my reuest is received and processed y my ealthcare Providers, ealth Insurers, and Specialty Pharmacies. In order to meet the financial eligibility criteria for receiving Sanofi medication at no cost, you must have an annual household income of ≤ 400% of the current Federal Poverty Level. 01. Monday-Friday, 8 am-9 pm ET. Dupilumab. 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. 02. Coverage varies by type and plan. I’m Laurie. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. Coverage varies by. There is another biologic very similar to Dupixent called Adbry. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. Maximum benefit (2023) = $1,483. 10 for placebo; difference between Dupixent and placebo: -2. ENROLLMENT FORMDUPIXENT is a form of medicine called a biologic that targets Type 2 inflammation, an underlying cause of nasal polyps. A case series of 12 people prescribed Dupixent reported an average weight gain of 6. I’m a registered nurse with DUPIXENT MyWay. The DUPIXENT MyWay program also provides useful tools and resources to help you stay on track with your treatment. 0156 Last Update: March 2023 DUP. Type text, add images, blackout confidential details, add comments, highlights and more. 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. 12. ) Please refer to Section 8, Patient Certifications, for. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. 67 mL; 200 mg per 1. 03. For children aged 6 months to 5 years, it is taken as 1 injection every 4 weeks. Using the drop. 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. 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). 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. If I am completing Section 5b, I authorize for my commercially insured patient one. 71 for Dupixent compared to 0. ) 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. 1‑844‑DUPIXENT 1-844-387-4936. Pregnancy: A pregnancy exposure registry monitors pregnancy outcomes in women exposed to DUPIXENT during pregnancy. ) 2 Prescription InformationDupixent® (dupilumab) approved by FDA as the first and only treatment indicated for prurigo nodularis. If I am completing Section 5b, I authorize for my commercially insured patient one. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. -The original form (from the first guy) was still in the system and the folks at MyWay were “confused” by it. So, even with a "prior authorization" and a "formulary override", the cost to me is $2900 per month, or about $1450. To enroll or obtain information call 1-877-311. You may be able to get a 90-day supply of Dupixent. DUPIXENT has been FDA approved for use in adults with uncontrolled moderate-to-severe eczema since 2017. 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. VO: DUPIXENT is a prescription medicine used: to treat people aged 6 years and older with moderate-to-severe atopic dermatitis (eczema) that is not well controlled with prescription therapies used on the skin (topical), or who cannot use topical therapies. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. 98% of Commercially Insured Patients. ) Please refer to Section 8, Patient Certifications, for. $0 is the amount you pay. 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. If you are a New York prescriber, please use an original New York. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. was not paid in whole or in part by Medicare, Medicaid, or any federal or state programs. g. 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. Rx: DUPIXENT® (dupilumab) (100 mg/0. For more information, call 1-844-DUPIXENT ( 1-844-387-4936) option 1. Assistance may be available for patients who do not have insurance. It's like $35k-$40k. 67 mL, 200 mg/1. 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. 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. . 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. 22. Follow these tips to take DUPIXENT while traveling: Store DUPIXENT in the original carton to protect it from light. Please see accompanying full Prescribing Information. Income at or below: Not Published: Medical expenses can be. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. 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. Since 2017, Dupixent has increased in price by 13%. Serious side effects can occur. DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older with uncontrolled, moderate-to-severe. DUPIXENT should not be stored above 77 °F (25 °C). 14 ml, 300 mg/2 ml: Asthma, atopic dermatitis: 3 syringes for the first 28 days. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. Serious side effects can occur. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. S. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may payable as little while $0* copay per fill by DUPIXENT. 89 and -1. 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. 0129 Last Update:. The doctor's office called to say I need to call to talk about my income and expenses. 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. 23. DUPIXENT can be used with or without topical corticosteroids. 2017;5 (6):1519-1531. DUPIXENT use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. 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. Eligible patients or caregivers of a patient must be: *For more information, dial 1-844-DUPIXENT 1-844-387-4936 option 5, Monday-Friday, 9 am - 9 pm ET. DUPIXENT® (dupilumab), in moderate-to-severe asthma treatment, is taken as an injection by a pre-filled syringe or pre-filled pen, review both options here. I give supplemental injection training to the patient and the patient’s caregiver. So, let's just pretend the total cost is $1,000/month. 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. 6 Submitting a PA request The appeal. Do not store DUPIXENT pre-filled syringes at room temperatures more than 77°F (25°C) Do not keep DUPIXENT at room temperature. Want to be a part of the DUPIXENT MyWay® Ambassador Program? Fill out this self-nomination form to see if you qualify. Select Condition Indication Moderate-to-Severe Eczema (Ages 6+ Months) Moderate-to-Severe Asthma (Ages 6+ Years) Chronic Rhinosinusitis with Nasal Polyposis (Ages 18+. 22. DUPIXENT® is indicated as an add-on maintenance treatment of adult and pediatric patients 6 years and older with moderate-to-severe asthma characterized by an eosinophilic phenotype or with oral corticosteroid dependent asthma. XXXX 00/0000 b y: A B C c o m pa n y, I n c. This copay card may be for you if you. In this case Dupixent myway will cover the first 13k, which is probably like 5 months. DUPIXENT was studied in adults and children 6 months of age and older. DUPIXENT can be used with or without topical corticosteroids. Section 5a. 00, but I do have some money invested. Hear from DUPIXENT® (dupilumab) patients & caregivers of patients 6 years and older with uncontrolled moderate-to-severe atopic dermatitis & healthcare professionals who treat atopic dermatitis, download helpful resources & explore future events. Dupixent has been studied in more than 8,000 patients ages 6 years and older across more than 40 clinical trials. At one point, I was getting cold sores every 2 to 3 weeks consistently. You may be able to lower your total cost by filling a greater quantity at one time. For more information, call 1. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. At this rate, I will no longer be able to afford the medication very soon. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. 99% of commercial patients (6+ months of age) nationally are covered for DUPIXENT. How many people live in your household? _____ Please refer to. 00 copay. Support. Program has an annual maximum of $13,000. LONG-LASTING CLEARER SKIN AT 16 and 52 Weeks 22% taking. It's like $35k-$40k. Robocalls increase diabetic retinopathy screenings in low-income patients. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. - Rachel, DUPIXENT Patient Mentor, living with asthma. Advertisement. 4 ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pm 01. 80). 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. chevron_right. I’m Laurie. S. I wanted to go out and make a difference and help people. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. 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. Serious adverse reactions may. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. *For patients on DUPIXENT 300 mg in a 24-week and a 52-week clinical trial vs 17% for placebo group. $125 is the amount Dupixent assistance pays. Effective Sept. My wife is on Dupixent, and has the MyWay card which allows up to $13,000/year. DUPIXENT® (dupilumab), is the first FDA-approved biologic to treat eosinophilic esophagitis (EoE) in patients 12 years and older who weigh at least 88lb (40kg).