Rx: DUPIXENT® (dupilumab) (100 mg/0. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. Option 1- you have to meet your deductible without Dupixent myway. ) 2 Prescription InformationDupixent® (dupilumab) approved by FDA as the first and only treatment indicated for prurigo nodularis. C M ET DUPIXENT MYWAY ENROLLMENT FORM Moderate-to-Severe Atopic Dermatitis SUBMIT COMPLETED PAGES 1 & 2 Fax: 1-844-387-9370 Document Drop: (code: 8443879370)The DUPIXENT MyWay Copay Card Program includes the Copay Card, the Debit Card, and any direct patient rebate, and has a combined annual maximum benefit of $13,000 per patient per calendar year. Learn how DUPIXENT® (dupilumab), the first FDA-approved weekly injectable biologic treatment for eosinophilic esophagitis (EoE) in patients 12 years and older who weigh at least 88lb (40kg) targets a source of inflammation, which contributes to EoE. So, how can you save? Manufacturer Sanofi offers Dupixent MyWay, a patient support program. 71 for Dupixent compared to 0. 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. 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. ®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. 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. 0185 Last Update: November 2022 DUP. Coverage varies by. Please see Important Safety Information and Patient Information on. 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. If you don’t have health insurance, talk. 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. 03. 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. Using the drop. For Healthcare Professionals. ) 2 Prescription InformationDUPIXENT is not a steroid. DUPIXENT® (dupilumab) is indicated as an add-on maintenance treatment in adult patients with inadequately controlled chronic rhinosinusitis with nasal polyposis (CRSwNP). 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. Program has an annual maximum of $13,000. PRESCRIBER TO FILL OUT Section 6a. You have to game the system instead of trying to get full coverage. 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. I found the carnivore diet helps immensely for autoimmune issues. 14 mL Dupixent subcutaneous solution from $3,787. The $500 payment counts towards the member’s deductible and out-of-pocket maximum. 01. 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. Subcutaneous Solution 100 mg/0. any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. 67 mL Dupixent subcutaneous solution from $3,787. But either way, after you or Dupixent myway meets your deductible, it should be free to you. Eligible commercially insured patients may pay $0 per prescription with a maximum savings of $13,000 per year; for additional information contact the program at 844-387-4936. 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. 00. 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. 1-844-DUPIXENT 1-844-387-4936. 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. Program Website : Program Applications and FormsView the possible side effects of DUPIXENT in patients with uncontrolled chronic rhinosinusitis with nasal polyposis. Serious side effects can occur. This year the program seems to have changed, requiring a separate 'copay card' with an annual limit of $13,000. 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. 2 Eligible US residents with an FDA-approved. DUPIXENT MyWay. Even when using the Copay Card, that would cover only cover 4 months worth, and would not go towards my deductible, totaling about. Tips. For more information, call 1-844-DUPIXEN (T) (1-844-387-4936. DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. 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. 67 mL, 200 mg/1. DUPIXENT (dupilumab) Dupixent FEP Clinical Criteria AND submission of medical records (e. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. 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. 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. How many people live in your household? _____ Please refer to. 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. Access the dupixent reimbursement form either online or through your healthcare provider. Manufacturer Coupon. . 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). 1‑844‑DUPIXENT 1-844-387-4936. 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. Watch videos for a supplemental demonstration on how to use and dispose of DUPIXENT® (dupilumab), a prescription medicine for subcutaneous injection. Regeneron and Sanofi are committed to helping patients in the U. They never mentioned only covering a. 14 mL, or 300 mg/2 mL) Call 1-844-387-4936, Option 1 to contact DUPIXENT MyWay ®. Compare . g. 02. My doctor gave me a copay card to cover mine. Check your eligibility for the DUPIXENT MyWay® Copay Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients. DUPIXENT MyWay coordinators are available Monday-Friday 8 am to 9 pm ET. 71 for Dupixent compared to 0. 98% of Commercially Insured Patients. 02. 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. I. 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. Serious side. 0156 Last Update: March 2023 DUP. 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. DUPIXENT is taken by injection under the skin (subcutaneous injection) once every two weeks. The U. I’m Laurie. Be sure to fill out your enrollment form completely and accurately. 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. 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. It temporarily provides eligible patients DUPIXENT at no cost, subject to program terms and conditions. I'm "only" 61 now though on Dupixent MyWay copay help. S. If you’re the spouse or. 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 cartons. The DUPIXENT MyWay team can research each patient’s situation and determine eligibility. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not ENROLL. Monday-Friday, 8 am - 9 pm ET I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay, and that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. After that, it is taken as 1 injection every 2 weeks or every 4 weeks, depending on your age and weight. 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. DUPIXENT® and DUPIXENT MyWay® are entered commercial of Sanofi Biotechnological. 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 can be stored at room temperature up to 77°F (25°C) up to 14 days. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. - Rachel, DUPIXENT Patient Mentor, living with asthma. - Rachel, DUPIXENT Patient Mentor, living with asthma. 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. Learn about the DUPIXENT® (dupilumab) mechanism of action inhibiting IL-4 and IL-13 signaling in appropriate asthma patients. 09. 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 PROGRAM. chevron_right. com. For more information, dial 1. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. Lancet. 67 mL, 200 mg/1. It was a process to get into the patient assist program. 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 understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. 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. a Coverage varies by type and plan. 1-844-DUPIXENT (1-844-387-4936) Topicort (desoximetasone spray 0. PRESCRIBER TO FILL OUT Section 6a. Follow these tips to take DUPIXENT while traveling: Store DUPIXENT in the original carton to protect it from light. Section 5a. The most common side effects include: DUPIXENT MyWay. Fill out the form accurately and completely, providing all. 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. When I was very young, I knew that I wanted to be a nurse. Most do, some don't. If you still have questions, you can speak with a DUPIXENT MyWay or request to join the program over the phone. It temporarily provides eligible patients DUPIXENT at no cost, subject to program terms and conditions. Please note that you will receive a confirmation fax after sending the form. Dupixent changed my life completely. Box 5925 Mailstop 55A-220A Bridgewater, NJ 08807. Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. form on DUPIXENT. THE DUPIXENT MyWay COPAY CARD. These programs and tips can help make your prescription more affordable. Assistance may be available for patients who do not have insurance. 14 mL, or 300 mg/2 mL)Call 1-844-387-4936, Option 1 to contact DUPIXENT MyWay ®. For more information, call 1-844-DUPIXENT. DUPIXENT can cause serious side effects, including: The most common side effects in patients with eczema include. For assistance, please call 1-844-468-2252 Monday Friday, 8AM to 8PM ET. DUPIXENT® (dupilumab) is taken as an injection by a pre-filled syringe or pre-filled pen. Based on the questions answered above, you are not eligible to register for a new copay card or to activate a copay card. Depends if your insurance cares that Dupixent myway is paying your deductible. 22. So, even with a "prior authorization" and a "formulary override", the cost to me is $2900 per month, or about $1450. I also have the dupixent myway card that covers a total of $13,000 for the year. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. 00. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. 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. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. There is another biologic very similar to Dupixent called Adbry. For more information, please call 1-844-DUPIXENT (1-844-387-4936) or visit . • Store DUPIXENT in the refrigerator at 36°F to 46°F (2°C to 8°C). 01. Dupixent MyWay pays the $500 copay. Learn why DUPIXENT® (dupilumab) may be an. 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. 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. 03. 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. I may opt out of receiving Communications, individual support services, including the DUPIXENT MyWay® Copay Card, or opt out of DUPIXENT MyWay® entirely at any time by notifying a representative by telephone at 1-800-633-1610 or by sending a letter to Sanofi US Customer Service P. DUPIXENT® (dupilumab), in moderate-to-severe asthma treatment, is taken as an injection by a pre-filled syringe or pre-filled pen, review both options here. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. Since MyWay covers 13,000 a year, that will count towards your deductible. ) Please refer to Section 8, Patient Certifications, for. 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 will run about $3000 per month with my insurance until my maximum is met. Effective Sept. any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. Oct 26, 2022 · Dupixent MyWay Program Enrollment Form for Allergists (AD, Asthma, CRSwNP). _____ What is your total annual household income? _____ (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. chevron_right. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. Also if your insurance does cover,Dupixent offers a co-pay card that. Get a Quick Start. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. Regeneron and Sanofi are committed to helping patients in the U. 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. What it is used for. I wanted to go out and make a difference and help people. Nationally are Covered for DUPIXENT. Household Size. 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. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Dupilumab. 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. Sign up or activate your card here. 2 cartons. with household income, to qualify. DUPIXENT MyWay Ambassador. 58 for 1. A program called Dupixent MyWay is available for this drug. Patient assistance program. C M ET DUPIXENT MYWAY ENROLLMENT FORM Moderate-to-Severe Atopic Dermatitis SUBMIT COMPLETED PAGES 1 & 2 Fax: 1-844-387-9370 Document Drop: (code: 8443879370) When filling out the DUPIXENT MyWay Enrollment Form, both you and your patient will be required to supply information, such as the patient’s insurance, diagnosis, and prescription. Gather all necessary information and documents, such as your insurance information, prescription details, and any supporting documentation. Manufacturer Coupon. 1,000-125=875 $875 is the amount your health insurance pays. Expert perspectives on management of moderate-to-severe atopic dermatitis: a multidisciplinary consensus addressing current and emerging therapies. He continued with Dupixent and his symptoms had partially improved 24 weeks after their onset. It should only be given by an adult caregiver in children 6 to 11 years of age. Sign it in a few clicks. 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 . • Store DUPIXENT in the original carton to protect from light. Rx: DUPIXENT® (dupilumab) (100 mg/0. 22. 0156 Past Update: March 2023 DUP. If I am completing Section 5b, I authorize for my commercially insured patient one. 89 and -1. 01. Dupixent (dupilamab) Dupixent MyWay patient support program. About Dupixent. Deductible is at $3k out of pocket insurance pays 80% and at $6k insurance pays 100%. 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. 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. 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. 14 mL, or 300 mg/2 mL)Section 5a. For me, the side effects didn’t really bother me or have me second guess my decision with Dupixent because my skin was. 67 mL, 200 mg/1. 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. Type text, add images, blackout confidential details, add comments, highlights and more. DUPIXENT® (dupilumab) is a. Income at or below: Not Published: Medical expenses can be deducted from reported income:. 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. 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. DUP. 1-844-DUPIXENT 1-844-387-4936. 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 MyWay® is a patient support program that can help with the enrollment process, offer. If this is the case, write the preferred specialty pharmacy. 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® 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. 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. Rx: DUPIXENT® (dupilumab) (100 mg/0. 1kg to 18. LH Patient View; data through June 16, 2023. financial assistance for eligible patients, provide one-on-one nursing support, and more. The formulary status tool below can help check DUPIXENT coverage for various plans. SINCE 2017, ≈253,000 PATIENTS HAVE FILLED AT LEAST 1 DUPIXENT PRESCRIPTION b,c. ) Please refer to Section 8, Patient Certifications, for. 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. Especially tell your healthcare provider if you. Serious side effects can occur. Assistance may be available for patients who do not have insurance. They will begin the benefits investigation and inform your office of the next steps. Social Security income, unemployment insurance benefits, disability income, any other income for the household. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will notOnce you’ve been prescribed DUPIXENT, your healthcare provider can download the enrollment form, help you fill it out, and fax it back to DUPIXENT MyWay at 1-844-387-9370. Rx: DUPIXENT® (dupilumab) (100 mg/0. . Fill out sections 5a and 5b completely to determine patient eligibility. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. Caring. For more information, dial 1‑844‑DUPIXENT( 1-844-387-4936 ), option 1. Injection site reactions and eye conditions are the most common side effects reported and, unlike several other biologics, the risk of infection is low. Each time you fill your DUPIXENT prescription, please ensure your. Please see Important Safety Information and Prescribing Information and Patient Information on website. If you are a New York prescriber, please use an original New York State prescription form. Serious side effects can occur. . 67 mL, 200 mg/1. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. The DUPIXENT MyWay team will research each patient’s situation and determine eligibility. 14 ml, 300 mg/2 ml: Asthma, atopic dermatitis: 3 syringes for the first 28 days. Note: All information is required unless otherwise indicated. 00 per injection. 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. 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. chevron_right. Watch videos from experts [,download materials,] and explore future events to further understand DUPIXENT® (dupilumab). 00 copay. Please see Important Safety Information and full PI on website. After removal from the refrigerator, DUPIXENT must be used within 14 days or discarded. After that, we will have met our family deductible. com, help you fill it out, and fax it back to DUPIXENT MyWay at 1-844-387-9370 • You or your healthcare provider can call 1-844-DUPIXEN(T), option 1 • Providing your email address allows DUPIXENT MyWay to give you more support resources about DUPIXENT HAS YOUR DOCTOR PRESCRIBED DUPIXENT ® (dupilumab)? 14 15. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. Clip the card and save • Save up to 80% on medications*Tell your healthcare provider about any new or worsening joint symptoms. Patient Signature _____ If you have questions about the . DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. Ways to save on Dupixent. Hello! Switching insurance this year and need to prepare for increasing costs of dupixent with my new insurance. To enroll or obtain information call 1-877-311. 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. living with prurigo nodularis. Children treated with Dupixent and topical corticosteroids (TCS) achieved clearer skin, experienced significantly improved overall disease severity and significantly reduced itch compared to TCS. Eligible patients will receive their cards by email. In this case Dupixent myway will cover the first 13k, which is probably like 5 months. Since 2018, DUPIXENT has been prescribed to over 100,000 asthma patients in the US. “Eczema otherwise unspecified” is not indicated for Dupixent. financial assistance for eligible patients, provide one-on-one nursing support, and more. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Injection in children 12 and older should be supervised by an adult. Pregnancy: A pregnancy exposure registry monitors pregnancy outcomes in women exposed to DUPIXENT during pregnancy. Learn how DUPIXENT® (dupilumab) works as the first and only FDA-approved treatment for prurigo nodularis (PN) in adults aged 18 years and older. How to fill out dupixent reimbursement: 01. Dupixent is an injection under the skin (subcutaneous injection) at different injection sites. b New adult and pediatric patients aged 6 years and older with moderate-to-severeSection 5a. Step One - let's gather our materials. 34 milliliters 200 mg/1. 06 and -1. Serious side effects can occur. Fax the Enrollment Form to DUPIXENT MyWay. withdraw this Authorization at any time by mailing or faxing a written request to DUPIXENT MyWay at 1800 Innovation Point, Fort Mill, SC 29715; Fax: 1-844-387-9370. Data on file, Regeneron Pharmaceuticals, Inc. For more information, call 1-844-DUPIXENT ( 1-844-387-4936) option 1. 1, 2022, the gross income limit for Supplemental Nutrition Assistance Program (SNAP) eligibility in Minnesota increased from 165% to 200% of the federal poverty line for most households. How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. Injection Support Center Injection Reminders and Tips FREQUENTLY ASKED QUESTIONS; Español. 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. Copay Card or you wish to discontinue your participation, please contact us. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. 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. any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. “It’s an incredible feeling to be validated and. LEARN ABOUT OUR PATIENT SUPPORT PROGRAM. 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. E. Patient is responsible for any out-of-pocket amounts that exceed the program limit. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. 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. Dedicated Dupixent MyWay Case Managers can explain information related to Dupixent. From my understanding, the Dupixent MyWay Program pays the $125 since your insurance is covering the rest. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase. That is good, because I was quoted 1400+ a month by my Medicare D provider. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may payable as little while $0* copay per fill by DUPIXENT. 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. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. S. Susie16 Oct 15, 2023 • 9:37 PM. DUPIXENT MyWay. DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older, with uncontrolled, moderate-to-severe eczema (atopic dermatitis). Please complete the form, sign, and FA to 1-844-23-312. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. A case series of 12 people prescribed Dupixent reported an average weight gain of 6. How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. QUEST (12+ years) DUPIXENT offers rapid breathing relief patients can feel as early as Week 2. 01. A 68-year-old woman developed generalized joint pain 6 weeks after starting Dupixent. including household income, to qualify. 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. 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. For more information, dial 1‑844‑DUPIXENT( 1-844-387-4936 ), option 1. Opinions clash over private equity’s effect on dermatology. At one point, I was getting cold sores every 2 to 3 weeks consistently. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. It contains 300 mg of DUPIXENT for injection under the skin (subcutaneous injection). 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. The increase was approved by the Minnesota Legislature and will help expand SNAP eligibility to families who may have previously been ineligible for the. 80). S. Patient and Co-pay Assistance: DUPIXENT MyWay helps eligible patients get access to therapy whether they are uninsured, lack. Since 2017, Dupixent has increased in price by 13%. com. Caring. 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. 1 Reactions. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. Rx: DUPIXENT® (dupilumab) (100 mg/0. Nationally are Covered for DUPIXENT. *For patients on DUPIXENT 300 mg in a 24-week and a 52-week clinical trial vs 17% for placebo group. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. THE DUPIXENT MyWay PROGRAM. 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. Decreased exacerbations and/or improvement in symptoms 2. O. 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. 23. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. Tell your healthcare provider about any new or worsening joint symptoms.