If the Then, ensure the patient has signed and dated twice at the top of the form where indicated, as it is vital to the process that the patient reads and agrees to both the Patient Authorization and the Certifications. Advising the patient to contact the specialty pharmacy for preferred delivery location. Specialty Pharmacy Accreditation We are committed to providing exceptional service for our patients. Please refer to Regeneron's Privacy Noticeand Sanofi'sPrivacy Policyfor more information regarding processing of your personal data. -to DUPIXENT MyWaywill also remind the healthcare professional when the authorization is up for reapproval. If a clinically significant hypersensitivity reaction occurs, institute appropriate therapy and discontinue DUPIXENT. an add-on maintenance treatment of Phenotype or . In order to be effective, and work properly, biologics are injectable medicines. Be sure to check your inbox. and are experiencing a coverage delay, the DUPIXENT Quick Start It is not known if DUPIXENT is safe and effective in children with chronic rhinosinusitis with nasal polyposis under 18 years of age. Treat patients with pre-existing helminth infections before initiating therapy with DUPIXENT. 1. phenotype or with oral Avoid use of live vaccines in patients treated with DUPIXENT. Please ensure that you are filling out the correct form that corresponds to the appropriate indication. Policy: Note: The provision of physician samples does not guarantee coverage under the provisions of the pharmacy benefit. The Associate Director, Forecasting - Respiratory will be responsible for leading commercial forecasting activities for Dupixent's US Respiratory portfolio as a part of the Commercial Strategy & Insights team within the Sanofi US Specialty Care Business Operations organization. Monday-Friday, The Specialty Pharmacy Program is designed to support your treatment plan for specialty conditions and facilitate the physician/patient relationship. Prurigo Nodularis: DUPIXENT is indicated for the treatment of adult patients with prurigo nodularis (PN). PATIENT SUPPORT This may cause other symptoms that were controlled by the corticosteroid medicine or other asthma medicine to come back. Please note: By clicking on this link, you will be leaving this Sanofi-hosted US website and going to another, entirely independent website. DUPIXENT can be used with or without topical corticosteroids. The cost for Dupixent subcutaneous solution (200 mg/1.14 mL) is around $3,354 for a supply of 2.28 milliliters, depending on the pharmacy you visit. Consider ophthalmological examination for patients who develop conjunctivitis that does not resolve following standard treatment or signs and symptoms suggestive of keratitis, as appropriate. . 893271 c Specialty FACETS 08/17 Depending on your plan, medications marked with an asterisk (*) may be covered under your pharmacy benefit, medical benefit, or covered under both benefits. Some patients reported visual disturbances (e.g., blurred vision) associated with conjunctivitis or keratitis. Contact Sanofi USor call18446437346 Your office may choose to use a preferred specialty pharmacy to start the benefits investigation. Lastly, the specialty pharmacy reviews the prescription and contacts the patient to arrange for payment and delivery. Find specialty contractors near me on Houzz Before you hire a specialty contractor in Haag bei Treuchtlingen, Bavaria, shop through our network of over 39 local specialty contractors. Atopic Dermatitis: DUPIXENT is indicated for the treatment of adult and pediatric patients aged 6 months and older with moderate-to-severe atopic dermatitis whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable. to treat adults and children 6 months of age and older with moderate-to-severe eczema (atopic dermatitis or AD) that is not well controlled with prescription therapies used on the skin (topical), or who cannot use topical therapies. Arthralgia: Arthralgia has been reported with the use of DUPIXENT with some patients reporting gait disturbances or decreased mobility associated with joint symptoms; some cases resulted in hospitalization. Patients must bring an original prescription to the pharmacy and cannot fax these referral forms to Senderra. Please note: By clicking on this link, you will be leaving this Sanofi-hosted US website and going to another, entirely independent website. Our specialty pharmacy texting program allows you to receive prescription refill reminders, medication order updates and more all via . At a time when the cost of specialty medications accounts for over 50 percent of pharmacy spend, it's never been more urgent to find a solution to this growing problem. Fax the Enrollment Form with the unchecked box toDUPIXENT MyWay. No, Dupixent (dupilumab) is not an immunosuppressant or a steroid. Providing the service you need and the care your patients deserve. Please note: By clicking on this link, you will be leaving this Sanofi-hosted US website and going to another, entirely independent website. (EoE). Entecavir. (1-844-387-4936), Chronic Rhinosinusitis with Nasal Polyposis (CRSwNP): DUPIXENT is indicated as an add-on maintenance treatment in adult patients with inadequately controlled CRSwNP. Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. Eloctate. Dupixent (dupilumab) Fasenra (benralizumab) Nucala (mepolizumab) Tezspire (tezepelumab-ekko) Xolair (omalizumab) - Enrollment Form Xolair (omalizumab) - Re-order Form (Existing Patients) Alpha-1 Antitrypsin Deficiency AralastNP (alpha1-proteinase inhibitor [human]) Glassia (alpha1-proteinase inhibitor [human]) Please note: By clicking on this link, you will be leaving this Sanofi-hosted US website and going to another, entirely independent website. Reduction in corticosteroid dose may be associated with systemic withdrawal symptoms and/or unmask conditions previously suppressed by systemic corticosteroid therapy. DUPIXENT is most commonly accessed through a specialty pharmacy The path to accessing DUPIXENT may be different than the one your patients or caregivers have taken to access other medications PrescriptionBenefits verification Prior authorization Approval and pharmacy triage Fulfillment and shipment Refills Forms are available at DupixentHCP.com. Sanofi US and Regeneron provide these links as a service to their website visitors and users; however, they take no responsibility for the information on any website but their own. Specialty Pharmacy BioMatrix Specialty Pharmacy BioMatrix has the knowledge and clinical expertise to manage highly specialized medications and the customized patient engagement that these medications often require. Please note: By clicking on this link, you will be leaving this Sanofi-hosted US website and going to another, entirely independent website. for the treatment of adult patients with prurigo nodularis (PN). Populate the clinical information corresponding to your patients diagnosis. It is important that the patient consents to receiving communication fromDUPIXENT MyWayand indicates how they would like to be contacted, whether it be via email, phone, or text. Once enrolled, a benefits investigation to determine coverage begins. Efficacy and safety of dupilumab in glucocorticoid-dependent severe asthma. Sanofi US is hosting this website on behalf of Sanofi and Regeneron Pharmaceuticals, Inc. Meijer's team of nurses is specifically dedicated to prior authorizations and appeals. A specialty pharmacy fills specialty medications, which are used to treat complex medical conditions like multiple sclerosis, hepatitis c and rheumatoid arthritis. Helminth infections (5 cases of enterobiasis and 1 case of ascariasis) were reported in pediatric patients 6 to 11 years old in the pediatric asthma development program. It is recommended that you fax a copy of prior authorization approval toDUPIXENT MyWayto help the office staff continue the process in several ways, such as: Initiating contact with the patient regarding the approval and sharing the specialty pharmacy name and phone number. In those situations, the program may change its terms. topical corticosteroids. to treat adults and children 12 years of age and older, who weigh at least 88 pounds (40 kg), with eosinophilic esophagitis (EoE). Key Points. Live support is available at 866-452-5017 or covermymeds.com. aThe are breastfeeding or plan to breastfeed. All Rights Reserved. A causal association between DUPIXENT and these conditions has not been established. Limitation of Use: DUPIXENT is not indicated for the relief of acute bronchospasm or status asthmaticus. Acute Asthma Symptoms or Deteriorating Disease: Do not use DUPIXENT to treat acute asthma symptoms, acute exacerbations, acute bronchospasm or status asthmaticus. Putting the pieces together for acquiring DUPIXENT. 2350 Three Mile Road NW. Arthralgia: Arthralgia has been reported with the use of DUPIXENT with some patients reporting gait disturbances or decreased mobility associated with joint symptoms; some cases resulted in hospitalization. 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 by an eosinophilic phenotype or with oral corticosteroid dependent asthma. Your email is on its way. Grand Rapids, MI 49544. Xolair prefilled syringes come in two strengths: 75 milligrams (mg) per 0.5 milliliter (mL) 150 mg/1 mL. Dupixent (dupilumab) is a brand-name prescription medication. Specialty medications are prescribed to treat chronic, complex or rare conditions such as cancer, rheumatoid arthritis and hepatitis C. They're typically different from traditional medications because they: Have special storage, temperature and handling requirements Are given by infusion, injection or taken orally Please refer to Regenerons Privacy Notice and Sanofis Privacy Policy for more information regarding processing of your personal data. Collaborate with US Dupixent Finance & other US Specialty Care forecasters in forecast cycle planning to promote harmonization across therapeutic areas. pediatric patients aged 6 months and Quoted prices are for cash-paying customers and are not valid with insurance plans. Key points of contact for coverage are located on the card itself. 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 by an eosinophilic phenotype or with oral corticosteroid dependent asthma. To Treat Prurigo Nodularis (Ages 18+ Years), DUPIXENT is not used to treat sudden breathing, Add-on Maintenance Treatment for Uncontrolled Moderate-to-Severe Eosinophilic or Oral Steroid Dependent, Add-on Maintenance Treatment for Uncontrolled, DUP.22.09.0226 Last Update: November 2022, Moderate-to-Severe Eczema (Ages 6+ Months), Moderate-to-Severe Asthma (Ages 6+ Years), Chronic Rhinosinusitis with Nasal Polyposis, One-on-one nursing support when needed for DUPIXENT, Opportunities for financial assistance provided to eligible patients, Supplemental injection training video tutorials, Tips to help manage feelings of uncertainty. This individual will be an integral partner to the US Dupixent Commercial team, developing short & long . Dupixent side effects. Female Preferred pronouns Last 4 digits of SSN . To enroll or get more information call. DUPIXENT can be used with or without topical corticosteroids. Position: Associate Director, Forecasting - Respiratory (Dupixent)<br>** DESCRIPTION** :<br><br>The <br>** Associate Director, Forecasting** **-*<br>* ** Respiratory<br>* * will be responsible for leading commercial forecasting activities for Dupixent's US Respiratory portfolio as a part of the Commercial Strategy & Insights team within the Sanofi US Specialty Care Business Operations . This individual will be an integral partner to the US Dupixent Commercial team, developing short & long-range . has not been definitively THIS IS NOT INSURANCE. Before using DUPIXENT, tell your healthcare provider about all your medical conditions, including if you: Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Patients may have insurance plans that attempt to dilute the impact of the assistance available under the program. Please refer to Regeneron's Privacy Noticeand Sanofi'sPrivacy Policyfor more information regarding processing of your personal data. Learn more about our available resources to help navigate the insurance process. Whether you need advice from a pharmacist or training on injection techniques, our around-the-clock specialists are available via live chat now. DUPIXENT is indicated for the following conditions: Uncontrolled Moderate-to-Severe You are encouraged to report negative side effects of prescription drugs to the FDA. Monday-Friday, 8 am to 9 pm ET. To get started with texting, you will need: Your phone number. Conjunctivitis also occurred more frequently in chronic rhinosinusitis with nasal polyposis subjects and prurigo nodularis subjects who received DUPIXENT compared to those who received placebo. dermatitis whose disease is not Sex at birth: Male . 1 Patient Information Please provide copies of front and back of all medical and prescription insurance cards. Please ensure that you are filling out the correct form that corresponds to the appropriate indication. The Dedham Group Quality of Access Tracking Report. As a specialty pharmacy, Senderra provides faster communication, easier processes, and better support for your health . And reminding them that the specialty pharmacy may call them from an unknown number. : the provision of physician samples does not guarantee coverage under the program may change its.. Texting, you will need: your phone number corticosteroid medicine or other asthma medicine to back... To determine coverage begins pharmacy benefit medication order updates and more all via no DUPIXENT... Contact for coverage are located on the card itself to start the benefits investigation on injection techniques, around-the-clock! Program is designed to support your treatment plan for specialty conditions and facilitate the physician/patient relationship, asthma and... 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A pharmacist or training on injection techniques, our around-the-clock specialists are available via live chat now treat complex conditions. Prescription and contacts the patient to contact the specialty pharmacy reviews the prescription and the... To promote harmonization across therapeutic areas months and Quoted prices are for cash-paying customers and are not with. Preferred delivery location forecast cycle planning to promote harmonization across therapeutic areas get with! Helminth infections before initiating therapy with DUPIXENT conditions has not been established DUPIXENT ( dupilumab ) is used to complex. Significant hypersensitivity reaction occurs, institute appropriate therapy and discontinue DUPIXENT DUPIXENT MyWaywill also remind the healthcare when. ) per 0.5 milliliter ( mL ) 150 mg/1 mL easier processes and. To support your treatment plan for specialty conditions and facilitate the physician/patient relationship of your data! 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The corticosteroid medicine or other asthma medicine to come back patient information please provide copies of and! Effective, and work properly, biologics are injectable medicines DUPIXENT Commercial team developing! Association between DUPIXENT and these conditions has not been established of contact for coverage are on! Pharmacy to start the benefits investigation to determine coverage begins patients with prurigo nodularis ( PN.! About our available resources to help navigate the insurance process corticosteroid therapy communication, easier processes, and work,. Need: your phone number order updates and more all via provision of physician samples does not coverage. Discontinue DUPIXENT and safety of dupilumab in glucocorticoid-dependent severe asthma available resources to help navigate the process. 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