S. 4 ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pm01. • Store DUPIXENT in the refrigerator at 36°F to 46°F (2°C to 8°C). The most common side effects include: DUPIXENT MyWay. I've been on Dupixent for over 2 years now and it has been such a great experience keeping my eczema under control. DUPIXENT use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. 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. 01. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. 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. This year the program seems to have changed, requiring a separate 'copay card' with an annual limit of $13,000. I found the carnivore diet helps immensely for autoimmune issues. 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. including household income, to qualify. Do not store DUPIXENT pre-filled syringes at room temperatures more than 77°F (25°C) Do not keep DUPIXENT at room temperature. March 29, 2018. , chart notes, laboratory values) and use of claims history documenting the following: 1. To enroll or obtain information call 1-877-311. I’m a registered nurse with DUPIXENT MyWay. Dupixent on a High Deductible Health Plan. Get a Quick Start. Patient Signature _____ If you have questions about the . DUPIXENT should not be stored above 77 °F (25 °C). Patient is responsible for any out-of-pocket amounts that exceed the program limit. 23. But either way, after you or Dupixent myway meets your deductible, it should be free to you. DUP. If necessary, DUPIXENT may be kept at room temperature up to 77 °F (25 °C) for a maximum of 14 days. On dupixent, Dupilumab, I honestly felt I was in my 60 to 70s+ with joint pains throughout my entire body even into the smallest of joints like fingers. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. Please see Important Safety Information and Prescribing Information and Patient Information on website. I have read and agree to the Income Verification included in Section 8 on page 5. you offering to give them $170 they assumed you didn’t want to bother contacting dupixent myway. Fill out sections 5a and 5b completely to determine patient eligibility. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. 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. g. 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. I’m Laurie. Want to be a part of the DUPIXENT MyWay® Ambassador Program? Fill out this self-nomination form to see if you qualify. If you don't have insurance at all, the only realistic option is to qualify for income-based help from Dupixent directly. Prior authorization and appeals. S. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. 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). 2 pens of 300mg/2ml. 2022;400 (10356):908-919. Program has an annual maximum of $13,000. DUPIXENT is not a steroid or immunosuppressant; it is a prescription biologic medicine given under the skin (subcutaneous injection). 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. DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older, with uncontrolled, moderate-to-severe eczema (atopic dermatitis). Patient and Co-pay Assistance: DUPIXENT MyWay helps eligible patients get access to therapy whether they are uninsured, lack. 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, 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. 38]). Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. $0!!!!! On April 6 I sent them income paperwork and my year to date prescription invoices. Section 5a. 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. Dupixent side effects. S. Please note that you will receive a confirmation fax after sending the form. 09. So, how can you save? Manufacturer Sanofi offers Dupixent MyWay, a patient support program. ) Please refer to Section 8, Patient Certifications, for. Serious side effects can occur. Rx: DUPIXENT® (dupilumab) (100 mg/0. 23. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. DUPIXENT can be used with or without topical corticosteroids. _____ What is your total annual household income? _____ (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. It's like $35k-$40k. 01. I knocked out the first copay out of pocket and went on the manufacturer website and applied for the dupixent my way card. Please see accompanying full Prescribing Information. If I am completing Section 5b, I authorize for my commercially insured patient one. The majority of DUPIXENT patients with commercial/employer-provided insurance use the DUPIXENT MyWay ® Copay Card. Pay as little as $0 per month. 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. ) 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. 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. 99% of commercial patients (6+ months of age) nationally are covered for DUPIXENT. You must also meet certain household income eligibility requirements as outlined below: 48 States and DC. chevron_right. Your office may choose to use a preferred specialty pharmacy to start the benefits investigation. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. First few months into taking Dupixent, I got laid off and worked w my doctors/Dupixent to get assistance. Your cost may depend on your treatment plan, your insurance coverage (if you have it), and the pharmacy you use. SIGN UP TO SPEAK WITH A DUPIXENT MyWay ® MENTOR . Sanofi and Regeneron are committed to helping patients in the U. 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. 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. 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. 1 Reactions. BIN: 020750 RX PCN: NMeds RX GRP: PDFPDF ID: NMNA019309901930 This is a drug discount program, not an insurance plan. 06 and -1. 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 . 2 pens of 300mg/2ml. DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. DUPIXENT . Well at a cost of roughly $3,500/dose which lasts a month, that will all be used up in four months. 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. I wanted to go out and make a difference and help people. Most do, some don't. 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, dial 1-844-DUPIXENT 1-844-387-4936 ), option 5, Monday-Friday, 9 am – 9 pm ET. financial assistance for eligible patients, provide one-on-one nursing support, and more. A program called Dupixent MyWay is available for this drug. 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. Rx: DUPIXENT® (dupilumab) (100 mg/0. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase. 34 milliliters 200 mg/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. Guam or the USVI, and demonstrate a financial need with a total annual adjusted gross income of $100,000 or less. Also if your insurance does cover,Dupixent offers a co-pay card that. Tips. I suppose it doesn't really matter now. 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. Learn why DUPIXENT® (dupilumab) may be an. 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. Option 1- you have to meet your deductible without Dupixent myway. 02. Edit your dupixent myway enrollment form online. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. 00, but I do have some money invested. 67 mL, 200 mg/1. 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. To contact DUPIXENT MyWay, please call 1-844-DUPIXENT (1-844-387-4936). United Healthcare covers it but I get insurance through my employer and it was a huge pain to get approved. who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay ® program. 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. Since 2018, DUPIXENT has been prescribed to over 100,000 asthma patients in the US. 14 mL, or 300 mg/2 mL)Section 5a. I’ve been with DUPIXENT MyWay since the very beginning. For me, the side effects didn’t really bother me or have me second guess my decision with Dupixent because my skin was. 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 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. Deductible is at $3k out of pocket insurance pays 80% and at $6k insurance pays 100%. 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. Dupixent® should be given by or under the supervision of an adult in children 12 years of age and older. Learn about DUPIXENT® (dupilumab) for moderate-to-severe asthma treatment. 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. A program called Dupixent MyWay is available for this drug. 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 pmAdditionally, Dupixent MyWay TM offers personalized support from registered nurses and other specialists who are available 24/7 to speak with patients and help them navigate the complex insurance process. DUPIXENT MyWay. If you still have questions, you can speak with a DUPIXENT MyWay or request to join the program over the phone. Be sure to fill out your enrollment form completely and accurately. · If the insurer does have a copay accumulator in place: the insurer pays the entire cost of the refill except for $500. 80). Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. It still covers the same amount. For more information and to find out if you’re eligible for support, call 844-DUPIXENT (844-387-4936) or visit the program website. S. DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. Dupilumab. SINCE 2017, ≈253,000 PATIENTS HAVE FILLED AT LEAST 1 DUPIXENT PRESCRIPTION b,c. XXXX 00/0000 b y: A B C c o m pa n y, I n c. Decreased utilization of rescue medications 3. Serious side effects can occur. (2 of 3) Patient signature/Legal representative if patient is <18 years Date Section 2. I wanted to go out and make a difference and help people. . Serious side. For more information, dial 1‑844‑DUPIXENT( 1-844-387-4936 ), option 1. S. If this is the case, write the preferred specialty pharmacy. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. Gather all necessary information and documents, such as your insurance information, prescription details, and any supporting documentation. 1-844-DUPIXENT 1-844-387-4936. DUPIXENT was studied in adults and children 6 months of age and older. Clip the card and save • Save up to 80% on medications* Tell your healthcare provider about any new or worsening joint symptoms. My wife is on Dupixent, and has the MyWay card which allows up to $13,000/year. for DUPIXENT® dupilumab therapy My Information. It is not an immunosuppressant or a steroid. BIN: 020750 RX PCN: NMeds RX GRP: PDFPDF ID: NMNA019309901930 This is a drug discount program, not an insurance plan. Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. will not conduct a benefits verification. My income is only 30000. In this case Dupixent myway will cover the first 13k, which is probably like 5 months. I just got approved thru Dupixent my way for a year of free medication. Eligible clients will receive their cards by email. . $4,930. living with prurigo nodularis. 2. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. Fill out sections 5a and 5b completely to determine patient eligibility. Serious side effects can occur. 0156 Past Update: March 2023 DUP. The DUPIXENT MyWay patient support program is here to help you at every step of your DUPIXENT treatment journey. 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. Clip the card and save • Save up to 80% on medications*Tell your healthcare provider about any new or worsening joint symptoms. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. 6 Submitting a PA request The appeal. Serious side effects can occur. The doctor's office called to say I need to call to talk about my income and expenses. 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. 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. Guam or the USVI, and demonstrate a financial need with a total annual adjusted gross income of $100,000 or less. 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. 67 mL, 200 mg/1. When I was very young, I knew that I wanted to be a nurse. And very recently got laid off due to Covid-19. DUPIXENT is not used to treat sudden breathing problems. DUPIXENT® (dupilumab) is a. 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. Even when using the Copay Card, that would cover only cover 4 months worth, and would not go towards my deductible, totaling about. And, if you're eligible, you can sign up and receive your card today. J Allergy Clin Immunol Pract. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. There is another biologic very similar to Dupixent called Adbry. After that, it is taken as 1 injection every 2 weeks or every 4 weeks, depending on your age and weight. 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. , Sanofi US, and their affiliates and agents (together, the “Alliance”) may verifyBy checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. 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. Quantity Limits: Dupixent: 200 mg/1. Edit your dupixent myway enrollment form online. $125 is the amount Dupixent assistance pays. In clinical trials, DUPIXENT reduced the. 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. 0156 Past Update: March 2023 DUP. 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 year) if they meet the eligibility requirements, including: Have commercial insurance, including health insurance exchanges, federal employee plans, or state employee plans 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 more. These programs and tips can help make your prescription more affordable. Financial criteria for patient assistance. 3. For more information, dial 1‑844‑DUPIXENT( 1-844-387-4936 ), option 1. I give supplemental injection training to the patient and the patient’s caregiver. It may be covered by your Medicare or insurance plan. Income at or below: Not Published: Medical expenses can be. $0 is the amount you pay. Just got off the phone with Dupixent My Way. 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). I'm guessing this will not be allowed once I'm on Medicare. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. DUPIXENT is taken by injection under the skin (subcutaneous injection) once every two weeks. I have applied for grants, financial hardships (my household income surpasses every programs caps, even with 6 children), etc and now I'm just being told to pay $3,000/month or too bad. You may be able to get a 90-day supply of Dupixent. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. So, how can you save? Manufacturer Sanofi offers Dupixent MyWay, a patient support program. If you are a New York prescriber, please use an original New York. - Rachel, DUPIXENT Patient Mentor, living with asthma. If you don't have insurance at all, the only realistic option is to qualify for income-based help from Dupixent directly. DUPIXENT® (dupilumab) is a prescription medicine FDA-approved to treat five conditions. 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. · If the insurer does have a copay accumulator in place: the insurer pays the entire cost of the refill except for $500. The formulary status tool below can help check DUPIXENT coverage for various plans. Please see Important Safety Information and Patient Information on. For patients with commercial insurance who are new to DUPIXENT and experiencing a. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. The language of the MyWay program back then never mentioned the $13,000 limit: they simply asked for income requirements, etc. 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. 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. who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay® program. ) 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. 0252 Last Update: Feb 2023 DUP. 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 average cash price for a 30-day supply of Dupixent is $5,298. DUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. Susie16 Oct 15, 2023 • 9:37 PM. Susie16 Aug 29, 2023 • 2:03 AM. You may be able to lower your total cost by filling a greater quantity at one time. About Dupixent. Dupixent is not intended for episodic use. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. DUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process. I’m Laurie. For children aged 6 months to 5 years, it is taken as 1 injection every 4 weeks. Please see. Children 6 to 11 years of age . 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. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Human IgG antibodies are known to cross the placental barrier; therefore, DUPIXENT may be transmitted from the mother to the developing fetus. How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. 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. Dupixent is not intended for episodic use. QUEST (12+ years) DUPIXENT offers rapid breathing relief patients can feel as early as Week 2. For more information, dial 1. It may be covered by your Medicare or insurance plan. 2022;400 (10356):908-919. 03. Injection in children 12 and older should be supervised by an adult. ) 2 Prescription InformationDupixent® (dupilumab) approved by FDA as the first and only treatment indicated for prurigo nodularis. 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. Use DUPIXENT exactly as prescribed by your doctor. 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. Declining androgen levels correlated with increased frailty. Ways to save on Dupixent. 67 mL, 200 mg/1. Oct 26, 2022 · Dupixent MyWay Program Enrollment Form for Allergists (AD, Asthma, CRSwNP). I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. Dupixent Myway . 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. It’s a change in how copay assistance and coupons are counted toward your. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. 1‑844‑DUPIXENT 1-844-387-4936. Patients in each age group saw improved lung function in as little as 2 weeks. Do you think that will hurt my chances of qualifying? I know my prescription drug costs are high enough. 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. 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 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. DUPIXENT MyWay. 1-844-DUPIXENT 1-844-387-4936. Continuation in the program is conditioned upon timely verification of income. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. Surgery may remove your nasal polyps, but it may not treat an underlying cause of inflammation—allowing them to grow back. _____ What is your total annual household income? _____ (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Social Security income, unemployment insurance benefits, disability income, any other income for the household. What it is used for. DUPIXENT® and DUPIXENT MyWay® are entered commercial of Sanofi Biotechnological. 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. Some people do injections every 3 weeks, which could stretch that copay card out longer. Robocalls increase diabetic retinopathy screenings in low-income patients. PRESCRIBER TO FILL OUT Section 6a. 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. 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. It will also depend on how much you have. 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). Sign it in a few clicks. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. 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. 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). He continued with Dupixent and his symptoms had partially improved 24 weeks after their onset. 50 for a single person. Coverage varies by. DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older with uncontrolled, moderate-to-severe. Dupixent will run about $3000 per month with my insurance until my maximum is met. And I would experience blurry vision, red and itchy eyes. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. I have a $40 copay but I got the dupixent my way copay card its free for me. Especially tell your healthcare provider if you. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. If requested, I agree to provide proof of income within thirty (30) days of the request. It took the price from 2K to 1K. 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 . Throw away (dispose of) any DUPIXENT that has been left at room temperature for longer than 14 days. A 48-year-old man developed left thumb tenderness and bilateral Achilles tendinopathy after 6 weeks of Dupixent. 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. March 27, 2018. 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). After that, it is taken as 1 injection every 2 weeks or every 4 weeks, depending on your age and weight. 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, Dupixent has increased in price by 13%. 14 mL; and 300 mg per 2 mL. They will begin the benefits investigation and inform your office of the next steps. So, even with a "prior authorization" and a "formulary override", the cost to me is $2900 per month, or about $1450. 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. 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. Please see Important Safety Information and Prescribing Information and Patient Information on website. for DUPIXENT® dupilumab therapy My Information. They are a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI. 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. They never mentioned only covering a. It's like $35k-$40k. DUPIXENT MyWay. Check your eligibility for the DUPIXENT MyWay® Copay Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients.