DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. Required if enrolling in the DUPIXENT MyWay. 00 per injection. For me, the side effects didn’t really bother me or have me second guess my decision with Dupixent because my skin was. I just spoke to someone through the MyWay Program. We just need you to answer a few questions to verify your eligibility and contact information. 14 mL, or 300 mg/2 mL)My insurance provider covers 85% and our Canadian version of 'MyWay' pays the remainder. The doctor's office called to say I need to call to talk about my income and expenses. 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. Dupixent is administered as an injection under the skin (subcutaneous injection) at different injection sites. I give supplemental injection training to the patient and the patient’s caregiver. Serious side effects can occur. Learn more about programs for eligible patients who are insured, underinsured, and uninsured. 01. 1kg over one year – the amount of weight gained ranged from 0. Please note that you will receive a confirmation fax after sending the form. The DUPIXENT MyWay team will research each patient’s situation and determine eligibility. 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). financial assistance for eligible patients, provide one-on-one nursing support, and more. 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 team will research each patient's situation and determine eligibility. Griffinej5 • 2 yr. 22. 00 per injection. The majority of DUPIXENT patients with commercial/employer-provided insurance use the DUPIXENT MyWay ® Copay Card. 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. 80). Assistance may be available for patients who do not have insurance. 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 MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Complete the entire form and submit pages 1-2 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. 26 [95% CI: 0. 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. The average cash price for a 30-day supply of Dupixent is $5,298. If you are a New York prescriber, please use an original New York State prescription form. 12. Got off of it as soon as I realized it was getting worse with every shot after spacing them out every other month. 01. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. 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. Base amount is $558. Hear real patients stories of life with uncontrolled moderate-to-severe asthma and how discovering DUPIXENT® (dupilumab) impacted their journey. Continuation in the program is conditioned upon timely verification of income. When I was very young, I knew that I wanted to be a nurse. I’m Laurie. 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. Prurigo Nodularis: The most common adverse reactions (incidence ≥2%) are nasopharyngitis, conjunctivitis, herpes infection, dizziness, myalgia, and diarrhea. DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older with uncontrolled, moderate-to-severe. 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). Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. (DUPIXENT + Topical Corticosteroids (TCS) vs TCS only): CLEAR OR ALMOST CLEAR SKIN AT 16 Weeks 39% taking DUPIXENT + TCS vs 12% using TCS only. Please see Important Safety Information and Prescribing Information and Patient Information on website. 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). SINCE 2017, ≈253,000 PATIENTS HAVE FILLED AT LEAST 1 DUPIXENT PRESCRIPTION b,c. Effective Sept. Advertisement. 01. including household income, to qualify. A 48-year-old man developed left thumb tenderness and bilateral Achilles tendinopathy after 6 weeks of Dupixent. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. 0156 Past Update: March 2023 DUP. , Sanofi US, and their affiliates and agents (together, the “Alliance”) may verifyDUPIXENT MyWay Nurse Educators are trained to help provide patients with supplemental injection training either online, over the phone, or in person with a training kit and practice syringe or practice pen. 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. Learn about DUPIXENT® (dupilumab) for moderate-to-severe asthma treatment. How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. 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. 02. $4,930. 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. DUPIXENT® is a prescription medicine used as an add-on maintenance treatment for uncontrolled moderate-to-severe eosinophilic or oral steroid dependent asthma in people aged 6 years and older. Dupixent is 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. 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. LONG-LASTING CLEARER SKIN AT 16 and 52 Weeks 22% taking. The fax number is 1. 1-844-DUPIXENT 1-844-387-4936. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. 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 is an injection that is usually given under the skin every other week for the treatment of asthma, eczema, and some other inflammatory conditions. About 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. You may be eligible for the DUPIXENT MyWayDUPIXENT MyWayAbout Dupixent Dupixent is administered as an injection under the skin (subcutaneous injection) at different injection sites. I'm guessing this will not be allowed once I'm on Medicare. 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. 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. 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. Fill out the form accurately and completely, providing all. XXXX 00/0000 b y: A B C c o m pa n y, I n c. Dupixent is currently approved in the U. After removal from the refrigerator, DUPIXENT must be used within 14 days or discarded. 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. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. DUPIXENT MyWay coordinators are available Monday-Friday 8 am to 9 pm ET. Especially tell your healthcare provider if you. 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. 1,000-125=875 $875 is the amount your health insurance pays. 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® A program to provide support to patients starting DUPIXENT. 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. 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. It was a process to get into the patient assist program. For assistance, please call 1-844-468-2252 Monday Friday, 8AM to 8PM ET. If I am completing Section 5b, I authorize for my commercially insured patient one. Fill out sections 5a and 5b completely to determine patient eligibility. DUPIXENT MyWay® Program Taking Dupixent. The appeal process Example letters. Although you are not eligible, you can sign up DUPIXENT MyWay. 09. a,b a Data on file, Sanofi and Regeneron, US. Hello! Switching insurance this year and need to prepare for increasing costs of dupixent with my new insurance. Form more information phone: 844-387-4936 or Visit website Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. 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. Please see. Eligible clients will receive their cards by email. Patients will need on hit the eligibility benchmark, including household income, to qualify. To more financial assistance news, dial 1‑844‑DUPIXENT ( 1-844-387-4936), option 1 Monday-Friday, 8 am - 9 pm ESTPRESCRIBER TO FILL OUT Section 6a. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. Hello! Switching insurance this year and need to prepare for increasing costs of dupixent with my new insurance. 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). ENROLLMENT FORMDUPIXENT is a form of medicine called a biologic that targets Type 2 inflammation, an underlying cause of nasal polyps. Option 1- you have to meet your deductible without Dupixent myway. It may be covered by your Medicare or insurance plan. 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 . $3,645. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. 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. Share your form with others. Throw away (dispose of) any DUPIXENT that has been left at room temperature for longer than 14 days. DUPIXENT MyWay. 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. I wanted to go out and make a difference and help people. I give supplemental injection training to the patient and the patient’s caregiver. 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. Pregnancy: A pregnancy exposure registry monitors pregnancy outcomes in women exposed to DUPIXENT during pregnancy. Deductible is at $3k out of pocket insurance pays 80% and at $6k insurance pays 100%. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3 program consisting of two pivotal trials. Need additional guidance with the enrollment process? Call DUPIXENT MyWay at 1-844-387-4936 Monday through Friday, 8 am to 9 pm Eastern Time. You may be able to lower your total cost by filling a greater quantity at one time. With the DUPIXENT MyWay Copay Card, eligible,. 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. For more information, dial 1‑844‑DUPIXENT( 1-844-387-4936 ), option 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 . 01. 03. . S. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Serious side effects can occur. Appears that my out of pocket maximum will be $8000 through insurance. Approximately 72% of the total FEV 1 improvement (470 mL improvement at Week 52 from baseline FEV 1 of 1. What it is used for. 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. They will begin the benefits investigation and inform your office of the next steps. 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. 0254 Last Update: February 2023 DUP. Serious adverse reactions may occur. 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). (2 of 3) Patient signature/Legal representative if patient is <18 years Date Section 2. 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. 71 for Dupixent compared to 0. The formulary status tool below can help check DUPIXENT coverage for various plans. The $500 payment counts towards the member’s deductible and out-of-pocket maximum. My insurance plan only covers a small amount of it with the rest being carried by the Copay program, which has a limit per year. Fill out sections 5a and 5b completely to determine patient eligibility. 2 cartons. 98% of Commercially Insured Patients. March 29, 2018. 03. 0156 Past Update: March 2023 DUP. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. LASTING CHANGE IS ACHIEVABLE. To contact DUPIXENT MyWay, please call 1-844-DUPIXENT (1-844-387-4936). How many people live in your household? _____ Please refer to. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. THIS IS NOT INSURANCE. 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. For more information, call 1. Eligible patients covered by commercial health insurance may pay as little as a $0 p copay per fill of DUPIXENT. It was granted and I pay $0. If this is the case, write the preferred specialty pharmacy. How to fill out dupixent reimbursement: 01. DUPIXENT® is a prescription medicine used as an add-on maintenance treatment for uncontrolled moderate-to-severe eosinophilic or oral steroid dependent asthma in people aged 6 years and older. Rx: DUPIXENT® (dupilumab) (100 mg/0. So, how can you save? Manufacturer Sanofi offers Dupixent MyWay, a patient support program. E. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. ) 2 Prescription InformationDUPIXENT is not a steroid. The patient must then take the following actions:I just got approved for dupixent this week however the copay is 3,000$ a month! The dupixent my way program only covers up to 13k or something like that. dupixent myway income guidelinesstellaris unbidden and war in heaven. 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. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Maybe try that while waiting for the Dupixent. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. QUEST (12+ years) DUPIXENT offers rapid breathing relief patients can feel as early as Week 2. If I am completing Section 5b, I authorize for my commercially insured patient one. It will also depend on how much you have. Copay Card or you wish to discontinue your participation, please contact us. S. If I am completing Section 5b, I authorize for my commercially insured patient one. DUPIXENT is a prescription medicine used as an add-on maintenance treatment for adults and children 6 years of age and older who have moderate-to-severe eosinophilic or oral steroid dependent asthma that is not controlled with their current asthma medicines. Section 5a. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3 program consisting of two pivotal trials About 75,000 adults in the U. will not conduct a benefits verification. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. Dupixent is not intended for episodic use. was not paid in whole or in part by Medicare, Medicaid, or any federal or state programs. How do my patients enroll in <em>DUPIXENT MyWay®</em>? When filling out the DUPIXENT MyWay Enrollment Form, both you and your patient will be required to. Assistance may be available for patients who do not have insurance. I’ve been with DUPIXENT MyWay since the very beginning. Especially tell your healthcare provider if you. Caring. Coverage varies by. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. Based on the questions answered above, you are not eligible to register for a new copay card or to activate a copay card. ) 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. 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. 50 for a single person. Maximum benefit (2023) = $1,483. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. 89 and -1. These programs and tips can help make your prescription more affordable. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. Dupixent is indicated for the treatment of severe atopic dermatitis in patients aged 6 to 11Dupilumab. Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. 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. Monday-Friday, 8 am - 9 pm ETto DUPIXENT MyWay at 1-844-387-9370. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. • Store DUPIXENT in the original carton to protect from light. The majority of DUPIXENT patients with commercial/employer-provided insurance use the DUPIXENT MyWay ® Copay Card. 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. Check the liquid in the prefilled pen or syringe. 06 and -1. With MyWay, I get the year for free. Learn how DUPIXENT helped treat children 6 to 11 years old with their moderate-to-severe asthma. 4. 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. 1-844-DUPIXENT (1-844-387-4936) Topicort (desoximetasone spray 0. 2 pens of 300mg/2ml. Please see Important Safety Information and Patient Information on website. Patient and Co-pay Assistance: DUPIXENT MyWay helps eligible patients get access to therapy whether they are uninsured, lack. For more information and to find out if you’re eligible for support, call 844-DUPIXENT (844-387-4936) or visit the program website. Please see. What it is used for. 02. Patient assistance program. Caring. For more informational, page 1‑844‑DUPIXENT (1-844-387-4936), option. comfysnail • 1 yr. 67 mL Dupixent subcutaneous solution from $3,787. Support. If requested, I agree to provide proof of income within thirty (30) days of the request. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. Section 5a. Eligible patients will receive their cards by email. DUPIXENT MyWay®. who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay® program. DUPIXENT has been FDA approved for use in adults with uncontrolled moderate-to-severe eczema since 2017. Box 5925 Mailstop 55A-220A Bridgewater, NJ 08807. Patient is responsible for any out-of-pocket amounts that exceed the program limit. DUPIXENT MyWay team will research each patient’s situation and determine eligibility. Using the drop. You have to game the system instead of trying to get full coverage. DUPIXENT is not a steroid or immunosuppressant; it is a prescription biologic medicine given under the skin (subcutaneous 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. It temporarily provides eligible patients DUPIXENT at no cost, subject to program terms and conditions. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. Please see Important Safety Information and Prescribing Information and Patient Information on website. DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. Please see accompanying full Prescribing Information. DUPIXENT® (dupilumab) is a. Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. 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. Serious side effects can occur. Susie16 Aug 29, 2023 • 2:03 AM. For children aged 6 months to 5 years, it is taken as 1 injection every 4 weeks. Im so stressed out about. Dedicated Dupixent MyWay Case Managers can explain information related to Dupixent. If you still have questions, you can speak with a DUPIXENT MyWay or request to join the program over the phone. If you have any additional questions about this pricing information, please call DUPIXENT MyWay at 1-844-DUPIXENT (1-844-387-4936). The DUPIXENT MyWay team can research each patient’s situation and determine eligibility. 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. 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. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. If you’re the spouse or. Biologic Drug: Biologic drugs are made from living cells and are often expensive. DUPIXENT MyWay®. 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. Each time you fill your DUPIXENT prescription, please ensure your. 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. If you are a New York prescriber, please use an original New York. That is what I am in the middle of. You must also meet certain household income eligibility requirements as outlined below: 48 States and DC. Please see Important Safety Information and full PI on website. 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. 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. 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. 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. Serious adverse reactions may occur. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. This copay card may be for you if you. Follow these tips to take DUPIXENT while traveling: Store DUPIXENT in the original carton to protect it from light. $125 is the amount Dupixent assistance pays. Patients may be eligible for the DUPIXENT MyWay Copay Card if: They have a DUPIXENT prescription for an FDA-approved condition. Type text, add images, blackout confidential details, add comments, highlights and more. Data from DUPIXENT ® clinical trials have shown that IL-4 and IL-13 are key drivers of the type 2 inflammation that plays a major role in asthma, atopic. Even when using the Copay Card, that would cover only cover 4 months worth, and would not go towards my deductible, totaling about. ) Please refer to Section 8, Patient Certifications, for. Dupixent changed my life completely. Dupixent is not intended for episodic use. The most common side effects include: DUPIXENT MyWay. Over 80% of insurance plans cover Dupixent, but many have restrictions. 0129 Last Update:. 23. A group of skin conditions characterized by skin inflammation, rash, and itch. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. I don't know what medical issues your son is having, but it's likey autoimmune issues. 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. 0kg. 2 Eligible US residents with an FDA-approved. Depends if your insurance cares that Dupixent myway is paying your deductible. 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. You don’t have to put your life on hold to fit your dosing schedule. Denied because of 2022 income threshold for household of two. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. There is another biologic very similar to Dupixent called Adbry. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. For more information, please call 1-844-Dupixent (1-844-387-4936) or visit a personalized discussion guide to make the most of your doctor's visit whether you're beginning your EoE treatment journey or looking for another option. 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. 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. Fill out sections 5a and 5b completely to determine patient eligibility. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. . 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. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. for DUPIXENT® dupilumab therapy My Information. 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. Enrolled patients receive: One-on-one support from our DUPIXENT MyWay support team; Help understanding insurance coverage; Financial assistance (for eligible patients only) Help. 18, 0. 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. b Data as of January 2023. 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. form on DUPIXENT. out and fax back to DUPIXENT MyWay at 1-844-387-9370 • You or your specialist can call 1-844-DUPIXEN(T), option 1 • Providing your email address allows DUPIXENT MyWay to give you more support resources about DUPIXENT. So, how can you save? Manufacturer Sanofi offers Dupixent MyWay, a patient support 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)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. Type text, add images, blackout confidential details, add comments, highlights and more. DUPIXENT® (dupilumab) is taken as an injection by a pre-filled syringe or pre-filled pen. 0156 Last Update: March 2023 DUP. any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. DUPIXENT MyWay team will research each patient’s situation and determine eligibility. ) Please refer to Section 8, Patient Certifications, for. DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older, with uncontrolled, moderate-to-severe eczema (atopic dermatitis). Guam or the USVI, and demonstrate a financial need with a total annual adjusted gross income of $100,000 or less. And, if you're eligible, you can sign up and receive your card today. They are a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI. Decreased exacerbations and/or improvement in symptoms 2. Sanofi and Regeneron are committed to helping patients in the U. Robocalls increase diabetic retinopathy screenings in low-income patients. 0185 Last Update: November 2022 DUP. Children 6 to 11 years of age . Well at a cost of roughly $3,500/dose which lasts a month, that will all be used up in four months. g. 00. At this rate, I will no longer be able to afford the medication very soon. 23. 00. who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay ® 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;. Sign it in a few clicks. 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. Patient Signature _____ If you have questions about the . A quantity of Dupixent will be considered medically necessary if the above criteria are met, as indicated in the table below:. 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 significantly reduced itch and skin lesions compared to placebo in direct-to-Phase. 99% of commercial patients (6+ months of age) nationally are covered for DUPIXENT. 14 mL; and 300 mg per 2 mL. 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. The most common side effects include: DUPIXENT MyWay. Program possessed one annual maximum from $13,000. DUPIXENT use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. 01. Connect with someone, ask questions, and learn about their experience with DUPIXENT® (dupilumab) treatment. Program Website : Program Applications and Forms will need to meet the eligibility criteria, including household income, to qualify. For more information or to enroll in the patient support program, contact us at: 1‑844‑DUPIXENT. BIN: 020750 RX PCN: NMeds RX GRP: PDFPDF ID: NMNA019309901930 This is a drug discount program, not an insurance plan. Data on file, Regeneron Pharmaceuticals, Inc. DUPIXENT® (dupilumab) is a. Since 2017, Dupixent has increased in price by 13%.