Learn how to prepare, inject, and dispose of the syringe safely and correctly. ReplyPRESCRIBER TO FILL OUT Section 6a. Patient and Co-pay Assistance: DUPIXENT MyWay helps eligible patients get access to therapy whether they are uninsured, lack. Before using DUPIXENT, tell your healthcare provider about all your medical conditions, including if you: have eye problems; have a parasitic (helminth)The most foolproof way to reduce out-of-pocket costs for Dupixent is a free coupon from SingleCare. The my way nurses are as useless as it gets. The most common side effects may include injection site reactions, pink eye, eyelid inflammation, cold sores, and mouth or throat. I agree to assist in e Éorts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. My dermatologist said I had some of the worst eczema she had ever seen and literally cried at one of my visits. Learn More. In pediatric patients 12 to 17 years of age, administer DUPIXENT under the supervision of an adult. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing,1‑844‑DUPIXENT 1-844-387-4936. After that, it is taken as 1 injection every 2 weeks or every 4 weeks, depending on your age and weight. 14 mL) is around $3,788 for a supply of 2. DUPIXENT, a biologic, is a type of medication that is processed in the body differently than oral or topical medications. Has been prescribing for the last 10+ years and was essentially told I F'd up on the over use and have to taper down. 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. Surgery may remove your nasal polyps, but it may not treat an underlying cause of inflammation—allowing them to grow back. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUPIXENT Quick Start Program product to the patient named herein. To help identify you in our system, please provide the following information. 1-844-DUPIXENT. My face/neck which has always. 7 out of 10 from a total of 188 reviews for the treatment of Eczema. my eligibility for the DUPIXENT MyWay Patient Assistance Program, and I understand that such verification may include contacting me or my healthcare provider for additional information and/or reviewing additional financial, insurance, and/or medical information. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. The average monthly retail price of Dupixent is $4,910 per 2, 2 mL of 300 mg/2 mL prefilled syringes. DUPIXENT® (dupilumab) is a. 1-844-387-4936 (toll free) Monday - Friday, 8AM - 9PM (ET) Multilingual options available. Serious side effects can occur. About Dupixent. Good luck to all! I still have it on legs and arms but it's nothing compared to full body day and night. Dupixent for Eczema User Reviews. I felt my Atopic problem went away for first 2 months ( I took 3 shots for the 1st month, and 2 shots from 2nd months). I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. •Store DUPIXENT Syringes in the refrigerator between 36°F to 46°F (2°C to 8°C). chevron_right. Please see Important Safety Information and Patient Information on website. It is not known if DUPIXENT is safe and effective in children with prurigo nodularis under 18 years of age. It was pretty smooth, the only difference with a vaccine is that the injection is much longer (5. Biopsy done and it’s eczema so back on dupixent. S. DUPIXENT is a form of medicine called a biologic that targets Type 2 inflammation, an underlying cause of nasal polyps. Rotate the injection site with each injection. Here’s what you can expect from DUPIXENT MyWay: (1) Help getting DUPIXENT to you: We research and explain your insurance benefits to help you understand how the process works to get DUPIXENT. Have commercial insurance, including health insurance. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. After another six weeks I could smell and taste. Dupixent has an average rating of 6. I cried hopeful tears as I gave myself my. All I can say is, I don’t know if I would be here today without Dupixent. If you are a New York prescriber, please use an original New York State prescription form. Serious side effects can occur. 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 MyWay. e. 1 A patient may self-inject DUPIXENT—or a caregiver may administer DUPIXENT—after training has been provided by a healthcare provider on proper subcutaneous injection technique using the pre-filled. Experience: Been on Dupixent since May 15, 2017. Step 4: Hold the syringe at a 45-degree angle. •DUPIXENT Syringes can be stored at room temperature up to 77°F (25°C) up to 14 days. 56 billion in sales in 2019 and turned in 8% growth in the first quarter to $832 million. SIGN UP TO SPEAK WITH A DUPIXENT MyWay ® MENTOR . After that, we will have met our family deductible. My insurance provider covers 85% and our Canadian version of 'MyWay' pays the remainder. com. O. DUPIXENT is administered by subcutaneous injection and intended for use under the guidance of a healthcare provider 1; Rotate injection site with each injection 1; A patient may self-inject DUPIXENT after training in subcutaneous injection technique using the pre-filled syringe or pre-filled pen 1; Provide proper training to patients and/or caregivers on the. For more information or to enroll in the patient support program, dial 1‑844‑DUPIXENT ( 1-844-387-4936 Monday-Friday, 8 am-9 pm EST. You may be eligible for the DUPIXENT MyWay Copay Card if you:. Severely painful. I chose to be a nurse because I wanted to help people, and I believe that people should be in service to others. I agrePIXENT e to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. You may be able to lower your total cost by filling a greater quantity at one time. DUPIXENT blocks the signaling of two key sources of Type 2 inflammation (IL-4 and IL-13). I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. Available. excessive tearing. 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. If you are a New York prescriber, please use an original New York State prescription form. 2 cartons. Patient Assistance Connection Financial Eligibility(for uninsured or functionally uninsured patients) Determine the maximum household income requirement to be considered for Patient Assistance Connection by selecting your household size and then viewing the 400% column. DUPIXENT ® ️ can cause serious side effects, including:. ️ ️ ReplyDupixent® (dupilumab) Four simple steps to submit your referral. . (I am one of those patients!) have seen a great results. Check the liquid in the prefilled pen or syringe. for DUPIXENT MyWay emails about. Serious side effects can occur. 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. Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Serious adverse reactions may occur. DUPIXENT is a prescription medicine used 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. TRANSFORM THE WAY YOU MANAGE EoE. my eligibility for the DUPIXENT MyWay Patient Assistance Program, and I understand that such verification may include contacting me or my healthcare provider for additional information and/or reviewing additional financial, insurance, and/or medical information. 26 [95% CI: 0. com. DUPIXENT Syringes can be stored at room temperature up to 77°F (25°C) up to 14 days. 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 have prescribed DUPIXENT to the patient named on this form for an DA-approved indication. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. Please see Important Safety Information. Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. For children weighing 15 kilograms (kg)* to less than 30 kg, the dosage is either: • 100 mg every other week, or. 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. In clinical studies utilizing a symptom measurement tool, people taking DUPIXENT saw a meaningful improvement in their nasal polyps symptoms, which included, but were not limited to: • Nasal blockage • Facial pain/pressure • Difficulty falling asleep • FatigueThe recommended dosage of DUPIXENT for adult patients is an initial dose of 600 mg (two 300 mg injections), followed by 300 mg given every other week (Q2W). More common side effects in people taking Dupixent for asthma include: reactions where the drug is injected, such as pain and swelling. Get the dupixent copay card and you will likely get it for no charge for a while. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. I chose to be a nurse because I wanted to help people, and I believe that people should be in service to others. DUPIXENT® (dupilumab) is 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. pretty obvious to both my pharmacist and MyWay nurses that simply running through the $13,000 in a few months is not the way the copay assistance is intended to be used, but. DUPIXENT® (dupilumab) 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 not a steroid. Learn how DUPIXENT helped treat children 6 to 11 years old with their moderate-to-severe asthma. What it is used for. I then submit a copy of my receipt via snail mail to the Dupixent my way reimbursement program and they send me a check for $250 via snail mail. Welcome to the Patient Support Portal! This site provides patients and healthcare professionals a fast secure way to submit the patient enrollment and supporting documentation to our patient services program team. DUPIXENT MyWay® is a program that helps eligible patients start and stay on track with their therapy for atopic dermatitis, asthma, chronic rhinosinusitis with nasal polyposis,. Pay as little as $0 per month. WARNINGS AND PRECAUTIONS. For more information, dial 1‑844‑DUPIXENT( 1-844-387-4936 ), option 1. Sign up or activate your card here. And despite those massive growth forecasts, some analysts figure Dupixent could be on. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUPIXENT Quick Start Program product to the patient named herein. To request access to someone else's record in MyHealth complete the Request Access to Someone Else’s Account form . 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. DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. The formulary status tool below can help check DUPIXENT coverage for various plans. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Be sure the details you add to the Dupixent Enrollment Form is updated and correct. Thankfully, because my insurance counts Dupixent towards my out of pocket maximum, that $2000 Accredo bill (that I never paid, of course) sent me over that limit and I was fine for the year, but I was so angry for another hypothetical me who wasn't so lucky or had a higher OOP Max. Do not store DUPIXENT pre-filled syringes at room temperatures more than 77°F (25°C) Do not keep DUPIXENT at room temperature. DUPIXENT can cause allergic reactions that can sometimes be severe. Welcome to RxCrossroads. Serious adverse. GF Strong Rehabilitation Centre. support and resources. Dupixent. Step One - let's gather our materials. 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. About Dupixent Dupixent is administered as an injection under the skin (subcutaneous injection) at different injection sites. PK !Ñ'/ å è · [Content_Types]. Long-term results from a clinical trial that studied DUPIXENT for 52 weeks. Fill a 90-Day Supply to Save. The help you get from a copay card is provided by theBUT, the Dupixent MyWay card paid the $600 for me. This will allow the specialty pharmacy to conduct the benefits investigation, and DUPIXENT MyWay will provide additional support to the patient. PRESCRIBER TO FILL OUT Section 5a. Program has an annual maximum of $13,000. g. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUPIXENT Quick Start Program product to the patient named herein. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing,DUPIXENT can cause allergic reactions that can sometimes be severe. fainting, dizziness, feeling lightheaded. 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. Step 1: Let the syringe sit outside of the fridge for at least 45 minutes. 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. If you are a New York prescriber, please use an original New York State prescription form. 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. –%F¯ Z®Iœ)Xô÷UQ)SºÒWëü ÂC þH„s¥Ê R ¯Œüà 7L )w=a¡¸£†# Uåx@£û az%!š ïBS _[/¹´ÙR“29ms€Óæ¹Ê ÕWnÎÛ B. Please see Important Safety Information and. Important Safety Information and Indication. Inspire has over 250 health communities supporting more than 3000 conditions. 1 Patient Information Please provide copies of front and back of all medical and prescription insurance cards. Registered nurses are also available to speak with eligible patients about DUPIXENT. How to use Dupixent (dupilumab) syringes: 1) Wash your hands with soap and water before injection. Like all biologics, Dupixent is made from proteins, and must be given by injection. I'm an adult and I just started Dupixent yesterday. Depending on the dose, uninsured patients can expect to pay up to $59,000 per year for Dupixent treatment. PRESCRIBER TO FILL OUT Section 6a. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing. yes! i am currently using both my insurance and dupixent my way. The way it works without copay accumulators is: myway covers your copay/deductible and by the time you have exhausted the benefit you’ve hit your deductible and your insurance is footing the bill for the rest of the year. Patient is responsible for any out-of-pocket amounts that exceed the program limit. Press and hold the Dupixent Pre-filled Pen firmly against your skin until you cannot see the yellow needle cover. DUPIXENT 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. What makes the dupixent digital document center legally binding? As the society ditches in-office work, the completion of documents more and more takes place electronically. I’m on the dupixent my way savings program as well as another one called “save on” iirc. Yesterday the nurse injected the first dose using a syringe in my leg. Dupixent - extreme pain while injecting. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. Serious adverse side effects can occur. You will find 3 options; typing, drawing, or uploading one. Dupixent is the first and only medicine indicated to treat eosinophilic esophagitis in the United States; approval granted more than two months ahead of FDA’s Priority Review action dateSince [Date], [Patient Full Name] has been under my care for [diagnosis] (ICD-10-CM code: [insert code]). Well at a cost of roughly $3,500/dose which lasts a month, that will all be used up in four months. Brovana - Save up to $30 per month. Subscribe. I y are a Ne r resrer, ease se a ra Ne r Sae resr r Te resrer s y ser sae-se resr rerees, s as e-resr, sae-se resr r, a aae, e N-ae sae-se rerees res rea e resrer. Dupixent is administered as an injection under the skin (subcutaneous injection) at different injection sites. I agree to assist in e Éorts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Do not try to inject DUPIXENT until you have been shown the right way by your healthcare provider. It is given as a subcutaneous (under the skin) injection. Learn how DUPIXENT® (dupilumab) works as the first and only FDA-approved treatment for prurigo nodularis (PN) in adults aged 18 years and older. Is412270-I have been on Dupixent for 4 months. Education and Nurse Support: One-on-one nursing support is available to educate and empower patients to use DUPIXENT as prescribed. 38]). Serious side effects can. Needed additional leadership equipped the enrollment process? Contact your section accessories dedicated or call DUPIXENT MyWay. If you don’t have health insurance, talk. Tell your healthcare provider about any new or worsening joint symptoms. 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. If you are struggling please consider this drug. DUPIXENT is taken by injection under the skin (subcutaneous injection) once every two weeks. The most common side effects include: DUPIXENT MyWay. I, _____, certify that the information provided for this reimbursement request is accurate to the best of my knowledge, and the product-specific copay, DUPIXENT MyWay is a patient support program designed to help you get access to DUPIXENT and stay on track while providing helpful tools and resources. Any questions about job listings can be directed to candidatesupport@regeneron. Dupilumab, sold under the brand name Dupixent, is a monoclonal antibody blocking interleukin 4 and interleukin 13, used for allergic diseases such as eczema (atopic dermatitis), asthma and nasal polyps which result in chronic sinusitis. My name is Shari and I’m a registered nurse with DUPIXENT MyWay. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing,Through the Patient Assistance Program, qualified patients who are uninsured or whose insurance does not cover DUPIXENT could receive DUPIXENT at no cost. PK !û˜õ ‹ _ [Content_Types]. There are 74 drugs known to interact with Dupixent (dupilumab), along with 2 disease interactions. View all Regeneron Pharmaceuticals Inc. I need another treatment. Like. Click on the "Enroll Now" button or link. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. DUPIXENT® is indicated as an add-on maintenance treatment of adult and pediatric patients 6 years and. 1 Disease severity was defined by an IGA score ≥3 in the overall assessment of atopic dermatitis. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing,My wife is on Dupixent, and has the MyWay card which allows up to $13,000/year. pain, redness, irritation, itching, or swelling of the eye, eyelid, or inner lining of the eyelid. Find local businesses, view maps and get driving directions in Google Maps. For more information, call 1. Get your personalized discussion guide to help yourself have a productive conversation with your doctor & see if DUPIXENT® (dupilumab) for uncontrolled moderate-to-severe atopic dermatitis is right for you. Coverage varies by type and plan. ®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 have prescribed DUPIXENT to the insurer. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. For children aged 6 months to 5 years, it is taken as 1 injection every 4 weeks. Normally my copay would be about $970 per refill, but with about 12 refills per year this does not max out the Dupixent MyWay copay card. Within 24 hours, one of our patient advocates will call you for a brief interview. Registered nurses are also available to speak with eligible patients about DUPIXENT. DUPIXENT can cause allergic reactions that can sometimes be severe. In order to be effective and work properly, most biologics are injectable medicines. If your healthcare provider decides that you or a caregiver can give DUPIXENT injections, you or your caregiver should receive training on the right way to prepare and inject DUPIXENT. Working with it utilizing electronic means is different from doing this in the physical world. Hello cinc: I have been on Dupixent approx 1-1/2 years with very rare eye irritation. For brand name drugs under review and drug reviews completed on or. I really liked the fact that DUPIXENT is not an immunosuppressant or a steroid, because it makes me feel that the medicine is a different way of treating atopic dermatitis. 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. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing,I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. “When I stay on top of my eczema, I don’t worry about my skin as much. I found the carnivore diet helps immensely for autoimmune issues. medisafe. Dupilumab se usa para el eczema en adultos y niños de 6 meses o más. DUPIXENT can cause serious side effects, including: Allergic reactions. Deductible is at $3k out of pocket insurance pays 80% and at $6k insurance pays 100%. INJECTION. 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. There’s no laboratory monitoring required, not at the beginning, not during therapy. For more information, dial 1‑844‑DUPIXENT 1-844-387-4936 Monday-Friday, 8 am-9 pm ET. Tell your healthcare provider about any new or worsening joint symptoms. My name is Shari and I’m a registered nurse with DUPIXENT MyWay. In children 12 years of age and older,For more information, dial 1‑844‑DUPIXENT ( 1-844-387-4936 ), option 1 Monday-Friday, 8 am - 9 pm ET. Mine had just exhausted a few months ago after 2 years, and I'm currently paying $70 for 2 shots with Blue Cross Blue Shield. The safety profile in pediatric patients through. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing, state-specific. This was my journal entry for that day: “…I decided I’m going to withdraw from Dupixent to see how “bad” my body is and if it’s still going through TSW. . I agre e to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. DUPIXENT ® ️ can cause allergic reactions that can sometimes be severe. 1-844-387-4936 (toll free) Monday - Friday, 8AM - 9PM (ET) Multilingual options available. New pati ent . my eligibility for the DUPIXENT MyWay Patient Assistance Program, and I understand that such verification may include contacting me or my healthcare provider for additional information and/or reviewing additional financial, insurance, and/or medical information. Check your eligibility for the DUPIXENT MyWay® Copay Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients. Fluticasone Propionate / Salmeterol - Pay As Little As $10. In patients aged 6 months to 5 years, Dupixent is administered with a pre-filled syringe every four weeks based on weight (200 mg for children ≥5 to <15 kg and 300 mg for children ≥15 to <30 kg). DUPIXENT® (dupilumab)'s patient education program events let you meet other adults living with moderate-to-severe eczema (atopic dermatitis) or caregivers of a patient living with moderate-to-severe eczema (atopic dermatitis). I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Luckily my supplemental ins pays it all with Medicare paying nothing. Learn more about DUPIXENT® (dupilumab), is the first FDA-approved biologic to treat eosinophilic esophagitis (EoE) in patients 12 years and older who weigh at least 88lb (40kg). I chose to be a nurse because I wanted to help people, and I believe that people should be in service to others. You must be shown the right way by your healthcare provider before injecting DUPIXENT. The parts of the DUPIXENT Syringe are shown below: • The DUPIXENT Pre-filled Syringe • 1 alcohol wipe* • 1 cotton ball or gauze* • a sharps disposal container* In children 6 months to less than 12 years of age, DUPIXENT should be given by a caregiver. Visit the official website of Dupixent My Way enrollment. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. 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 OUR PATIENT SUPPORT PROGRAM. coverage delay for DUPIXENT by the patient’s insurer. (See “Children’s dosage” below for. Learn how to order DUPIXENT. For more information, to speak with a member of the DUPIXENT MyWay support team, or to enroll over the phone, call our toll-free line. Fill out this form with a valid email address and see if you’re eligible for the DUPIXENT MyWay ® Copay Card. 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. Working with it utilizing electronic means is different from doing this in the physical world. The way it works for me and Dupixent is I pay $250 co-pay a month at the pharmacy. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing,How someone else should inject Dupixent. If you are a New York prescriber, please use an original New York State prescription form. Send the completed form to: MyHealth@islandhealth. Support. If you’re eligible, you can enroll online or by phone and receive your card by email. 5. 1-844-DUPIXENT 1-844-387-4936. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Yes it was left out and room temp. Then it got worse, 2nd derm said psoriasis hence humira for about 1 month, no improvement. 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. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Most do, some don't. from our Health Equity Funds? PAF has established disease specific health equity funds that provide financial support to eligible patients living in certain counties. Welcome to the Patient Support Portal! This site provides patients and healthcare professionals a fast secure way to submit the patient enrollment and supporting documentation to our patient services program team. 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. I'm supposed to start myself at some point, I guess with the pen though I know there's a choice. I really enjoy the patient interaction. In children 12 years of age and older, it is recommended that DUPIXENT be given by or under the supervision of an adult. Serious side effects can occur. Exception: Requests for drugs administered by a healthcare professional that will be billed to the medical plan, call 1-866-752-7021 or fax. I agre e to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. 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 supply information, such as the patient’s insurance, diagnosis, and prescription. Currently no side effects, just 95% clear and I had full body, severe eczema. In children 12 years of age and older,Q7: Why will copay card support no longer be contributed toward my accumulator totals (i. The cost of the 300-milligrams per 2-milliliters (mg/mL) shot of Dupixent will vary based on several factors. Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. In my second year on Dupixent (2020), it was covered in full as the copay assistance payments of $13,000 counted against my deductible/out-of-pocket maximum ($8,500). 99% of commercial patients (6+ months of age) nationally are covered for DUPIXENT. Fill a 90-Day Supply to Save. Learn more about DUPIXENT® (dupilumab) in moderate-to-severe asthma and if it may be the right treatment option for you. I am so sorry you are having side effects that may make you stop taking it. For families/households with more than 8 persons, add $5,140 for each. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUPIXENT Quick Start Program product to the patient named herein. DUPIXENT works by targeting an underlying source of inflammation that could be a root cause of your eczema. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. Box 5925 Mailstop 55A-220A Bridgewater, NJ 08807. You can be eligible for and DUPIXENT MyWay Copay Card if you:. 98% of Commercially Insured Patients. Box 5925 Mailstop 55A-220A Bridgewater, NJ 08807. Start Program product to the patient named herein. If you are a New York prescriber, please use an original New York State prescription form. Dupixent side effects. DUPIXENT can be used with or without topical corticosteroids. 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) 1‑844‑DUPIXENT 1-844-387-4936. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing, state-specific. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. DUPIXENT is a weekly single-dose injection that can be given by your doctor in an office or a clinic, or can be taken at home. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing, state-specific. Have commercial insurance, including health insurance. DUPIXENT, a biologic, is a type of medication that is processed in the body differently than oral or topical medications. Patient Rebate Portal. To get patient-specific information about coverage for a drug, phone Health Insurance BC. I don't know what medical issues your son is having, but it's likey autoimmune issues. If your healthcare provider decides that you or a caregiver can give DUPIXENT injections, you or your caregiver should receive training on the right way to prepare and inject DUPIXENT. I, _____, certify that the information provided for this reimbursement request is accurate to the best of my knowledge, and. DUPIXENT MyWay Copay Card may help eligible, commercially‑insured patients cover the out-of-pocket cost of DUPIXENT. ®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 have prescribed DUPIXENT to the DUPIXENT: your first choice to adequately control this chronic, systemic disease. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3 program consisting of two pivotal trials. This is very helpful!Dupixent MyWay Program Dupixent (dupilumab injection) CONTACT INFODupixent is an injection that is usually given under the skin every other week for the treatment of asthma, eczema, and some other inflammatory conditions. So far this has happened 4 times - once with 2 injections from the. If you are successfully enrolled in the program, we. Dosage in Pediatric Patients 6 Months to 5 Years of Age. The way I describe DUPIXENT to my patients is that DUPIXENT inhibits IL-4 and IL-13 signaling. Ways to save on Dupixent. About 75,000 adults in the U. loss of voice. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. You may be eligible for the DUPIXENT MyWay Copay Card if you:. Learn about the DUPIXENT® (dupilumab) mechanism of action inhibiting IL-4 and IL-13 signaling in appropriate asthma patients. DUPIXENT® (dupilumab) is a prescription medicine FDA-approved to treat five conditions. DUPIXENT® (dupilumab) 13. Have commercial insurance, including health insurance. They never mentioned only covering a certain amount of injections, just said they would cover it for a year. I authorize the Alliance to use my Social Security number and/or additional. The prescriber is to comply with his/her state-specific prescription requirements, such as e-prescribing,Pharmaceuticals, Inc. com. I agree to assist in efforts to secure access to DUPIXENT for my commercially insured patient in the event of a coverage delay. Filter by condition. insurer. 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 is a prescription medicine used to treat certain skin conditions, asthma, and chronic rhinosinusitis with nasal polyps. 2 pens of 300mg/2ml. For families/households with more than 8 persons, add $5,140 for each. difficulty in breathing. DUPIXENT is a weekly single-dose injection that can be given by your doctor in an office or a clinic, or can be taken at home. I am new to Dupixent. LEARN HOW WE CAN HELP DUPIXENT MyWay. DUPIXENT MyWay. 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. In children 12 years of age and older, it. Dupixent is the only monoclonal antibody approved by the FDA to treat atopic dermatitis and eczema. 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. Monday-Friday, 8 am-9 pm ET. My itching was a 15 out of 10. Just got the fun news that I will need to pay $2,700 for a monthly dose of Dupixent. The cost of Dupixent may vary based on the strength and dosage form you use. This information will ONLY be used to validate your eligibility. Find DUPIXENT® (dupilumab) injection videos and instructions for the pre-filled pen (200 mg or 300 mg) for ages 2+ years. 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. Ask the prescriber for a free sampleDUPIXENT® 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. Monday-Friday, 8 am - 9 pm ET Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. fever. I’m ready to make a difference. Last name . For any questions or concerns, please contact us at the phone number located on your enrollment form. Most dermatologists should know about it. MELINDA: Before I started DUPIXENT, I told my doctor about all the medical conditions I had and medications I was taking. Well at a cost of roughly $3,500/dose which lasts a month, that will all be used up in four months. after two days im at about a 6 to 7. Reload page. I authorize DUPIXENT MyWay to forward this prescription to the pharmacy dispensing the DUPIXENT Quick Start Program product to the patient named herein. Good luck. The most common side effects include: DUPIXENT MyWay. Especially tell your healthcare provider if you. x Store DUPIXENT Syringes in the original carton to protect them from light.