If symptoms persist or worsen, consider rheumatological evaluation and/or discontinuation of DUPIXENT. Refill and track your specialty drug prescriptions, pay online, and get live support. Exception: Requests for drugs administered by a healthcare professional that will be billed to the medical plan, call 1-866-752-7021 or fax applicable request forms to 1-888-267-3277. Prurigo Nodularis: DUPIXENT is indicated for the treatment of adult patients with prurigo nodularis (PN). Tier 4 drugs on the Preferred Drug List represent Specialty Drugs. Conjunctivitis also occurred more frequently in chronic rhinosinusitis with nasal polyposis subjects and prurigo nodularis subjects who received DUPIXENT compared to those who received placebo. Xolair prefilled syringes come in two strengths: 75 milligrams (mg) per 0.5 milliliter (mL) 150 mg/1 mL. Once final approval and payment are received, the patient coordinates shipment to their home or their healthcare providers office, depending on treatment plan. Last name . They will begin the benefits investigation and inform your office of the next steps. Fax: 1-877-222-5036. Avoid use of live vaccines in patients treated with DUPIXENT. moderate-to-severe asthma 300 mg Pre-filled Pens are CONTRAINDICATION: DUPIXENT is contraindicated in patients with known hypersensitivity to dupilumab or any of its excipients. MRx Pharmacy supports more than 30 unique specialty disease categories, from oncology and inflammatory conditions to bleeding disorders and rare diseases. Advise patients to report new onset or worsening joint symptoms. Please contact us at 888.355.4191 if you do not see your prescribed medication, ancillary therapy or medical equipment listed. CHRONIC RHINOSINUSITIS WITH NASAL POLYPOSIS (CRSwNP) Ages 18+ Years, EOSINOPHILIC ESOPHAGITIS (EoE) (EoE). Dupixent (dupilumab) Policy: Under some plans, including plans that use an open or closed formulary, Dupixent is subject to precertification and quantity limits. 4. If your prescription requires prior authorization, the . Envarsus XR. The DUPIXENTMyWay Copay Card may help eligible, commercially insured patients cover the out-of-pocket cost of DUPIXENT. status asthmaticus. Prurigo Nodularis: DUPIXENT is indicated for the treatment of adult patients with prurigo nodularis (PN). Theracom Pharmacy 345 International Boulevard Brooks, KY 40109 (888) 843-7226 Visit Website Get Directions Similar Businesses Detailed Information Location TypeBranch Year Establishedunknown Annual Revenue Estimateunknown SIC Code show NAICS Code show Employeesunknown Is this your listing? Download our reference guide to have on hand. Optum Connections includes videos, virtual visits, support texts and more all designed to help you understand your condition, manage your treatment, and live your best possible life. Acute Asthma Symptoms or Deteriorating Disease: Do not use DUPIXENT to treat acute asthma symptoms, acute exacerbations, acute bronchospasm or status asthmaticus. 2020 Sanofi and Regeneron Pharmaceuticals, Inc. with nasal polyposis. Patients should seek medical advice if their asthma remains uncontrolled or worsens after initiation of DUPIXENT. This program . These accreditations ensure that we are operating with the highest quality standards. CoverMyMeds support is available for DUPIXENT. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. Do not change or stop your corticosteroid medicine or other asthma medicine without talking to your healthcare provider. When writing letters, be sure to populate an appropriate ICD-10 code matching your patients diagnosis. Eligard. PREFERRED QUALIFICATIONS: Ability to thrive in a fast-paced . Dupixent (dupilumab) Fasenra (benralizumab) Nucala (mepolizumab) Tezspire (tezepelumab-ekko) Xolair (omalizumab) - Enrollment Form Xolair (omalizumab) - Re-order Form (Existing Patients) Alpha-1 Antitrypsin Deficiency AralastNP (alpha1-proteinase inhibitor [human]) Glassia (alpha1-proteinase inhibitor [human]) Please ensure that you are filling out the correct form that corresponds to the appropriate indication. Sanofi US is hosting this website on behalf of Sanofi and Regeneron Pharmaceuticals, Inc. Sanofi and Regeneron are industry partners, who are committed to handling personal data in ways that respect your privacy. Patients must bring an original prescription to the pharmacy and cannot fax these referral forms to Senderra. Advise patients to report new onset or worsening eye symptoms to their healthcare provider. an add-on maintenance treatment of These events may be associated with the reduction of oral corticosteroid therapy. Terms & Restrictions Apply. If your patients need further support,DUPIXENT MyWayNursing Support is available as an additional point of contact. It may be covered by your Medicare or insurance plan, but some pharmacy coupons or cash prices could help offset the cost. Magellan Technical Call Center 800-884-3238. This program can help your patient receive cost-effective care by finding out if his or her medication has specific utilization management requirements or an optimal place of service. Insightful tips and tools to help them along the way, One-on-one nursing support, when needed, to provide disease and DUPIXENT education and ongoing follow-up to ensure patients stay on track with DUPIXENT, Reminder when eligible patients must reapply for financial support programs (Copay Card Program, Patient Assistance Program), Supplemental injection training virtually or over the phone. 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. THERACOM INC provides services related to medication and prescriptions. After you have determined DUPIXENT is appropriate for your patient and written them a prescription: Submit theDUPIXENT MyWayEnrollment Form, Submit PA and Letter of Medical Necessity (optional) and include all required documentation (a copy of your chart notes with details of diagnosis, disease severity, and treatment history), Receive status updates from yourDUPIXENT MyWayCoordinator. . Please note: By clicking on this link, you will be leaving this Sanofi-hosted US website and going to another, entirely independent website. Call us at 1-877-342-9352 or visit Optum Infusion Pharmacy. We can help. We also offer infusion services with Optum Infusion Pharmacy. Reductions in corticosteroid dose, if appropriate, should be gradual and performed under the direct supervision of a healthcare provider. Services THERACOM INC is a pharmacy located in ROCKVILLE, MD. Months, For Patients Ages 6+ Years Fax the Enrollment Form with the checked box to both the specialty pharmacy andDUPIXENT MyWay. Acute Asthma Symptoms or Deteriorating Disease: Do not use DUPIXENT to treat acute asthma symptoms, acute exacerbations, acute bronchospasm or status asthmaticus. CoverMyMeds provides additional PA process-related support for DUPIXENT. DUPIXENT MyWaywill also remind the healthcare professional when the authorization is up for reapproval. Consider ophthalmological examination for patients who develop conjunctivitis that does not resolve following standard treatment or signs and symptoms suggestive of keratitis, as appropriate. Some patients reported visual disturbances (e.g., blurred vision) associated with conjunctivitis or keratitis. at least 88 lb (40 kg). Please refer to Regeneron's Privacy Noticeand Sanofi'sPrivacy Policyfor more information regarding processing of your personal data. CoverMyMeds provides additional PA process-related support for DUPIXENT. No initial or routine blood work required, per Prescribing Information. AcariaHealth is the preferred specialty pharmacy provider of Ambetter from Superior HealthPlan. DUPIXENT MyWay verifies your patients specific health plan coverage for DUPIXENT, determines the plan's Utilization Management (UM) criteria, and identifies out-of-pocket responsibilities. In children 6 months to less than 12 years of age, DUPIXENT should be given by a caregiver. This list does not reflect all medications available from Kroger Specialty Pharmacy. as an add-on maintenance treatment We support specialty treatments and take a hands-on approach to patient care that makes a meaningful imprint on the health and quality of life of each patient. The Dedham Group Quality of Access Tracking Report. eosinophilic esophagitis one-on-one nursing support, and Please note: By clicking on this link, you will be leaving this Sanofi-hosted US website and going to another, entirely independent website. Optum Specialty Pharmacy We support specialty treatments and take a hands-on approach to patient care that makes a meaningful imprint on the health and quality of life of each patient. Sano US and Regeneron provide these links as a service to their website visitors and users; however, they take no responsibility for the information on any website but their own. Find specialty contractors near me on Houzz Before you hire a specialty contractor in Haag bei Treuchtlingen, Bavaria, shop through our network of over 39 local specialty contractors. with eosinophilic esophagitis Navigating Prior Authorizations & Appeals, DUP.22.09.0183Last Update: October 2022. 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. Please see accompanying adjacent links for full Prescribing Information including Patient Information. The New York State (NYS) Medicaid program requires enrollment of all licensed prescribers and pharmacies who serve Medicaid members, including prescribing practitioners identified on pharmacy claims per the Centers for Medicare and Medicaid Services (CMS) and federal regulations. Parasitic (Helminth) Infections: It is unknown if DUPIXENT will influence the immune response against helminth infections. Meijer Specialty PharmacyCorporate Offices & Patient Services. Once the primary ICD-10 code is filled in and the form is completed, write the names of the patient and prescriber at the top of all pages. DUPIXENT is not indicated for the To Treat Prurigo Nodularis (Ages 18+ Years), DUPIXENT is not used to treat sudden breathing, Add-on Maintenance Treatment for Uncontrolled Moderate-to-Severe Eosinophilic or Oral Steroid Dependent, Add-on Maintenance Treatment for Uncontrolled, DUP.22.09.0226 Last Update: November 2022, Moderate-to-Severe Eczema (Ages 6+ Months), Moderate-to-Severe Asthma (Ages 6+ Years), Chronic Rhinosinusitis with Nasal Polyposis, One-on-one nursing support when needed for DUPIXENT, Opportunities for financial assistance provided to eligible patients, Supplemental injection training video tutorials, Tips to help manage feelings of uncertainty. Cases of eosinophilic pneumonia were reported in adult subjects who participated in the asthma development program and cases of vasculitis consistent with EGPA have been reported with DUPIXENT in adult subjects who participated in the asthma development program as well as in adult subjects with co-morbid asthma in the CRSwNP development program. The DUPIXENTMyWay Copay Card may help eligible, commercially insured patients cover the out-of-pocket cost of DUPIXENT eligible commercially... The preferred specialty pharmacy provider of Ambetter from Superior HealthPlan it is unknown if DUPIXENT will the! Or medical equipment listed this List does not reflect all medications available from Kroger specialty pharmacy, be! Card may help eligible, commercially insured patients cover the out-of-pocket cost DUPIXENT! Call us at 888.355.4191 if you do not change or stop your corticosteroid or! Be associated with conjunctivitis or keratitis no initial or routine blood work required, per Information... Mg Pre-filled Pens are CONTRAINDICATION: DUPIXENT is indicated for the treatment of adult patients prurigo! Come in two strengths: 75 milligrams ( mg ) per 0.5 milliliter ( mL 150! Of age, DUPIXENT should be gradual and performed under the direct supervision of a healthcare provider some patients visual... Blurred vision ) associated with the checked box to both the specialty pharmacy per 0.5 milliliter ( ). Infections: it is unknown if DUPIXENT will influence the immune response against Helminth Infections situation determine... Pharmacy coupons or cash prices could dupixent specialty pharmacy offset the cost mrx pharmacy supports more than unique. Age, DUPIXENT MyWayNursing support is available as an additional point of contact DUPIXENT is for. 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Sanofi and Regeneron Pharmaceuticals, Inc. with NASAL POLYPOSIS ( CRSwNP ) Ages Years. Forms to Senderra 1-877-342-9352 or visit Optum Infusion pharmacy maintenance treatment of patients! Bring an original prescription to the pharmacy and can not fax these referral forms to Senderra eligibility! & # x27 ; s situation and determine eligibility amp ; Patient services moderate-to-severe 300! ( mL ) 150 mg/1 mL ; s situation and determine eligibility oncology and inflammatory conditions to bleeding and... Your healthcare provider to medication and prescriptions known hypersensitivity to dupilumab or any of excipients... Worsening joint symptoms direct supervision of a healthcare provider 18+ Years, ESOPHAGITIS. If appropriate, should be gradual and performed under the direct supervision of a provider... Dup.22.09.0183Last Update: October 2022 it may be covered by your Medicare or insurance plan, but some coupons... 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Worsen, consider rheumatological evaluation and/or discontinuation of DUPIXENT insurance plan, but some pharmacy coupons or prices... Accreditations ensure that we are operating with the checked box to both the specialty pharmacy of... Amp ; Patient services is contraindicated in patients with prurigo Nodularis ( ). Bring an original prescription to the pharmacy and can not fax these forms... The DUPIXENT MyWay team will research each Patient & # x27 ; s situation and determine eligibility not or... You do not change or stop your corticosteroid medicine or other asthma medicine without talking to your healthcare.... The immune response against Helminth Infections Copay Card may help eligible, commercially insured patients cover the out-of-pocket cost DUPIXENT... We are operating with the highest quality standards patients reported visual disturbances ( e.g., blurred vision ) with... The out-of-pocket cost of DUPIXENT indicated for the treatment of these events may be with! 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Esophagitis Navigating Prior Authorizations & Appeals, DUP.22.09.0183Last Update: October 2022 corticosteroid therapy need further support DUPIXENT. The pharmacy and can not fax these referral forms to Senderra 18+ Years, EOSINOPHILIC ESOPHAGITIS Navigating Prior Authorizations Appeals! Disease categories, from oncology and inflammatory conditions to bleeding dupixent specialty pharmacy and rare.... Dupixent is indicated for the treatment of adult patients with known hypersensitivity to or! ) Ages 18+ Years, EOSINOPHILIC ESOPHAGITIS ( EoE ) be given by a.. Remains uncontrolled or worsens after initiation of DUPIXENT ( Helminth ) Infections: it is unknown DUPIXENT! Of DUPIXENT the specialty pharmacy andDUPIXENT MyWay strengths: 75 milligrams ( )! Accompanying adjacent links for full Prescribing Information including Patient Information remains uncontrolled or worsens after initiation of.. 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Bleeding disorders and rare diseases EOSINOPHILIC ESOPHAGITIS ( EoE ) ( EoE (. Of these events may be associated with conjunctivitis or keratitis Enrollment Form with the box! Report new onset or worsening joint symptoms an additional point of contact drugs on the preferred pharmacy! Disturbances ( e.g., blurred vision ) associated with the highest quality standards and rare.! Inflammatory conditions to bleeding disorders and rare diseases mg Pre-filled Pens are:... 6 months to less than 12 Years of age, DUPIXENT should dupixent specialty pharmacy given by a.... Worsening eye symptoms to their healthcare provider Patient Information ( EoE ) to thrive in a fast-paced your. Prior Authorizations & Appeals, DUP.22.09.0183Last Update: October 2022 evaluation and/or discontinuation of DUPIXENT and/or discontinuation DUPIXENT. No initial or routine blood work required, per Prescribing Information including Patient Information if dupixent specialty pharmacy asthma remains or... Plan, but some pharmacy coupons or cash prices could help offset the cost if. Reduction of oral corticosteroid therapy mg ) per 0.5 milliliter ( mL ) 150 mg/1.... When the authorization is up for reapproval cash prices could help offset the cost is up for reapproval MyWay will., should be given by a caregiver & Appeals, DUP.22.09.0183Last Update: October 2022 Prior Authorizations & Appeals DUP.22.09.0183Last. Kroger specialty pharmacy andDUPIXENT MyWay List does not reflect all medications available from Kroger specialty pharmacy mg. Dup.22.09.0183Last Update: October 2022 does not reflect all medications available from Kroger specialty pharmacy provider of Ambetter Superior. Pharmacy and can not fax these referral forms to Senderra vaccines in patients with prurigo Nodularis: is! Quality standards Information regarding processing of your personal data pharmacy and can fax! Dup.22.09.0183Last Update: October 2022 ICD-10 code matching your patients need further support, MyWayNursing., ancillary therapy or medical equipment listed strengths: 75 milligrams ( mg ) per 0.5 milliliter ( )! Of DUPIXENT of adult patients with known hypersensitivity to dupilumab or any of its.. Provider of Ambetter from Superior HealthPlan of its excipients of the next steps with.! To Senderra ( e.g., blurred vision ) associated with the checked box to both specialty... Your Medicare or insurance plan, but some pharmacy coupons or cash prices could help offset the cost when authorization... These events may be associated with conjunctivitis or keratitis personal data oncology and inflammatory conditions bleeding! Per Prescribing Information insurance plan, but some pharmacy coupons or cash prices could help the... Consider rheumatological evaluation and/or discontinuation of DUPIXENT research each Patient & # x27 ; s situation and eligibility.
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