I'm "only" 61 now though on Dupixent MyWay copay help. For more information, call 1-844-DUPIXEN (T) (1-844-387-4936. Use DUPIXENT exactly as prescribed by your doctor. Fill out sections 5a and 5b completely to determine patient eligibility. 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. I also enrolled in the dupixent my way program and my ambassador told me that as long as you don’t make $100,000 a year you qualify for the program to get dupixent free for a year. How much does Dupixent cost without insurance? The average monthly retail price of Dupixent is $4,910 per 2, 2 mL of 300 mg/2 mL prefilled syringes. Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. , Sanofi US, and their affiliates and agents (together, the “Alliance”) may verifyBy checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. At one point, I was getting cold sores every 2 to 3 weeks consistently. Program Website : Program Applications and FormsView the possible side effects of DUPIXENT in patients with uncontrolled chronic rhinosinusitis with nasal polyposis. if speciality. O. any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. Select Condition Indication Moderate-to-Severe Eczema (Ages 6+ Months) Moderate-to-Severe Asthma (Ages 6+ Years) Chronic Rhinosinusitis with Nasal Polyposis (Ages 18+. Sanofi and Regeneron are committed to helping patients in the U. 1-844-DUPIXENT (1-844-387-4936) Topicort (desoximetasone spray 0. Serious side effects can occur. 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. After that, it is taken as 1 injection every 2 weeks or every 4 weeks, depending on your age and weight. 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. 17 and 0. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. 1-844-387-4936 (toll free) Monday - Friday, 8AM - 9PM (ET) Multilingual options available. To contact DUPIXENT MyWay, please call 1-844-DUPIXENT (1-844-387-4936). 2022;400 (10356):908-919. 0156 Past Update: March 2023 DUP. The increase was approved by the Minnesota Legislature and will help expand SNAP eligibility to families who may have previously been ineligible for the. 80). It temporarily provides eligible patients DUPIXENT at no cost, subject to program terms and conditions. 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. DUPIXENT® (dupilumab) is a subcutaneous injectable medication used in the treatment of patients aged 6 years and older with uncontrolled moderate-to-severe atopic dermatitis with two delivery options available, pre-filled syringe & pre-filled pen (aged 12+ years). The Dupixent pre-filled syringe is available in the following strengths: 100 mg per 0. 0129 Last Update:. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as a $0* copay per fill of DUPIXENT, maximum of $13,000 per patient per calendar year. DUPIXENT can be used with or without topical corticosteroids. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. 6 Submitting a PA request The appeal. Dupixent is currently approved in the U. Prior authorization and appeals. I don't know what medical issues your son is having, but it's likey autoimmune issues. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. 1. Your doctor will tell you how much DUPIXENT to inject and how often to inject it. 89 and -1. 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. For more information or to enroll in the patient support program, contact us at: 1‑844‑DUPIXENT 1-844-387-4936 Monday-Friday, 8 am-9 pm ET. Guam or the USVI, and demonstrate a financial need with a total annual adjusted gross income of $100,000 or less. 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). Dedicated Dupixent MyWay Case Managers can explain information related to Dupixent. -The original form (from the first guy) was still in the system and the folks at MyWay were “confused” by it. Using the drop. who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay ® program. DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. Social Security income, unemployment insurance benefits, disability income, any other income for the household. S. 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. For Healthcare Professionals. I have read and agree to the Income Verification included in Section 8 on page 5. 01. Please see Important Safety Information and full PI on website. Needed additional leadership equipped the enrollment process? Contact your section accessories dedicated or call DUPIXENT MyWay. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. For more information, dial 1‑844‑DUPIXENT( 1-844-387-4936 ), option 1. The majority of DUPIXENT patients with commercial/employer-provided insurance use the DUPIXENT MyWay ® Copay Card. DUPIXENT® (dupilumab) is taken as an injection by a pre-filled syringe or pre-filled pen. 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. Dupixent Myway . But either way, after you or Dupixent myway meets your deductible, it should be free to you. DUPIXENT MyWay® Program Taking Dupixent. If I am completing Section 5b, I authorize for my commercially insured patient one. How many people live in your household? _____ Please refer to. Oct 26, 2022 · Dupixent MyWay Program Enrollment Form for Allergists (AD, Asthma, CRSwNP). LEARN ABOUT OUR PATIENT SUPPORT PROGRAM. 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. They are a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI. 23. 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). Draw your signature, type it, upload its image, or use your mobile device as a signature pad. When I was very young, I knew that I wanted to be a nurse. If I am completing Section 5b, I authorize for my commercially insured patient one. March 29, 2018. 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. 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 . DUPIXENT MyWay. THE DUPIXENT MyWay PROGRAM. The DUPIXENT MyWay program also provides useful tools and resources to help you stay on track with your treatment. For more information and to find out if you’re eligible for support, call 844-DUPIXENT (844-387-4936) or visit the program website. Deductible is at $3k out of pocket insurance pays 80% and at $6k insurance pays 100%. 1, 2022, the gross income limit for Supplemental Nutrition Assistance Program (SNAP) eligibility in Minnesota increased from 165% to 200% of the federal poverty line for most households. Enrolled patients receive: One-on-one support from our DUPIXENT MyWay support team; Help understanding insurance coverage; Financial assistance (for eligible patients only) Help scheduling deliveries 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 is not intended for episodic use. 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. 1kg over one year – the amount of weight gained ranged from 0. 23. 2022;400 (10356):908-919. For more information, please call 1-844-DUPIXENT (1-844-387-4936) or visit . Serious side effects can occur. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. ®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 Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. 2 cartons. 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. There is currently no generic alternative to Dupixent. 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. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Also, make sure to store the DUPIXENT MyWay phone number in your phone’s contacts so you. Learn more about programs for eligible patients who are insured, underinsured, and uninsured. I’ve been with DUPIXENT MyWay since the very beginning. DUPIXENT® (dupilumab) is a. Eligible clients will receive their cards by email. ) Please refer to Section 8, Patient Certifications, for. 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). Your healthcare provider may stop DUPIXENT if you develop joint symptoms. It will also depend on how much you have. Dupixent® should be given by or under the supervision of an adult in children 12 years of age and older. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. VO: DUPIXENT is a prescription medicine used: to treat people aged 6 years and older with moderate-to-severe atopic dermatitis (eczema) that is not well controlled with prescription therapies used on the skin (topical), or who cannot use topical therapies. First few months into taking Dupixent, I got laid off and worked w my doctors/Dupixent to get assistance. They will begin the benefits investigation and inform your office of the next steps. Monday-Friday, 8 am - 9 pm ET 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. Each time you fill your DUPIXENT prescription, please ensure your. 14 mL, or 300 mg/2 mL)The Dupixent MyWay program is not available to medicare patients. Please see accompanying full Prescribing InformationTell us about yourself. I wanted to go out and make a difference and help people. 00 per injection. Dupixent changed my life completely. Eligible commercially insured patients may pay $0 per prescription with a maximum savings of $13,000 per year; for additional information contact the program at 844-387-4936. If this is the case, write the preferred specialty pharmacy. 5. DUPIXENT is not a steroid or immunosuppressant; it is a prescription biologic medicine given under the skin (subcutaneous injection). 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. For me, the side effects didn’t really bother me or have me second guess my decision with Dupixent because my skin was. The formulary status tool below can help check DUPIXENT coverage for various plans. A group of skin conditions characterized by skin inflammation, rash, and itch. DUPIXENT MyWay. a $85. 09. I suppose it doesn't really matter now. For more information, call 1-844-DUPIXENT. Once 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. $125 is the amount Dupixent assistance pays. Based on the questions answered above, you are not eligible to register for a new copay card or to activate a copay card. 00. 71 for Dupixent compared to 0. DUPIXENT MyWay team will research each patient’s situation and determine eligibility. 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. This year the program seems to have changed, requiring a separate 'copay card' with an annual limit of $13,000. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Since MyWay covers 13,000 a year, that will count towards your deductible. Caring. Dupilumab. The $500 payment counts towards the member’s deductible and out-of-pocket maximum. With the Copay Card, You Could Pay as Little as $0 † The majority of DUPIXENT patients with commercial/employer-provided insurance use the DUPIXENT MyWay ® Copay Card. 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. I also have the dupixent myway card that covers a total of $13,000 for the year. If you don't have insurance at all, the only realistic option is to qualify for income-based help from Dupixent directly. 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. Depends if your insurance cares that Dupixent myway is paying your deductible. ) 2 Prescription InformationIn adults and children 6 years and older, your initial dose of DUPIXENT is 2 injections under the skin (subcutaneous injection) at different injection sites. Program has an annual maximum of $13,000. Eligible patients covered by commercial health insurance may pay as little as a $0 p copay per fill of DUPIXENT. Serious side effects can occur. 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. I’m a registered nurse with DUPIXENT MyWay. DUPIXENT is a biologic and can help reduce your patients' use of systemic corticosteroids. ago. Browse the DUPIXENT® (dupilumab) sitemap to help you learn more about uncontrolled moderate- to-severe eczema in adults and children aged 6 months & older and navigate DUPIXENT. Check the liquid in the prefilled pen or syringe. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. For more information, dial 1‑844‑DUPIXENT ( 1-844-387-4936 ), option 1 Monday-Friday, 8 am - 9 pm ET. Patient Signature _____ If you have questions about the . com, help you fill it out, and fax it back to DUPIXENT MyWay at 1-844-387-9370 • You or your healthcare provider can call 1-844-DUPIXEN(T), option 1 • Providing your email address allows DUPIXENT MyWay to give you more support resources about DUPIXENT HAS YOUR DOCTOR PRESCRIBED DUPIXENT ® (dupilumab)? 14 15. For assistance, please call 1-844-468-2252 Monday Friday, 8AM to 8PM ET. And very recently got laid off due to Covid-19. I’m a registered nurse with DUPIXENT MyWay. Ways to save on Dupixent. Serious side effects can occur. Dupixent MyWay pays the $500 copay. you offering to give them $170 they assumed you didn’t want to bother contacting dupixent myway. I have a $40 copay but I got the dupixent my way copay card its free for me. 0252 Last Update: Feb 2023 DUP. DUPIXENT® (dupilumab) Prescription Information Quick Start may be able to provide DUPIXENT at no cost to help bridge patients to therapy if there is a coverage delay. (The patient is lucky / unlucky enough to have an income that would rule out the Patient Assistance Program. With the DUPIXENT MyWay Copay Card, eligible,. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. 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. Follow these tips to take DUPIXENT while traveling: Store DUPIXENT in the original carton to protect it from light. 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. $3,645. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. Sign up to connect with a DUPIXENT MyWay® mentor to help patients with Nasal Polyps through their DUPIXENT. I know people who make six figures on a joint income and still use MyWay. Patients in each age group saw improved lung function in as little as 2 weeks. Monday-Friday, 8 am-9 pm ET. 10 for placebo; difference between Dupixent and placebo: -2. 25%) Taro Pharma patient access. 14 mL, or 300 mg/2 mL)My insurance provider covers 85% and our Canadian version of 'MyWay' pays the remainder. Monday-Friday, 8 am-9 pm ET. This DUPIXENT Pre-filled Pen is a single-dose device. 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;. 01. And, if you're eligible, you can sign up and receive your card today. DUPIXENT was studied in adults and children 6 months of age and older. ) 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. ®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. Just got off the phone with Dupixent My Way. Section 5a. Required if enrolling in the DUPIXENT MyWay. Robocalls increase diabetic retinopathy screenings in low-income patients. 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. Please see Important Safety Information and Patient Information on website. Fill a 90-Day Supply to Save. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. The DUPIXENT MyWay team will research each patient’s situation and determine eligibility. 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 otherBy checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. 8K subscribers in the eczeMABs community. 1kg to 18. Dupixent is administered as an injection under the skin (subcutaneous injection) at different injection sites. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. 80). S. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. For patients with commercial insurance who are new to DUPIXENT and experiencing a. Fill out sections 5a and 5b completely to determine patient eligibility. 03. 01. It still covers the same amount. Maximum benefit (2023) = $1,483. DUPIXENT MyWay ENROLLMENT FORMS; English Enrollment Form. , chart notes, laboratory values) and use of claims history documenting the following: 1. It is not an immunosuppressant or a steroid. 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. Enroll now to receive emails and resources designed to help patients, caregivers and information seekers through the DUPIXENT® (dupilumab) treatment journey. Household Size. In this case Dupixent myway will cover the first 13k, which is probably like 5 months. A 68-year-old woman developed generalized joint pain 6 weeks after starting Dupixent. 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. Patient and Co-pay Assistance: DUPIXENT MyWay helps eligible patients get access to therapy whether they are uninsured, lack. 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. My wife is on Dupixent, and has the MyWay card which allows up to $13,000/year. Gather all necessary information and documents, such as your insurance information, prescription details, and any supporting documentation. 23. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3 program consisting of two pivotal trials. 1 Reactions. 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. I give supplemental injection training to the patient and the patient’s caregiver. Since 2017, Dupixent has increased in price by 13%. 0185 Last Update: November 2022 DUP. You must also meet certain household income eligibility requirements as outlined below: 48 States and DC. Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. Maximum Monthly Gross Income. DUPIXENT use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. · If the insurer does have a copay accumulator in place: the insurer pays the entire cost of the refill except for $500. 1-844-387-4936 (toll free) Monday - Friday, 8AM - 9PM (ET) Multilingual options available. At this rate, I will no longer be able to afford the medication very soon. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. I’m Laurie. LH Patient View; data through June 16, 2023. Well at a cost of roughly $3,500/dose which lasts a month, that will all be used up in four months. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. Support. 67 mL, 200 mg/1. Since 2018, DUPIXENT has been prescribed to over 100,000 asthma patients in the US. Eligible patients will receive their cards by email. 12. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. I also have the dupixent myway card that covers a total of $13,000 for the year. Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. So, even with a "prior authorization" and a "formulary override", the cost to me is $2900 per month, or about $1450. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase. 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. Option 1- you have to meet your deductible without Dupixent myway. It contains 300 mg of DUPIXENT for injection under the skin (subcutaneous injection). 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. Does anyone know the eligibility process for the dupixent copay assistance? Do they ask for tax forms? Is there an income limit? comments sorted by Best Top New Controversial Q&A Add a Comment More posts you may like. · If the insurer does have a copay accumulator in place: the insurer pays the entire cost of the refill except for $500. 18, 0. It's like $35k-$40k. 01. Some people do injections every 3 weeks, which could stretch that copay card out longer. 02. Dedicated Dupixent MyWay Case Managers can explain information related to Dupixent. 12. Over 80% of insurance plans cover Dupixent, but many have restrictions. Box 5925 Mailstop 55A-220A Bridgewater, NJ 08807. Check your eligibility for the DUPIXENT MyWay® Copay Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients. Not valid for prescriptions paid, in whole or in part, by Medicaid, Medicare, VA, DOD, TRICARE, or. 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. SIGN UP TO SPEAK WITH A DUPIXENT MyWay ® MENTOR . chevron_right. Susie16 Oct 15, 2023 • 9:37 PM. Fill out sections 5a and 5b completely to determine patient eligibility. a Coverage varies by type and plan. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. 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. Your insurance has to deny twice and then you can apply for patient assistance. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. 2 Eligible US residents with an FDA-approved prescription for DUPIXENT may pay as little as $0 copay per fill of DUPIXENT (annual maximum of $13,000). Surgery may remove your nasal polyps, but it may not treat an underlying cause of inflammation—allowing them to grow back. Your cost may depend on your treatment plan, your insurance coverage (if you have it), and the pharmacy you use. 38]). I was given the MyWay copay card but it had a limit of $13,000/calendar year and that has been exhausted at this point. 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) 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. 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. From my understanding, the Dupixent MyWay Program pays the $125 since your insurance is covering the rest. Watch videos from experts [,download materials,] and explore future events to further understand DUPIXENT® (dupilumab). The DUPIXENT MyWay team can research each patient’s situation and determine eligibility. 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 other 4 ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pm This will allow the specialty pharmacy to conduct the benefits investigation, and DUPIXENT MyWay will provide additional support to the patient. 01. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not 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) 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. Watch videos for a supplemental demonstration on how to use and dispose of DUPIXENT® (dupilumab), a prescription medicine for subcutaneous injection. United Healthcare covers it but I get insurance through my employer and it was a huge pain to get approved. Rx: DUPIXENT® (dupilumab) (100 mg/0. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not ENROLL. 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. Serious adverse reactions may. 50 for a single person. Dupixent inhibits the overactive signaling of interleukin-4 (IL-4) and. 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. Do NOT shakeConoce las dos opciones de administración disponibles: jeringa precargada de 200 mg y 300 mg, y pluma precargada de 200 mg y 300 mg (para edades de 12 años o más), y revisa cómo inyectar DUPIXENT® (dupilumab), un medicamento para inyección subcutánea, de venta con receta, para el eczema moderado a grave en adultos y niños de 6 meses o más. for DUPIXENT® dupilumab therapy My Information. Please see accompanying full Prescribing Information. PRESCRIBER TO FILL OUT Section 6a. To enroll or obtain information call 1-877-311. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. including household income, to qualify. Learn how DUPIXENT helped treat children 6 to 11 years old with their moderate-to-severe asthma. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. After that, we will have met our family deductible. Support. Section 5a. Learn how DUPIXENT® (dupilumab), the first FDA-approved weekly injectable biologic treatment for eosinophilic esophagitis (EoE) in patients 12 years and older who weigh at least 88lb (40kg) targets a source of inflammation, which contributes to EoE. 67 mL, 200 mg/1. 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). 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. Hear real patients stories of life with uncontrolled moderate-to-severe asthma and how discovering DUPIXENT® (dupilumab) impacted their journey. So, how can you save? Manufacturer Sanofi offers Dupixent MyWay, a patient support program. Nationally are Covered for DUPIXENT. We'll keep those "Instructions for Use" nearby and then lay the pre-filled syringe on a flat surface and let it naturally warm at a room temperature of less than 77°F (25°C). Appears that my out of pocket maximum will be $8000 through insurance. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. The most common side effects include: DUPIXENT MyWay. 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. 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. With MyWay, I get the year for free. $4,930. If you still have questions, you can speak with a DUPIXENT MyWay or request to join the program over the phone. Dupixent. Assistance may be available for patients who do not have insurance. 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. Serious side effects can occur. Serious adverse reactions may occur. 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. 02. DUPIXENT . Eligible patients will receive they cards by e-mail. 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. Please see accompanying full Prescribing Information. _____ What is your total annual household income? _____ (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Guam or the USVI, and demonstrate a financial need with a total annual adjusted gross income of $100,000 or less. The Dupixent MyWay program is not available to medicare patients. 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 can be used with or without topical corticosteroids. 58 for 2. The doctor's office called to say I need to call to talk about my income and expenses. Clip the card and save • Save up to 80% on medications*Tell your healthcare provider about any new or worsening joint symptoms. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. Over 80% of insurance plans cover Dupixent, but many have restrictions. 1,000-125=875 $875 is the amount your health insurance pays.