who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay ® program. I suppose it doesn't really matter now. 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. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. Please see accompanying full Prescribing Information. I'm "only" 61 now though on Dupixent MyWay copay help. I also have the dupixent myway card that covers a total of $13,000 for the year. Serious side effects can occur. DUPIXENT® (dupilumab) is a. For pediatric patients aged 6 to 11 years, Dupixent dosing is based on weight (100 mg every two weeks or 300 mg every four weeks for children ≥15 to <30 kg, and 200 mg every two weeks for children ≥30 kg) and is supplied as a pre-filled syringe. The DUPIXENT MyWay patient support program is here to help you at every step of your DUPIXENT treatment journey. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay, and that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. Please see Important Safety Information and Prescribing Information and Patient Information on website. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. withdraw this Authorization at any time by mailing or faxing a written request to DUPIXENT MyWay at 1800 Innovation Point, Fort Mill, SC 29715; Fax: 1-844-387-9370. Patient Signature _____ If you have questions about the . He continued with Dupixent and his symptoms had partially improved 24 weeks after their onset. 1 Reactions. If this is the case, write the preferred specialty pharmacy name and then check the box indicating that you have sent the prescription to the specialty pharmacy, which will. 4. DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. If I am completing Section 5b, I authorize for my commercially insured patient one. You must also meet certain household income eligibility requirements as outlined below: 48 States and DC. Serious side effects can occur. The formulary status tool below can help check DUPIXENT coverage for various plans. Financial criteria for patient assistance. “It’s an incredible feeling to be validated and. The patient must then take the following actions:I just got approved for dupixent this week however the copay is 3,000$ a month! The dupixent my way program only covers up to 13k or something like that. 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. I've been on Dupixent for over 2 years now and it has been such a great experience keeping my eczema under control. In addition, I agree to notify DUPIXENT MyWay if my insurance situation changes. Fill a 90-Day Supply to Save. Type text, add images, blackout confidential details, add comments, highlights and more. 74 (2023), plus an amount based on how much you. Fill out sections 5a and 5b completely to determine patient eligibility. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. 1. Please note that you will receive a confirmation fax after sending the form. It was a process to get into the patient assist program. any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. 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). who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay ® program. 14 mL, or 300 mg/2 mL)The Dupixent MyWay program is not available to medicare patients. I’m a registered nurse with DUPIXENT MyWay. Patient Signature _____ If you have questions about the . With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. ago It is actually not a change in the myway program. The DUPIXENT MyWay team will research each patient’s situation and determine eligibility. I wanted to go out and make a difference and help people. Please see. 38]). including household income, to qualify. How to fill out dupixent reimbursement: 01. for DUPIXENT® dupilumab therapy My Information. Support. Dupixent is indicated for the treatment of moderate to severe atopic dermatitis in patients aged 12 years and older who are candidates for chronic systemic therapy. Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. March 29, 2018. 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. Please see Important Safety Information and Prescribing Information and Patient Information on website. The Dupixent pre-filled syringe is available in the following strengths: 100 mg per 0. 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. Use DUPIXENT exactly as prescribed by your doctor. 00. I just spoke to someone through the MyWay Program. Rx: DUPIXENT® (dupilumab) (100 mg/0. 2 cartons. Lancet. 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. Some Medicare plans may help cover the cost of mail-order drugs. DUPIXENT was studied in adults and children 6 months of age and older. 2. Continuation in the program is conditioned upon timely verification of income. Serious side effects can occur. The $500 payment counts towards the member’s deductible and out-of-pocket maximum. 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. For Healthcare Professionals. After removal from the refrigerator, DUPIXENT must be used within 14 days or discarded; DUPIXENT should not be exposed to heat or direct sunlight; Do NOT freeze. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. 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. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. For more information, dial 1‑844‑DUPIXENT( 1-844-387-4936 ), option 1. You can email or print the enrollment forms below. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. 03. March 27, 2018. Im so stressed out about. 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). Assistance may be available for patients who do not have insurance. 0kg. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. Serious adverse reactions may. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. 2 Eligible US residents with an FDA-approved. 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. Approximately 72% of the total FEV 1 improvement (470 mL improvement at Week 52 from baseline FEV 1 of 1. PRESCRIBER TO FILL OUT Section 6a. I wanted to go out and make a difference and help people. 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. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Patients in each age group saw improved lung function in as little as 2 weeks. I'm guessing this will not be allowed once I'm on Medicare. Each time you fill your DUPIXENT prescription, please ensure your. Over 80% of insurance plans cover Dupixent, but many have restrictions. Fill out sections 5a and 5b completely to determine patient eligibility. DUPIXENT has been FDA approved for use in adults with uncontrolled moderate-to-severe eczema since 2017. including household income, to qualify. DUPIXENT MyWay®. 8K subscribers in the eczeMABs community. That is good, because I was quoted 1400+ a month by my Medicare D provider. They never mentioned only covering a. 99% of commercial patients (6+ months of age) nationally are covered for DUPIXENT. Regeneron and Sanofi are committed to helping patients in the U. 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. 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. Injection Support Center Injection Reminders and Tips FREQUENTLY ASKED QUESTIONS; Español. Please see accompanying full Prescribing Information. 23. out and fax back to DUPIXENT MyWay at 1-844-387-9370 • You or your specialist can call 1-844-DUPIXEN(T), option 1 • Providing your email address allows DUPIXENT MyWay to give you more support resources about DUPIXENT. 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. TEL: 844. Program Website : Patient Assistance Applicationsfor DUPIXENT® dupilumab therapy My Information. For more information, call 1. First few months into taking Dupixent, I got laid off and worked w my doctors/Dupixent to get assistance. 0129 Last Update:. DUPIXENT MyWay®. 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. and other countries to treat several diseases driven by type 2 inflammation. So, let's just pretend the total cost is $1,000/month. living with prurigo nodularis. 58 for 1. Sanofi offers a Dupixent MyWay copay card to some patients with commercial insurance, but it has eligibility requirements and a yearly maximum of $13,000. 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;. Gather all necessary information and documents, such as your insurance information, prescription details, and any supporting documentation. After that, we will have met our family deductible. Susie16 Oct 15, 2023 • 9:37 PM. Fill out sections 5a and 5b completely to determine patient eligibility. DUPIXENT® is indicated as an add-on maintenance treatment of adult and pediatric patients 6 years and older with moderate-to-severe asthma characterized by an eosinophilic phenotype or with oral corticosteroid dependent asthma. I have read and agree to the Income Verification included in Section 8 on page 5. Patient to Fill Out. DUPIXENT® (dupilumab) is indicated as an add-on maintenance treatment in adult patients with inadequately controlled chronic rhinosinusitis with nasal polyposis (CRSwNP). 98% of Commercially Insured Patients. Patient assistance program. Does anyone know of any assistance programs I can use to help assist in the copay after dupixent my way limit is reached?33% and 27% reduction in their nasal polyps score compared to a 7% and 4% increase with placebo in SINUS-24 and SINUS-52, respectively (LS mean change from baseline of -1. Sign up or activate your card here. Fax the Enrollment Form to DUPIXENT MyWay. 18, 0. LEARN ABOUT OUR PATIENT SUPPORT PROGRAM. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. Eligible patients covered by commercial health insurance may pay as little as a $0 p copay per fill of DUPIXENT. Rx: DUPIXENT® (dupilumab) (100 mg/0. You don’t have to put your life on hold to fit your dosing schedule. SINCE 2017, ≈253,000 PATIENTS HAVE FILLED AT LEAST 1 DUPIXENT PRESCRIPTION b,c. 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. Fill out sections 5a and 5b completely to determine patient eligibility. DUPIXENT should not be stored above 77 °F (25 °C). Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. I also have the dupixent myway card that covers a total of $13,000 for the year. Eosinophilic Esophagitis: DUPIXENT is indicated for the treatment of adult and pediatric patients aged 12 years and older, weighing at least 40 kg, with eosinophilic esophagitis (EoE). S. 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. Get a Quick Start. You may be eligible for the DUPIXENT MyWayDUPIXENT MyWayAbout Dupixent Dupixent is administered as an injection under the skin (subcutaneous injection) at different injection sites. There is currently no generic alternative to Dupixent. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. 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. Access the dupixent reimbursement form either online or through your healthcare provider. financial assistance for eligible patients, provide one-on-one nursing support, and more. 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. Want to be a part of the DUPIXENT MyWay® Ambassador Program? Fill out this self-nomination form to see if you qualify. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. Just got off the phone with Dupixent My Way. DUPIXENT MyWay. In a clinical trial at 16 weeks in teens (aged 12-17 years) taking DUPIXENT* when used alone compared to teens not taking DUPIXENT: Clearer skinSAW CLEAR or Almost clear SKIN 24% vs 2% not taking DUPIXENT (placebo) nOTICEABLY LESS ITCHEXPERIENCED ITCH 37% vs 5% not taking DUPIXENT (placebo) ≥75%SKIN. For me, the side effects didn’t really bother me or have me second guess my decision with Dupixent because my skin was. Type text, add images, blackout confidential details, add comments, highlights and more. 89 and -1. 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. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not affect any disclosure of My Information based on1-844-DUPIXENT 1-844-387-4936. Injection site reactions and eye conditions are the most common side effects reported and, unlike several other biologics, the risk of infection is low. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. About 75,000 adults in the U. They will begin the benefits investigation and inform your office of the next steps. 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. BIN: 020750 RX PCN: NMeds RX GRP: PDFPDF ID: NMNA019309901930 This is a drug discount program, not an insurance plan. For more information and to find out if you’re eligible for support, call 844-DUPIXENT (844-387-4936) or visit the program website. ®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. 26 [95% CI: 0. Option 1- you have to meet your deductible without Dupixent myway. 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. 00 per injection. For more information, call 1-844-DUPIXENT ( 1-844-387-4936) option 1. • Store DUPIXENT in the original carton to protect from light. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. for DUPIXENT® dupilumab therapy My Information. 03. Since 2017, Dupixent has increased in price by 13%. Using the drop. I’ve been with DUPIXENT MyWay since the very beginning. Learn how DUPIXENT® (dupilumab) works as the first and only FDA-approved treatment for prurigo nodularis (PN) in adults aged 18 years and older. 23. So, how can you save? Manufacturer Sanofi offers Dupixent MyWay, a patient support program. DUPIXENT MyWay ENROLLMENT FORMS; English Enrollment Form. These programs and tips can help make your prescription more affordable. chevron_right. DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. It may be covered by your Medicare or insurance plan. QUEST (12+ years) DUPIXENT offers rapid breathing relief patients can feel as early as Week 2. Well at a cost of roughly $3,500/dose which lasts a month, that will all be used up in four months. 28. 0252 Last Update: Feb 2023 DUP. It was granted and I pay $0. Income at or below: Not Published: Medical expenses can be. Serious adverse reactions may occur. Nationally are Covered for DUPIXENT. · If the insurer does have a copay accumulator in place: the insurer pays the entire cost of the refill except for $500. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Patient has been compliant on Dupixent therapy 4. If you still have questions, you can speak with a DUPIXENT MyWay representative or request to join the program over the phone. 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. 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. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. Sanofi and Regeneron are committed to helping patients in the U. Do not store DUPIXENT pre-filled syringes at room temperatures more than 77°F (25°C) Do not keep DUPIXENT at room temperature. I knocked out the first copay out of pocket and went on the manufacturer website and applied for the dupixent my way card. Program has an annual maximum of $13,000. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. Eczema. Hello! Switching insurance this year and need to prepare for increasing costs of dupixent with my new insurance. According to the manufacturers, Dupixent can be dosed to a maximum daily dose as indicated below. 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. 67 mL; 200 mg per 1. Find the safety profile, including most common side effects, of DUPIXENT® (dupilumab) for infant to preschoolers 6 months to 5 years of age with uncontrolled moderate-to-severe atopic dermatitis . dupixent myway income guidelinesstellaris unbidden and war in heaven. 4 ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pm 01. Your doctor will tell you how much DUPIXENT to inject and how often to inject it. ( 1-844-387-4936 ), option 1. the info from that copay savings card you will give to alliance and they process that after insurance (so the $170 copay they’d cover) which would leave you with $0 copay. Needed additional leadership equipped the enrollment process? Contact your section accessories dedicated or call DUPIXENT MyWay. Dupixent MyWay Copay Card. Hear real patients stories of life with uncontrolled moderate-to-severe asthma and how discovering DUPIXENT® (dupilumab) impacted their journey. 0185 Last Update: November 2022 DUP. DUPIXENT MyWay® is a patient support program designed to help you get access to DUPIXENT and help eligible patients cover the out-of-pocket costs of DUPIXENT. chevron_right. 23. So, even with a "prior authorization" and a "formulary override", the cost to me is $2900 per month, or about $1450. 14 mL, or 300 mg/2 mL) Call 1-844-387-4936, Option 1 to contact DUPIXENT MyWay ®. Compare . (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. (2 of 3) Patient signature/Legal representative if patient is <18 years Date Section 2. I just started this week so I look forward to seeing the results. Rx: DUPIXENT® (dupilumab) (100 mg/0. was not paid in whole or in part by Medicare, Medicaid, or any federal or state programs. DUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process. Dupixent® (dupilumab) approved by FDA as the first and only treatment indicated for prurigo nodularis Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. Please see accompanying full Prescribing InformationTell us about yourself. 12. 1‑844‑DUPIXENT 1-844-387-4936. ) 2 Prescription InformationDupixent® (dupilumab) approved by FDA as the first and only treatment indicated for prurigo nodularis. C M ET DUPIXENT MYWAY ENROLLMENT FORM Moderate-to-Severe Atopic Dermatitis SUBMIT COMPLETED PAGES 1 & 2 Fax: 1-844-387-9370 Document Drop: (code: 8443879370)The DUPIXENT MyWay Copay Card Program includes the Copay Card, the Debit Card, and any direct patient rebate, and has a combined annual maximum benefit of $13,000 per patient per calendar year. Browse the DUPIXENT® (dupilumab) sitemap to help you learn more about eosinophilic esophagitis (EoE) in patients 12 years and older who weigh at least 88lb (40kg) and navigate DUPIXENT. 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. form on DUPIXENT. 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. Throw away (dispose of) any DUPIXENT that has been left at room temperature for longer than 14 days. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. Enrolled patients receive: One-on-one support from our DUPIXENT MyWay support team; Help understanding insurance coverage; Financial assistance (for eligible patients only) Help. 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. Monday-Friday, 8 am - 9 pm ETto DUPIXENT MyWay at 1-844-387-9370. 01. Base amount is $558. Dupixent is an injection under the skin (subcutaneous injection) at different injection sites. com. Fill out sections 5a and 5b completely to determine patient eligibility. 67 mL, 200 mg/1. Robocalls increase diabetic retinopathy screenings in low-income patients. LONG-LASTING CLEARER SKIN AT 16 and 52 Weeks 22% taking. It is not an immunosuppressant or a steroid. DUPIXENT ® is a fully human monoclonal antibody that inhibits the signaling of the interleukin-4 (IL-4) and interleukin-13 (IL-13) proteins 3 and is not an immunosuppressant. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. Children treated with Dupixent and topical corticosteroids (TCS) achieved clearer skin, experienced significantly improved overall disease severity and significantly reduced itch compared to TCS. “Eczema otherwise unspecified” is not indicated for Dupixent. chevron_right. 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). 5011 XXX X < M A T > 00000 0 300 mg/ 2 m L Look at theFull Prescribing Information: Patient Information: Learn more about DUPIXENT: Thanks for c. Every enrolled patient is assigned a phone-based DUPIXENT MyWay® Nurse Educator, who takes a patient-centric approach to providing tools, support resources, and education throughout the patient’s treatment journey. For patients with commercial insurance who are new to DUPIXENT and experiencing a. After that, it is taken as 1 injection every 2 weeks or every 4 weeks, depending on your age and weight. But either way, after you or Dupixent myway meets your deductible, it should be free to you. For more information, dial 1-844-DUPIXENT 1-844-387-4936 ), option 5, Monday-Friday, 9 am – 9 pm ET. For additional information or if you have questions, contact your Field Representative or call DUPIXENT MyWay at 1-844-DUPIXEN(T) (1-844-387-4936) Option 1, Monday–Friday, 8 am–9 pm Eastern time. Patients will need on hit the eligibility benchmark, including household income, to qualify. Some people do injections every 3 weeks, which could stretch that copay card out longer. You may be able to get a 90-day supply of Dupixent. com. 0156 Past Update: March 2023 DUP. who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay® program. The most common side effects include: DUPIXENT MyWay. 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. A 68-year-old woman developed generalized joint pain 6 weeks after starting Dupixent. Dupixent Myway . 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. J Allergy Clin Immunol Pract. 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 Enrollment FormYes, it does appear that Dupixent can cause weight gain, although this is not listed as a side effect in the product information. store above 77 °F (25 °C). If you don't have insurance at all, the only realistic option is to qualify for income-based help from Dupixent directly. How many people live in your household? _____ Please refer to Section 8, Patient Certifications , for. Dupixent (dupilamab) Dupixent MyWay patient support program. 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. It's like $35k-$40k. For more information, dial 1‑844‑DUPIXENT 1-844-387-4936 Monday-Friday, 8 am-9 pm ET. how to afford it then - it's been so helpful!! 3 Reactions. 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. A case series of 12 people prescribed Dupixent reported an average weight gain of 6. 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. DUPIXENT . And very recently got laid off due to Covid-19. 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. LEARN ABOUT OUR PATIENT SUPPORT PROGRAM. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. 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. 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). DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. S. will need to meet the eligibility criteria, including household income, to qualify. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. Share your form with others. Household Size. 01. ) I agree that Regeneron Pharmaceuticals, Inc. was not paid in whole or in part by Medicare, Medicaid, or any federal or state programs. I understand the disclosure to the Alliance will be for the purposes of enrolling me in, and providing certain services through the DUPIXENT MyWay Program, including • to determine if I am eligible to participate in DUPIXENT MyWay coverage assistance programs, patient assistance programs, or other4 ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pmDUPIXENT MyWay complements your office’s process for accessing DUPIXENT. Since MyWay covers 13,000 a year, that will count towards your deductible. DUPIXENT® is a prescription medicine used as an add-on maintenance treatment for uncontrolled moderate-to-severe eosinophilic or oral steroid dependent asthma in people aged 6 years and older. Dupixent is currently approved in the U. By 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. 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. I’ve been with DUPIXENT MyWay since the very beginning. Help educate and inspire other patients trying to manage their conditions by sharing your treatment journey through the DUPIXENT MyWay® Ambassador Program. DUPIXENT is available as a single dose in a pre-filled syringe (200 mg or 300 mg) with needle shield, or single-dose pre-filled pen (200 mg or 300 mg) for ages 2+ years. Program has an annual maximum of $13,000. $4,930. 00 per injection. Connect with someone, ask questions, and learn about their experience with DUPIXENT® (dupilumab) treatment. 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. 2 pens of 300mg/2ml. S. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. LASTING CHANGE IS ACHIEVABLE. Patient is responsible for any out-of-pocket amounts that exceed the program limit. You or your patients can contact DUPIXENT MyWay® at 1-844-DUPIXEN(T) (1-844-387-4936) 1-844-DUPIXEN(T) (1-844-387-4936) to learn more. 0254 Last Update: February 2023 DUP. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not affect any disclosure of My Information based on I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay, and that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. 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. For more information, dial 1‑844‑DUPIXENT( 1-844-387-4936 ), option 1. Please complete the form, sign, and FA to 1-844-23-312. For me, the side effects didn’t really bother me or have me second guess my decision with Dupixent because my skin was. 1-844-DUPIXENT (1-844-387-4936) Topicort (desoximetasone spray 0. I give supplemental injection training to the patient and the patient’s caregiver.