Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not affect any disclosure of My Information based on this Authorization made before my request is received and processed by my Healthcare Providers, Health Insurers,DUPIXENT has been prescribed to over 50,000 uncontrolled nasal polyp patients and counting! DUPIXENT is the first biologic nasal polyp treatment that’s an alternative to nasal polyp surgery. 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. 14 mL, or 300 mg/2 mL)Call 1-844-387-4936, Option 1 to contact DUPIXENT MyWay ®. 2 cartons. Assistance may be available for patients who do not have insurance. Copay Card or you wish to discontinue your participation, please contact us. Dupixent inhibits the overactive signaling of interleukin-4 (IL-4) and. March 27, 2018. 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. 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. 23. XXXX 00/0000 b y: A B C c o m pa n y, I n c. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. DUPIXENT can be used with or without topical corticosteroids. The DUPIXENT MyWay team will research each patient’s situation and determine eligibility. 2 cartons. SINCE 2017, ≈253,000 PATIENTS HAVE FILLED AT LEAST 1 DUPIXENT PRESCRIPTION b,c. Denied because of 2022 income threshold for household of two. ) Please refer to Section 8, Patient Certifications, for. . Household Income. Clip the card and save • Save up to 80% on medications* Tell your healthcare provider about any new or worsening joint symptoms. Want to be a part of the DUPIXENT MyWay® Ambassador Program? Fill out this self-nomination form to see if you qualify. Household Size. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. *For patients on DUPIXENT 300 mg in a 24-week and a 52-week clinical trial vs 17% for placebo group. Im so stressed out about. _____ What is your total annual household income? _____ (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. for DUPIXENT® dupilumab therapy My Information. (2 of 3) Patient signature/Legal representative if patient is <18 years Date Section 2. DUPIXENT use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Patient and Co-pay Assistance: DUPIXENT MyWay helps eligible patients get access to therapy whether they are uninsured, lack. 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. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. Learn about the DUPIXENT® (dupilumab) mechanism of action inhibiting IL-4 and IL-13 signaling in appropriate asthma patients. Some people do injections every 3 weeks, which could stretch that copay card out longer. 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. Advertisement. 01. Those who may qualify must be at least 18 years of age or older, a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam, or the USVI, and demonstrate a. You may be able to lower your total cost by filling a greater quantity at one time. A program called Dupixent MyWay is available for this drug. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. For more information, dial 1-844-DUPIXENT 1-844-387-4936 ), option 5, Monday-Friday, 9 am – 9 pm ET. a ®® ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pm600 mg (two 300 mg injections) 300 mg Q4W : 30 to less than 60 kg ; 400 mg (two 200 mg injections) 200 mg Q2W : 60 kg or more : 600 mg (two 300 mg injections)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. Injection site reactions and eye conditions are the most common side effects reported and, unlike several other biologics, the risk of infection is low. Since 2017, Dupixent has increased in price by 13%. 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 and Co-pay Assistance: DUPIXENT MyWay helps eligible patients get access to therapy whether they are uninsured, lack coverage, or need assistance with their out-of. 3. Dupixent is an injection under the skin (subcutaneous injection) at different injection sites. a $85. 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. To contact DUPIXENT MyWay, please call 1-844-DUPIXENT (1-844-387-4936). At one point, I was getting cold sores every 2 to 3 weeks consistently. At this rate, I will no longer be able to afford the medication very soon. Maybe try that while waiting for the Dupixent. Dupixent is not intended for episodic use. The average cash price for a 30-day supply of Dupixent is $5,298. With and DUPIXENT MyWay Copay Card, eligible, commercially insured care may pay when little as $0* copay by fill the DUPIXENT. 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. I’m Laurie. 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® is a patient support program that can help with the enrollment process, offer. I understand that. 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. 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). 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. Fill out the form accurately and completely, providing all. I don't know what medical issues your son is having, but it's likey autoimmune issues. Please see Important Safety Information and full PI on website. Ways to save on Dupixent. S. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Dupixent is not intended for episodic use. any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. form on DUPIXENT. For any questions or concerns, or to report side effects with a Sanofi and Regeneron product while enrolled in DUPIXENT MyWay®, please contact 1-844-DUPIXEN(T) (1-844-387-4936) Option 1, Monday–Friday, 8 am–9 pm Eastern time. Patients in each age group saw improved lung function in as little as 2 weeks. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. 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. 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). 67 mL, 200 mg/1. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. 12. It’s a change in how copay assistance and coupons are counted toward your. Dupixent will run about $3000 per month with my insurance until my maximum is met. If I am completing Section 5b, I authorize for my commercially insured patient one. If you still have questions, you can speak with a DUPIXENT MyWay representative or request to join the program over the phone. LEARN ABOUT OUR PATIENT SUPPORT PROGRAM. Prurigo Nodularis: The most common adverse reactions (incidence ≥2%) are nasopharyngitis, conjunctivitis, herpes infection, dizziness, myalgia, and diarrhea. 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. Option 1- you have to meet your deductible without Dupixent myway. 0254 Last Update: February 2023 DUP. There is currently no generic alternative to Dupixent. It may be covered by your Medicare or insurance plan. 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. Since 2018, DUPIXENT has been prescribed to over 100,000 asthma patients in the US. Section 5a. -The MyWay forms themselves changed to a new revision and had to be resubmitted by my doctor -The revised new form needed me to resign then over the phone. DUPIXENT should not be stored above 77 °F (25 °C). DUPIXENT use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Sign up or activate your card here. A program called Dupixent MyWay is available for this drug. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. Fill a 90-Day Supply to Save. I just spoke to someone through the MyWay Program. Sign up or activate your card here. Susie16 Aug 29, 2023 • 2:03 AM. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. Patients may be eligible for the DUPIXENT MyWay Copay Card if: They have a DUPIXENT prescription for an FDA-approved condition. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. 0129 Last Update:. 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. DUPIXENT MyWay. 50 for a single person. So, how can you save? Manufacturer Sanofi offers Dupixent MyWay, a patient support program. 1 Reactions. S. DUPIXENT® (dupilumab) is a prescription medicine FDA-approved to treat five conditions. Not valid for prescriptions paid, in whole or in part, by Medicaid, Medicare, VA, DOD, TRICARE, or. Serious side effects can occur. financial assistance for eligible patients, provide one-on-one nursing support, and more. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. com. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will notOnce you’ve been prescribed DUPIXENT, your healthcare provider can download the enrollment form, help you fill it out, and fax it back to DUPIXENT MyWay at 1-844-387-9370. If you’re the spouse or. Human IgG antibodies are known to cross the placental barrier; therefore, DUPIXENT may be transmitted from the mother to the developing fetus. $0!!!!! On April 6 I sent them income paperwork and my year to date prescription invoices. 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. I’ve been with DUPIXENT MyWay since the very beginning. For patients with commercial insurance who are new to DUPIXENT and experiencing a. 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;. 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. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. Get emergency medical help if you have signs of an allergic reaction to Dupixent: hives, rash, itching; fever, swollen glands, joint pain; feeling light-headed, difficult breathing; swelling of your face, lips, tongue, or throat. 1‑844‑DUPIXENT 1-844-387-4936. DUPIXENT® (dupilumab) Prescription Information Quick Start may be able to provide DUPIXENT at no cost to help bridge patients to therapy if there is a coverage delay. I have read and agree to the Income Verification included in Section 8 on page 5. Data on file, Regeneron Pharmaceuticals, Inc. Use DUPIXENT exactly as prescribed by your doctor. Rx: DUPIXENT® (dupilumab) (100 mg/0. 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. DUPIXENT is taken by injection under the skin (subcutaneous injection) once every two weeks. Effective Sept. We just need you to answer a few questions to verify your eligibility and contact information. DUPIXENT can be used with or without topical corticosteroids. With the DUPIXENT MyWay Copay Card, eligible,. Susie16 Oct 15, 2023 • 9:37 PM. TEL: 844. , Sanofi US, and their affiliates and agents (together, the “Alliance”) may verifyDUPIXENT MyWay Nurse Educators are trained to help provide patients with supplemental injection training either online, over the phone, or in person with a training kit and practice syringe or practice pen. 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. 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. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. 0252 Last Update: Feb 2023 DUP. Eligible clients will receive their cards by email. Human IgG antibodies are known to cross the placental barrier; therefore, DUPIXENT may be transmitted from the mother to the developing fetus. For more information, call 1-844-DUPIXENT. g. Please see accompanying full Prescribing Information. If you are a New York prescriber, please use an original New York State. I wanted to go out and make a difference and help people. 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 prescription for DUPIXENT may pay as little as $0 copay per fill of DUPIXENT (annual maximum of $13,000). It was granted and I pay $0. Over 80% of insurance plans cover Dupixent, but many have restrictions. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. Eligible patients covered by commercial health insurance may pay as little as a $0 p copay per fill of DUPIXENT. Check the liquid in the prefilled pen or syringe. After removal from the refrigerator, DUPIXENT must be used within 14 days or discarded. 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. Eligible patients will receive their cards by email. Your doctor will tell you how much DUPIXENT to inject and how often to inject it. On dupixent, Dupilumab, I honestly felt I was in my 60 to 70s+ with joint pains throughout my entire body even into the smallest of joints like fingers. Página de inicio de franquicias ; Eczema moderado a grave (6 meses de edad o más) Asma moderada a grave (6 años de edad o más) DUPIXENT Pricing Information For Healthcare Professionals. Fill out sections 5a and 5b completely to determine patient eligibility. Refrigerate it at 36 °F to 46 °F. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. living with prurigo nodularis are most in need of new treatment options . 23. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. ago. A 48-year-old man developed left thumb tenderness and bilateral Achilles tendinopathy after 6 weeks of Dupixent. Learn why DUPIXENT® (dupilumab) may be an. Dupixent is indicated for the following type 2 inflammatory diseases:,Atopic Dermatitis,Adults and adolescents,Dupixent is indicated for the treatment of moderate to severe atopic dermatitis in patients aged 12 years and older who are candidates for chronic systemic therapy. Johns Hopkins EHP i think goes with cigna and CVS Specialty pharmacy covers. • DUPIXENT can be stored at room temperature up to 77°F (25°C) up to 14 days. Select Condition Indication Moderate-to-Severe Eczema (Ages 6+ Months) Moderate-to-Severe Asthma (Ages 6+ Years) Chronic Rhinosinusitis with Nasal Polyposis (Ages 18+. 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. 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. 01. 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. 1. Appears that my out of pocket maximum will be $8000 through insurance. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. 26 [95% CI: 0. Ways to save on Dupixent. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. and other countries to treat several diseases driven by type 2 inflammation. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. 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. Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. 0185 Last Update: November 2022 DUP. Learn how DUPIXENT helped treat children 6 to 11 years old with their moderate-to-severe asthma. If you don’t have health insurance, talk. To enroll or obtain information call 1-877-311. 0kg. 1,000-125=875 $875 is the amount your health insurance pays. Guam or the USVI, and demonstrate a financial need with a total annual adjusted gross income of $100,000 or less. For children aged 6 months to 5 years, it is taken as 1 injection every 4 weeks. Box 5925 Mailstop 55A-220A Bridgewater, NJ 08807. The doctor's office called to say I need to call to talk about my income and expenses. Each time you fill your DUPIXENT prescription, please ensure your. Check your eligibility for the DUPIXENT MyWay® Copay Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. These programs and tips can help make your prescription more affordable. 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. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. 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. Dupixent MyWay pays the $500 copay. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. You may be eligibility on the DUPIXENT MyWay Copay Card if you:DUPIXENT MyWay Copay Card if you:Dupixent® should be given by or under the supervision of an adult in children 12 years of age and older. a,b a Data on file, Sanofi and Regeneron, US. Decreased utilization of rescue medications 3. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. 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. 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). Please see. 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. 0254 Last Update: February 2023 DUP. 01. 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. The fax number is 1. 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. _____ What is your total annual household income? _____ (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. DUP. 12. For more information, please call 1-844-DUPIXENT (1-844-387-4936) or visit . S. 67 mL, 200 mg/1. There is currently no generic alternative to Dupixent. 89 and -1. 98% of Commercially Insured Patients. If you don't have insurance at all, the only realistic option is to qualify for income-based help from Dupixent directly. According to the manufacturers, Dupixent can be dosed to a maximum daily dose as indicated below. You may be able to get a 90-day supply of Dupixent. Support. How to fill out dupixent reimbursement: 01. Get ongoing, personalized nursing support; help scheduling monthly prescription refills and deliveries; and in-home, in-office, or online supplemental injection training. Appears that my out of pocket maximum will be $8000 through insurance. Eligible patients will receive they cards by e-mail. ®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. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. It was a process to get into the patient assist program. Most do, some don't. Tips. Assistance may be available for patients who do not have insurance. -The original form (from the first guy) was still in the system and the folks at MyWay were “confused” by it. After that, it is taken as 1 injection every 2 weeks or every 4 weeks, depending on your age and weight. 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. Patient Assistance Program. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. 00. In clinical trials, DUPIXENT reduced the. For more information, call 1-844-DUPIXEN (T) (1-844-387-4936. Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. If you are a New York prescriber, please use an original New York. Especially tell your healthcare provider if you. 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. Nurse Educators Nurse Educators offer one-on-one support to help patients start and stay on track with therapy. 8K subscribers in the eczeMABs community. 71 for Dupixent compared to 0. Program Website : Patient Assistance Applicationsfor DUPIXENT® dupilumab therapy My Information. I know people who make six figures on a joint income and still use MyWay. Opinions clash over private equity’s effect on dermatology. 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). For more information, dial 1‑844‑DUPIXENT ( 1-844-387-4936 ), option 1 Monday-Friday, 8 am - 9 pm ET. Do not store DUPIXENT pre-filled syringes at room temperatures more than 77°F (25°C) Do not keep DUPIXENT at room temperature. Learn how DUPIXENT® (dupilumab) works as the first and only FDA-approved treatment for prurigo nodularis (PN) in adults aged 18 years and older. The DUPIXENT MyWay patient support program is here to help you at every step of your DUPIXENT treatment journey. There is currently no generic alternative to Dupixent. Deductible is at $3k out of pocket insurance pays 80% and at $6k insurance pays 100%. My wife is on Dupixent, and has the MyWay card which allows up to $13,000/year. I just got approved thru Dupixent my way for a year of free medication. chevron_right. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. - Rachel, DUPIXENT Patient Mentor, living with asthma. DUPIXENT MyWay. Watch videos for a supplemental demonstration on how to use and dispose of DUPIXENT® (dupilumab), a prescription medicine for subcutaneous injection. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. For more information, dial 1‑844‑DUPIXENT( 1-844-387-4936 ), option 1. DUPIXENT is not a steroid or immunosuppressant; it is a prescription biologic medicine given under the skin (subcutaneous injection). The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Dupixent. So, let's just pretend the total cost is $1,000/month. b New adult and pediatric patients aged 6 years and older with moderate-to-severeSection 5a. My doctor gave me a copay card to cover mine. Please see Important Safety Information and Prescribing Information and Patient Information on website. how to afford it then - it's been so helpful!! 3 Reactions. Rx: DUPIXENT® (dupilumab) (100 mg/0. DUPIXENT MyWay®. 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. 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 assistance program. ) Please refer to Section 8, Patient Certifications, for. 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. In SINUS-24 and SINUS-52, 74% fewer patients required SCS use at Week 52 with DUPIXENT 300 mg Q2W + INCS compared to placebo + INCS (HR: 0. For more information, dial 1. 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 formulary status tool below can help check DUPIXENT coverage for various plans. That is what I am in the middle of. My income is only 30000. Guam or the USVI, and demonstrate a financial need with a total annual adjusted gross income of $100,000 or less. How many people live in your household? _____ Please refer to Section 8, Patient Certifications , for. 23. 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. 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. Pay as little as $0 per month. A 68-year-old woman developed generalized joint pain 6 weeks after starting Dupixent. If you have an adjusted net income or adjusted household net income between $30,000 and $32,000, you may receive a reduced supplement amount. Program Website : Program Applications and Forms will need to meet the eligibility criteria, including household income, to qualify. 67 mL, 200 mg/1. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. 67 mL, 200 mg/1. $125 is the amount Dupixent assistance pays. S. J Allergy Clin Immunol Pract. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will notEnrollment 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. a Coverage varies by type and plan. 99% of commercial patients (6+ months of age) nationally are covered for DUPIXENT. Patient to Fill Out. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. 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. For assistance, please call 1-844-468-2252 Monday Friday, 8AM to 8PM ET. 14 mL, or 300 mg/2 mL)Section 5a. 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. living with prurigo nodularis. for DUPIXENT® dupilumab therapy My Information. You can email or print the enrollment forms below. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. Patient is responsible for any out-of-pocket amounts that exceed the program limit. 14 mL, or 300 mg/2 mL)My insurance provider covers 85% and our Canadian version of 'MyWay' pays the remainder. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. I suppose it doesn't really matter now. Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. If you are a New York prescriber, please use an original New York State prescription form. 2 Eligible US residents with an FDA-approved. Serious side effects can occur. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. Dupixent is an injection that is usually given under the skin every other week for the treatment of asthma, eczema, and some other inflammatory conditions. 1kg to 18. DUPIXENT MyWay®. 0252 Last Update: Feb 2023 DUP. The majority of DUPIXENT patients with commercial/employer-provided insurance use the DUPIXENT MyWay ® Copay Card.