It temporarily provides eligible patients DUPIXENT at no cost, subject to program terms and conditions. Fill out sections 5a and 5b completely to determine patient eligibility. 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). This DUPIXENT Pre-filled Pen is a single-dose device. ) 2 Prescription InformationDupixent® (dupilumab) approved by FDA as the first and only treatment indicated for prurigo nodularis. BIN: 020750 RX PCN: NMeds RX GRP: PDFPDF ID: NMNA019309901930 This is a drug discount program, not an insurance plan. • Store DUPIXENT in the refrigerator at 36°F to 46°F (2°C to 8°C). For more information, call 1. • DUPIXENT can be stored at room temperature up to 77°F (25°C) up to 14 days. 28. If you’re the spouse or. It may be covered by your Medicare or insurance plan. Your cost may depend on your treatment plan, your insurance coverage (if you have it), and the pharmacy you use. DUPIXENT® (dupilumab) is a prescription medicine FDA-approved to treat five conditions. Dupixent MyWay Program CONTACT INFO: Address:, Phone: 1-844-387-4936: Provider Phone: Fax: 1-844-387-3970: Website: Program Website: ELIGIBILITY Eligibility Info:. 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). Maximum Monthly Gross Income. dupixent myway income guidelinesstellaris unbidden and war in heaven. 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. 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. Eligible patients will receive they cards by e-mail. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. Serious adverse reactions may. The doctor's office called to say I need to call to talk about my income and expenses. 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). In patients aged 6 months to 5 years, Dupixent is administered with a pre-filled syringe every four weeks based on weight (200 mg for children ≥5 to <15 kg and 300 mg for children ≥15 to <30 kg). DUPIXENT is a biologic and can help reduce your patients' use of systemic corticosteroids. Do you think that will hurt my chances of qualifying? I know my prescription drug costs are high enough. There is currently no generic alternative to Dupixent. You have to game the system instead of trying to get full coverage. Support. 02. 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. 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. 2 pens of 300mg/2ml. , 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. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. The average cash price for a 30-day supply of Dupixent is $5,298. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3 program consisting of two pivotal trials. 1kg to 18. 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). Coverage varies by. Fill a 90-Day Supply to Save. For more information, dial 1‑844‑DUPIXENT ( 1-844-387-4936 ), option 1 Monday-Friday, 8 am - 9 pm ET. Learn how DUPIXENT helped treat children 6 to 11 years old with their moderate-to-severe asthma. 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. 00 per injection. They pay the first $13K (in a year) then when that is exhausted I will have to pay around $250 per month and the $13K starts over in January 2019. 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. Refrigerate it at 36 °F to 46 °F. 22. _____ What is your total annual household income? _____ (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. DUPIXENT® (dupilumab) is taken as an injection by a pre-filled syringe or pre-filled pen. If you still have questions, you can speak with a DUPIXENT MyWay or request to join the program over the phone. 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. Last time I checked income didn’t matter? The only way it became affordable for me was to get the deluxe package of my insurance. Serious side effects can occur. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will notDUPIXENT MyWay may ask for proof of income at any time for the purpose of audit/verification. 78 L) was seen at Week 2 in patients taking DUPIXENT 200 mg Q2W + SOC (n=264) (baseline blood EOS ≥300 cells/μL, QUEST, secondary endpoint). About Dupixent. It may be covered by your Medicare or insurance plan. Dupixent MyWay Program Dupixent (dupilumab injection). I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. Dupixent. It was a process to get into the patient assist program. $3,645. 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. And I would experience blurry vision, red and itchy eyes. living with prurigo nodularis. Fill out sections 5a and 5b completely to determine patient eligibility. 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. Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. The patient would prefer not to try. What it is used for. Decreased utilization of rescue medications 3. 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. Assistance may be available for patients who do not have insurance. Patient Signature _____ If you have questions about the . Eligible patients covered by commercial health insurance may pay as little as a $0 p copay per fill of DUPIXENT. Some people do injections every 3 weeks, which could stretch that copay card out longer. United Healthcare covers it but I get insurance through my employer and it was a huge pain to get approved. Please note that you will receive a confirmation fax after sending the form. $0!!!!! On April 6 I sent them income paperwork and my year to date prescription invoices. Dupixent is not intended for episodic use. DUPIXENT MyWay is a patient support program that can help enable access to DUPIXENT and offers financial assistance for eligible patients, one-on-one nursing support, and more. And very recently got laid off due to Covid-19. How to fill out dupixent reimbursement: 01. ) I agree that Regeneron Pharmaceuticals, Inc. 67 mL, 200 mg/1. Nationally are Covered for 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. As far as choosing a better plan with a lower deductible, I don't really have much of a choice. 74 (2023), plus an amount based on how much you. After that, it is taken as 1 injection every 2 weeks or every 4 weeks, depending on your age and weight. Watch videos from experts [,download materials,] and explore future events to further understand DUPIXENT® (dupilumab). Serious side effects can occur. You don’t have to put your life on hold to fit your dosing schedule. 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. Sign it in a few clicks. I also have the dupixent myway card that covers a total of $13,000 for the year. DUPIXENT MyWay coordinators are available Monday-Friday 8 am to 9 pm ET. 2017;5 (6):1519-1531. J Allergy Clin Immunol Pract. It temporarily provides eligible patients DUPIXENT at no cost, subject to program terms and conditions. The patient must then take the following actions:I just got approved for dupixent this week however the copay is 3,000$ a month! The dupixent my way program only covers up to 13k or something like that. b Data as of January 2023. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. ago It is actually not a change in the myway program. Learn more about programs for eligible patients who are insured, underinsured, and uninsured. 67 mL, 200 mg/1. For more information, please call 1-844-DUPIXENT (1-844-387-4936) or visit got Dupixent MyWay copay assistance and they never asked one question about my income. 02. Sign it in a few clicks. The DUPIXENT MyWay team can research each patient’s situation and determine eligibility. It should only be given by an adult caregiver in children 6 to 11 years of age. The $500 payment counts towards the member’s deductible and out-of-pocket maximum. 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. 67 mL, 200 mg/1. 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. Your office may choose to use a preferred specialty pharmacy to start the benefits investigation. Required if enrolling in the DUPIXENT MyWay. Rx: DUPIXENT® (dupilumab) (100 mg/0. Sign up to connect with a DUPIXENT MyWay® mentor to help patients with Nasal Polyps through their DUPIXENT. Please see. DUPIXENT MyWay®. DUPIXENT MyWay. DUPIXENT can cause serious side effects, including: The most common side effects in patients with eczema include. Human IgG antibodies are known to cross the placental barrier; therefore, DUPIXENT may be transmitted from the mother to the developing fetus. Im so stressed out about. For me, the side effects didn’t really bother me or have me second guess my decision with Dupixent because my skin was. 23. Share your form with others. To contact DUPIXENT MyWay, please call 1-844-DUPIXENT (1-844-387-4936). DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. 03. Fill out sections 5a and 5b completely to determine patient eligibility. Patient assistance program. 58 for 2. Please see Important Safety Information and full PI on website. At this rate, I will no longer be able to afford the medication very soon. 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. Sign up for the DUPIXENT MyWay® mentor program for adults with uncontrolled chronic rhinosinusitis with nasal polyposis that is associated with type 2 inflammation. 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. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. I know people who make six figures on a joint income and still use MyWay. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. 23. ) Please refer to Section 8, Patient Certifications, for. Gather all necessary information and documents, such as your insurance information, prescription details, and any supporting documentation. Dupixent. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will notFor 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. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. LH Patient View; data through June 16, 2023. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. 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). First few months into taking Dupixent, I got laid off and worked w my doctors/Dupixent to get assistance. I’m Laurie. 14 mL, or 300 mg/2 mL)Section 5a. How much does Dupixent cost without insurance? The average monthly retail price of Dupixent is $4,910 per 2, 2 mL of 300 mg/2 mL prefilled syringes. 1kg over one year – the amount of weight gained ranged from 0. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. Long-term results from a clinical trial that studied DUPIXENT for 52 weeks. Get a Quick Start. 5. How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older with uncontrolled, moderate-to-severe. For more information, dial 1-844-DUPIXENT 1-844-387-4936 ), option 5, Monday-Friday, 9 am – 9 pm ET. 12. Decreased exacerbations and/or improvement in symptoms 2. The patient must then take the following actions:I just got approved for dupixent this week however the copay is 3,000$ a month! The dupixent my way program only covers up to 13k or something like that. DUPIXENT (dupilumab) Dupixent FEP Clinical Criteria AND submission of medical records (e. If you are a New York prescriber, please use an original New York State prescription form. If you don’t have health insurance, talk. 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. SIGN UP TO SPEAK WITH A DUPIXENT MyWay ® MENTOR . For patients with commercial insurance who are new to DUPIXENT and experiencing a. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. 8K subscribers in the eczeMABs community. The formulary status tool below can help check DUPIXENT coverage for various plans. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. Patient is responsible for any out-of-pocket amounts that exceed the program limit. 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. Monday-Friday, 8 am - 9 pm ETto DUPIXENT MyWay at 1-844-387-9370. for DUPIXENT® dupilumab therapy My Information. The appeal process Example letters. You may be able to lower your total cost by filling a greater quantity at one time. 01. DUPIXENT is a prescription medicine used as an add-on maintenance treatment for adults and children 6 years of age and older who have moderate-to-severe eosinophilic or oral steroid dependent asthma that is not controlled with their current asthma medicines. 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. Sign up or activate your card here. Needed additional leadership equipped the enrollment process? Contact your section accessories dedicated or call DUPIXENT MyWay. Each time you fill your DUPIXENT prescription, please ensure your. Serious side effects can occur. 03. If you still have questions, you can speak with a DUPIXENT MyWay representative or request to join the program over the phone. 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. Enroll now to receive emails and resources designed to help patients, caregivers and information seekers through the DUPIXENT® (dupilumab) treatment journey. LONG-LASTING CLEARER SKIN AT 16 and 52 Weeks 22% taking. For more information, please call 1-844-Dupixent (1-844-387-4936) or visit a personalized discussion guide to make the most of your doctor's visit whether you're beginning your EoE treatment journey or looking for another option. 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. 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. If I am completing Section 5b, I authorize for my commercially insured patient one. I wanted to go out and make a difference and help people. Human IgG antibodies are known to cross the placental barrier; therefore, DUPIXENT may be transmitted from the mother to the developing fetus. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. 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. 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. Income at or below: Not Published: Medical expenses can be deducted from reported income:. was not paid in whole or in part by Medicare, Medicaid, or any federal or state programs. $0 is the amount you pay. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. 4 ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pm01. If I am completing Section 5b, I authorize for my commercially insured patient one. 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. A case series of 12 people prescribed Dupixent reported an average weight gain of 6. Option 1- you have to meet your deductible without Dupixent myway. 89 and -1. It may be covered by your Medicare or insurance plan. Data on file, Regeneron Pharmaceuticals, Inc. It was granted and I pay $0. For more information or to enroll in the patient support program, contact us at: 1‑844‑DUPIXENT. _____ What is your total annual household income? _____ (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Select Condition Indication Moderate-to-Severe Eczema (Ages 6+ Months) Moderate-to-Severe Asthma (Ages 6+ Years) Chronic Rhinosinusitis with Nasal Polyposis (Ages 18+. 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. 58 for 1. Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. DUP. 67 mL, 200 mg/1. Depends if your insurance cares that Dupixent myway is paying your deductible. For more information, call 1-844-DUPIXENT ( 1-844-387-4936) option 1. 2 cartons. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. The most common side effects include: DUPIXENT MyWay. Serious adverse reactions may occur. It contains 300 mg of DUPIXENT for injection under the skin (subcutaneous injection). 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. If you are a New York prescriber, please use an original New York State prescription form. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not affect any disclosure of My Information based onto DUPIXENT MyWay at 1-844-387-9370. , chart notes, laboratory values) and use of claims history documenting the following: 1. That is good, because I was quoted 1400+ a month by my Medicare D provider. Sign up or activate your card here. 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. financial assistance for eligible patients, provide one-on-one nursing support, and more. Lancet. 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. 22. Program Website : Program Applications and FormsView the possible side effects of DUPIXENT in patients with uncontrolled chronic rhinosinusitis with nasal polyposis. For children aged 6 months to 5 years, it is taken as 1 injection every 4 weeks. 22. So, even with a "prior authorization" and a "formulary override", the cost to me is $2900 per month, or about $1450. . 00 copay. Please see accompanying full Prescribing Information. Compare . will need to meet the eligibility criteria, including household income, to qualify. for DUPIXENT® dupilumab therapy My Information. What it is used for. 17 and 0. The formulary status tool below can help check DUPIXENT coverage for various plans. DUPIXENT MyWay® can assist with: Verifying patient’s specific health plan coverage for DUPIXENT; Determining utilization management (UM) criteria; Identifying patient’s possible out-of-pocket responsibilities; Helping navigate any required prior authorization (PA) processes; Educating you and your patient about the appeals process if. 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). 2 cartons. any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. 23. 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. 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. S. Continuation in the DUPIXENT MyWay Patient Assistance Program is conditioned upon timely verification of income. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. 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. · If the insurer does have a copay accumulator in place: the insurer pays the entire cost of the refill except for $500. If you are a New York prescriber, please use an original New York. Eligible patients will receive their cards by email. Serious side effects can occur. 0156 Last Update: March 2023 DUP. Caring. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. For more information, call 1. S. LEARN ABOUT OUR PATIENT SUPPORT PROGRAM. Follow these tips to take DUPIXENT while traveling: Store DUPIXENT in the original carton to protect it from light. form on DUPIXENT. (DUPIXENT + Topical Corticosteroids (TCS) vs TCS only): CLEAR OR ALMOST CLEAR SKIN AT 16 Weeks 39% taking DUPIXENT + TCS vs 12% using TCS only. 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. How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. A program called Dupixent MyWay is available for this drug. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. I wanted to go out and make a difference and help people. The DUPIXENT MyWay patient support program is here to help you at every step of your DUPIXENT treatment journey. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. Support. Governed and delivered by Service Canada. Compare monoclonal antibodies. 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. ( 1-844-387-4936 ), option 1. 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 1‑844‑DUPIXENT 1-844-387-4936. 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. When I was very young, I knew that I wanted to be a nurse. I just spoke to someone through the MyWay Program. THE DUPIXENT MyWay PROGRAM. Edit your dupixent myway enrollment form online. Sanofi and Regeneron are committed to helping patients in the U. Well at a cost of roughly $3,500/dose which lasts a month, that will all be used up in four months. Your insurance has to deny twice and then you can apply for patient assistance. financial assistance for eligible patients, provide one-on-one nursing. 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 just started this week so I look forward to seeing the results. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. Hello! Switching insurance this year and need to prepare for increasing costs of dupixent with my new insurance. They never mentioned only covering a. ) I agree that Regeneron Pharmaceuticals, Inc. Rx: DUPIXENT® (dupilumab) (100 mg/0. 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. 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. 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. Talk one-on-one live with a dedicated Dupixent MyWay Case Manager. 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. It's like $35k-$40k. 01. So the nurse told me to fax receipts for year to date prescriptions and last year's income forms (W2, 1099, etc). Rx: DUPIXENT® (dupilumab) (100 mg/0. Regeneron and Sanofi are committed to helping patients in the U. 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. 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® (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. 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. S. DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older, with uncontrolled, moderate-to-severe eczema (atopic dermatitis). Ways to save on Dupixent. Dupixent Myway . 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. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. Injection Support Center Injection Reminders and Tips FREQUENTLY ASKED QUESTIONS; Español. 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. It took the price from 2K to 1K. Box 5925 Mailstop 55A-220A Bridgewater, NJ 08807. S. The Dupixent MyWay program is not available to medicare patients. Approximately 72% of the total FEV 1 improvement (470 mL improvement at Week 52 from baseline FEV 1 of 1. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. Household Income. ®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. Also if your insurance does cover,Dupixent offers a co-pay card that. 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. 34 milliliters 200 mg/1. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. 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. Rx: DUPIXENT® (dupilumab) (100 mg/0. 3. They will begin the benefits investigation and inform your office of the next steps. 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 ALLERGISTSyou are supposed to get a copay savings card from dupixent myway. 71 for Dupixent compared to 0. For more information, please call 1-844-DUPIXENT (1-844-387-4936) or visit . 80). Just got off the phone with Dupixent My Way. Dupixent will run about $3000 per month with my insurance until my maximum is met. Please see Important Safety Information and Patient Information on. Check your eligibility for the DUPIXENT MyWay® Copay Card that may help cover the out-of-pocket cost of DUPIXENT® (dupilumab) for eligible patients. My doctor gave me a copay card to cover mine. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. chevron_right. Some Medicare plans may help cover the cost of mail-order drugs. And, if you're eligible, you can sign up and receive your card today. If you don't have insurance at all, the only realistic option is to qualify for income-based help from Dupixent directly. 00, but I do have some money invested. - Rachel, DUPIXENT Patient Mentor, living with asthma. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. Serious side effects can occur.