Share your form with others. For more information, please call 1-844-DUPIXENT (1-844-387-4936) or visit . Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. 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® A program to provide support to patients starting DUPIXENT. 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. 67 mL, 200 mg/1. I'm "only" 61 now though on Dupixent MyWay copay help. S. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. Robocalls increase diabetic retinopathy screenings in low-income patients. LEARN ABOUT OUR PATIENT SUPPORT PROGRAM. 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. Got off of it as soon as I realized it was getting worse with every shot after spacing them out every other month. 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. FUN Documents, MMIT, and Policy Reporter as of July 12, 2023. Effective Sept. 4. Fill a 90-Day Supply to Save. For more information, dial 1‑844‑DUPIXENT 1-844-387-4936 Monday-Friday, 8 am-9 pm ET. ) 2 Prescription InformationDUPIXENT is not a steroid. 00 per injection. 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. 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. Regeneron and Sanofi are committed to helping patients in the U. $3,645. How many people live in your household? _____ Please refer to. 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. was not paid in whole or in part by Medicare, Medicaid, or any federal or state programs. 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. 00 per injection. DUPIXENT® (dupilumab) is a. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. If you don't have insurance at all, the only realistic option is to qualify for income-based help from Dupixent directly. 67 mL Dupixent subcutaneous solution from $3,787. living with prurigo nodularis. Each time you fill your DUPIXENT prescription, please ensure your. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. 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. Please see Important Safety Information and Prescribing Information and Patient Information on website. financial assistance for eligible patients, provide one-on-one nursing support, and more. Also, make sure to store the DUPIXENT MyWay phone number in your phone’s contacts so you. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. 23. 1. 14 mL, or 300 mg/2 mL)Call 1-844-387-4936, Option 1 to contact DUPIXENT MyWay ®. 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. 14 mL Dupixent subcutaneous solution from $3,787. Fill out sections 5a and 5b completely to determine patient eligibility. The majority of DUPIXENT patients with commercial/employer-provided insurance use the DUPIXENT MyWay ® Copay Card. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. “Eczema otherwise unspecified” is not indicated for Dupixent. 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. 0185 Last Update: November 2022 DUP. 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. The doctor's office called to say I need to call to talk about my income and expenses. For more information, call 1-844-DUPIXENT ( 1-844-387-4936) option 1. LASTING CHANGE IS ACHIEVABLE. Please see accompanying full Prescribing Information. 22. A 68-year-old woman developed generalized joint pain 6 weeks after starting Dupixent. Human IgG antibodies are known to cross the placental barrier; therefore, DUPIXENT may be transmitted from the mother to the developing fetus. It's like $35k-$40k. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. Dupixent MyWay Program CONTACT INFO: Address:, Phone: 1-844-387-4936: Provider Phone: Fax: 1-844-387-3970: Website: Program Website: ELIGIBILITY Eligibility Info:. Nationally are Covered for DUPIXENT. The fax number is 1. 1-844-DUPIXENT (1-844-387-4936) Topicort (desoximetasone spray 0. My wife is on Dupixent, and has the MyWay card which allows up to $13,000/year. DUPIXENT . 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 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. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. 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. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Gather all necessary information and documents, such as your insurance information, prescription details, and any supporting documentation. In clinical trials, the impact of DUPIXENT on lung function was studied in patients 6 to 11 years of age and patients 12 years of age and older. Eligible patients will receive their cards by email. ) Please refer to Section 8, Patient Certifications, for. Dupixent is administered as an injection under the skin (subcutaneous injection) at different injection sites. DUPIXENT can cause serious side effects, including: The most common side effects in patients with eczema include. For patients with commercial insurance who are new to DUPIXENT and experiencing a. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. Fill out sections 5a and 5b completely to determine patient eligibility. I knocked out the first copay out of pocket and went on the manufacturer website and applied for the dupixent my way card. 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). Nurse Educators Nurse Educators offer one-on-one support to help patients start and stay on track with therapy. They will begin the benefits investigation and inform your office of the next steps. After that, it is taken as 1 injection every 2 weeks or every 4 weeks, depending on your age and weight. Program possessed one annual maximum from $13,000. What it is used for. ) Please refer to Section 8, Patient Certifications, for. 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. If you are moderate to low-income person with eczema or just need help paying for your health care or prescription costs, you’ve come to the right place. 2022;400 (10356):908-919. 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 otherThis DUPIXENT Pre-filled Pen is only for use in adults and children aged 2 years and older. Dupixent is an injection under the skin (subcutaneous injection) at different injection sites. 0254 Last Update: February 2023 DUP. Check the liquid in the prefilled pen or syringe. Applies to: Dupixent Number of uses: per prescription per year. A quantity of Dupixent will be considered medically necessary if the above criteria are met, as indicated in the table below:. Clip the card and save • Save up to 80% on medications* Tell your healthcare provider about any new or worsening joint symptoms. 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. b Data as of January 2023. DUPIXENT MyWay ENROLLMENT FORMS; English Enrollment Form. Does anyone know the eligibility process for the dupixent copay assistance? Do they ask for tax forms? Is there an income limit? comments sorted by Best Top New Controversial Q&A Add a Comment More posts you may like. The DUPIXENT MyWay team will research each patient's situation and determine eligibility. Over 80% of insurance plans cover Dupixent, but many have restrictions. 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. If you have any additional questions about this pricing information, please call DUPIXENT MyWay at 1-844-DUPIXENT (1-844-387-4936). The DUPIXENT MyWay patient support program is here to help you at every step of your DUPIXENT treatment journey. Pregnancy: A pregnancy exposure registry monitors pregnancy outcomes in women exposed to DUPIXENT during pregnancy. 18, 0. Pay as little as $0 per month. Quantity Limits: Dupixent: 200 mg/1. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. for reimbursement to any payer, including Medicare and Medicaid; and no free product may be sold, traded, or distributed for sale. Section 5a. ( 1-844-387-4936 ), option 1. DUPIXENT was studied in adults and children 6 months of age and older. 1kg over one year – the amount of weight gained ranged from 0. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. Decreased utilization of rescue medications 3. 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. 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). You can email or print the enrollment forms below. So, even with a "prior authorization" and a "formulary override", the cost to me is $2900 per month, or about $1450. ENROLLMENT FORMDUPIXENT is a form of medicine called a biologic that targets Type 2 inflammation, an underlying cause of nasal polyps. financial assistance for eligible patients, provide one-on-one nursing support, and more. 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. Learn about DUPIXENT® (dupilumab) for moderate-to-severe asthma treatment. 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. Fill out sections 5a and 5b completely to determine patient eligibility. For more information, please call 1-844-DUPIXENT (1-844-387-4936) or visit . So, how can you save? Manufacturer Sanofi offers Dupixent MyWay, a patient support program. Compare . 0156 Past Update: March 2023 DUP. March 27, 2018. 67 mL, 200 mg/1. S. ®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. 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. 01. 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. Learn how DUPIXENT® (dupilumab) works as the first and only FDA-approved treatment for prurigo nodularis (PN) in adults aged 18 years and older. with household income, to qualify. 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 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. 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. It still covers the same amount. · If the insurer does have a copay accumulator in place: the insurer pays the entire cost of the refill except for $500. A group of skin conditions characterized by skin inflammation, rash, and itch. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. DUPIXENT® (dupilumab), in moderate-to-severe asthma treatment, is taken as an injection by a pre-filled syringe or pre-filled pen, review both options here. How many people live in your household? _____ Please refer to. 89 and -1. It took the price from 2K to 1K. DUPIXENT use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Patients in each age group saw improved lung function in as little as 2 weeks. The $500 payment counts towards the member’s deductible and out-of-pocket maximum. 01. Dupixent is not intended for episodic use. Note: All information is required unless otherwise indicated. If you don’t have health insurance, talk. Food and Drug Administration has approved Dupixent ® (dupilumab) as an add-on maintenance therapy in patients with moderate-to-severe asthma aged 12 years and older with an eosinophilic phenotype or with oral corticosteroid-dependent asthma. 1-844-387-4936 (toll free) Monday - Friday, 8AM - 9PM (ET) Multilingual options available. - Rachel, DUPIXENT Patient Mentor, living with asthma. 5. 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. 2 pens of 300mg/2ml. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. Dupixent® should be given by or under the supervision of an adult in children 12 years of age and older. Learn about the DUPIXENT® (dupilumab) mechanism of action inhibiting IL-4 and IL-13 signaling in appropriate asthma patients. Coverage varies by. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. Serious side effects can occur. DUPIXENT use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. Eligible patients will receive their cards by email. 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. 98% of Commercially Insured Patients. 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. 22. b New adult and pediatric patients aged 6 years and older with moderate-to-severeSection 5a. 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) Education and Nurse Support: One-on-one nursing support is available to educate and empower patients to use DUPIXENT as prescribed. 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. They never mentioned only covering a. 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. DUPIXENT® (dupilumab) is a. Serious side effects can occur. 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. 38]). 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. 14 ml, 300 mg/2 ml: Asthma, atopic dermatitis: 3 syringes for the first 28 days. Assistance may be available for patients who do not have insurance. Section 5a. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. DUPIXENT® (dupilumab) is indicated as an add-on maintenance treatment in adult patients with inadequately controlled chronic rhinosinusitis with nasal polyposis (CRSwNP). The specialty pharmacy is responsible for securing coverage on my patient’s behalf. 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. DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older, with uncontrolled, moderate-to-severe eczema (atopic dermatitis). Dupixent MyWay Program Dupixent (dupilumab injection). 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. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Serious adverse reactions may occur. you offering to give them $170 they assumed you didn’t want to bother contacting dupixent myway. . Use DUPIXENT exactly as prescribed by your doctor. Since 2017, Dupixent has increased in price by 13%. Human IgG antibodies are known to cross the placental barrier; therefore, DUPIXENT may be transmitted from the mother to the developing fetus. for DUPIXENT® dupilumab therapy My Information. for DUPIXENT® dupilumab therapy My Information. 71 for Dupixent compared to 0. 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. I give supplemental injection training to the patient and the patient’s caregiver. 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. 03. Hear real patients stories of life with uncontrolled moderate-to-severe asthma and how discovering DUPIXENT® (dupilumab) impacted their journey. , 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. Additionally, Dupixent MyWay ™ offers personalized support from registered nurses and other specialists who are available 24/7 to speak with patients and help them navigate the complex insurance. Dupixent. Your healthcare provider may stop DUPIXENT if you develop joint symptoms. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT (maximum of $13,000 per patient per calendar year) if they meet the eligibility requirements, including: Have commercial insurance, including health insurance exchanges, federal employee plans, or state employee plans DUPIXENT MyWay is a patient support program that can help enable access to DUPIXENT and offers financial assistance to eligible patients, one-on-one nursing support, and more. Approximately 72% of the total FEV 1 improvement (470 mL improvement at Week 52 from baseline FEV 1 of 1. The formulary status tool below can help check DUPIXENT coverage for various plans. Experience: Been on Dupixent since May 15, 2017. Withdrawal of this Authorization will end my participation in the DUPIXENT MyWay Program and will not ENROLL. 74 (2023), plus an amount based on how much you. 03. 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. 4 ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pm01. 12. I was given the MyWay copay card but it had a limit of $13,000/calendar year and that has been exhausted at this point. chevron_right. Need additional guidance with the enrollment process? Call DUPIXENT MyWay at 1-844-387-4936 Monday through Friday, 8 am to 9 pm Eastern Time. Serious side effects can occur. Patient to Fill Out. Continuation in the program is conditioned upon timely verification of income. Get your personalized discussion guide to help yourself have a productive conversation with your doctor & see if DUPIXENT® (dupilumab) for uncontrolled moderate-to-severe atopic dermatitis is right for you. It may be covered by your Medicare or insurance plan. I've been on Dupixent for over 2 years now and it has been such a great experience keeping my eczema under control. DUPIXENT MyWay® Program Taking Dupixent. 22. Sign up or activate your card here. DUPIXENT® (dupilumab) is a subcutaneous injectable medication used in the treatment of patients aged 6 years and older with uncontrolled moderate-to-severe atopic dermatitis with two delivery options available, pre-filled syringe & pre-filled pen (aged 12+ years). To enroll or obtain information call 1-877-311. Patient has been compliant on Dupixent therapy 4. I give supplemental injection training to the patient and the patient’s caregiver. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. The patient must then take the following actions:I just got approved for dupixent this week however the copay is 3,000$ a month! The dupixent my way program only covers up to 13k or something like that. Children 6 to 11 years of age . I’m Laurie. Support. Patient Signature _____ If you have questions about the . Please see. 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 . Household Size. 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. For more information, call 1-844-DUPIXENT ( 1-844-387-4936) option 1. J Allergy Clin Immunol Pract. Serious side effects can occur. S. With and DUPIXENT MyWay Copay Card, eligible, commercially insured care may pay when little as $0* copay by fill the DUPIXENT. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. The majority of DUPIXENT patients with commercial/employer-provided insurance use the DUPIXENT MyWay ® Copay Card. who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay ® program. So, how can you save? Manufacturer Sanofi offers Dupixent MyWay, a patient support program. 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. DUPIXENT® and DUPIXENT MyWay® are entered commercial of Sanofi Biotechnological. For more information or to enroll in the patient support program, contact us at: 1‑844‑DUPIXENT. 17 and 0. If you are a New York prescriber, please use an original New York State. Susie16 Aug 29, 2023 • 2:03 AM. 12. The most common side effects include: DUPIXENT MyWay. 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. Deductible is at $3k out of pocket insurance pays 80% and at $6k insurance pays 100%. DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. 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. For children aged 6 months to 5 years, it is taken as 1 injection every 4 weeks. THE DUPIXENT MyWay PROGRAM. It contains 300 mg of DUPIXENT for injection under the skin (subcutaneous injection). 01. _____ What is your total annual household income? _____ (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. 00. 00 copay. • DUPIXENT can be stored at room temperature up to 77°F (25°C) up to 14 days. 01. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3 program consisting of two pivotal trials. Ways to save on Dupixent. How to fill out dupixent reimbursement: 01. Fill out sections 5a and 5b completely to determine patient eligibility. 17 and 0. 67 mL, 200 mg/1. A program called Dupixent MyWay is available for this drug. 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. Tell your healthcare provider about any new or worsening joint symptoms. how to afford it then - it's been so helpful!! 3 Reactions. There is another biologic very similar to Dupixent called Adbry. Patient assistance program. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. As far as choosing a better plan with a lower deductible, I don't really have much of a choice. Step One - let's gather our materials. Depends if your insurance cares that Dupixent myway is paying your deductible. Patient is responsible for any out-of-pocket amounts that exceed the program limit. 3. 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). a Coverage varies by type and plan. Griffinej5 • 2 yr. 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. “It’s an incredible feeling to be validated and. 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). The specialty pharmacy is responsible for securing coverage on my patient’s behalf. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. . Eligible clients will receive their cards by email. • Store DUPIXENT in the refrigerator at 36°F to 46°F (2°C to 8°C). 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. How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. Learn more about programs for eligible patients who are insured, underinsured, and uninsured. Sign up for the DUPIXENT MyWay® mentor program for adults with uncontrolled chronic rhinosinusitis with nasal polyposis that is associated with type 2 inflammation. TEL: 844-387-4936 FAX: 844-387-9370: Languages Spoken: English, Spanish, Others By Translation Service. 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. 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 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. Lancet. 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. 0156 Last Update: March 2023 DUP. 2. Dupixent (dupilamab) Dupixent MyWay patient support program. Type text, add images, blackout confidential details, add comments, highlights and more. Compare . You must also meet certain household income eligibility requirements as outlined below: 48 States and DC. Household Income. Dupixent is an injection under the skin (subcutaneous injection) at different injection sites. If you don't have insurance at all, the only realistic option is to qualify for income-based help from Dupixent directly. DUPIXENT® (dupilumab) 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. 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. With the DUPIXENT MyWay Copay Card, eligible,. Monday-Friday, 8 am - 9 pm ETto DUPIXENT MyWay at 1-844-387-9370. Dedicated Dupixent MyWay Case Managers can explain information related to Dupixent. Dupixent side effects. 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. 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. Ready to connect with actual patients and caregivers being treated with DUPIXENT? The DUPIXENT MyWay Mentor Program helps put current and prospective moderate-to-severe eczema (atopic dermatitis or AD) DUPIXENT patients in contact with people going through similar. 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 Copay Card. 01. Serious side effects can occur. 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. Sign up or activate your card here. There is currently no generic alternative to Dupixent. Your insurance has to deny twice and then you can apply for patient assistance. Serious adverse reactions may. The $500 payment counts towards the member’s deductible and out-of-pocket maximum. Also if your insurance does cover,Dupixent offers a co-pay card that. 23. Form more information phone: 844-387-4936 or Visit website Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. 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. 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. Just got off the phone with Dupixent My Way. 14 mL, or 300 mg/2 mL)Section 5a. Manufacturer Coupon. 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) is used to treat certain patients with eczema, asthma, and nasal polyps. Eligible patients will receive they cards by e-mail. 00, but I do have some money invested. $125 is the amount Dupixent assistance pays. My income is only 30000.