Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. 0185 Last Update: November 2022 DUP. To contact DUPIXENT MyWay, please call 1-844-DUPIXENT (1-844-387-4936). Please see Important Safety Information and full PI on website. Biologic Drug: Biologic drugs are made from living cells and are often expensive. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. At that point we will owe 20% of the cost of the medication, which adds up to just under $700/month. Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. 67 mL, 200 mg/1. Be sure to fill out your enrollment form completely and accurately. LONG-LASTING CLEARER SKIN AT 16 and 52 Weeks 22% taking. Follow these tips to take DUPIXENT while traveling: Store DUPIXENT in the original carton to protect it from light. If this is the case, write the preferred specialty pharmacy. 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. If you are a New York prescriber, please use an original New York State prescription form. - Rachel, DUPIXENT Patient Mentor, living with asthma. 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. For me, the side effects didn’t really bother me or have me second guess my decision with Dupixent because my skin was. How do my patients enroll in <em>DUPIXENT MyWay®</em>? When filling out the DUPIXENT MyWay Enrollment Form, both you and your patient will be required to. Serious adverse reactions may. Compare . 00. I wanted to go out and make a difference and help people. 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. 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. 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). Serious side effects can occur. 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. Patient to Fill Out. 14 mL, or 300 mg/2 mL)Section 5a. Please see Important Safety Information and Prescribing Information and Patient Information on website. 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. If necessary, DUPIXENT may be kept at room temperature up to 77 °F (25 °C) for a maximum of 14 days. Each time you fill your DUPIXENT prescription, please ensure your. 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. My wife is on Dupixent, and has the MyWay card which allows up to $13,000/year. 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. 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. Please see Dosage Regimens, How to Inject DUPIXENT® and Instructions for Use. , 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. If you are a New York prescriber, please use an original New York State prescription form. I consent to DUPIXENT MyWay contacting me by fax, mail, or email to provide additional information about DUPIXENT injection or DUPIXENT MyWay. A program called Dupixent MyWay is available for this drug. 23. Tips. ) Please refer to Section 8, Patient Certifications, for. Dupixent MyWay Program This program provides brand name medications at no or low cost: Provided by: Sanofi and Regeneron Pharmaceuticals, Inc. Type text, add images, blackout confidential details, add comments, highlights and more. I’ve been with DUPIXENT MyWay since the very beginning. A group of skin conditions characterized by skin inflammation, rash, and itch. The formulary status tool below can help check DUPIXENT coverage for various plans. 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. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. , chart notes, laboratory values) and use of claims history documenting the following: 1. Compare monoclonal antibodies. 03. It still covers the same amount. If you still have questions, you can speak with a DUPIXENT MyWay or request to join the program over the phone. If you don’t have health insurance, talk. I'm "only" 61 now though on Dupixent MyWay copay help. 02. Most do, some don't. DUPIXENT was studied in adults and children 6 months of age and older. who are prescribed Dupixent gain access to the medicine and receive the support they may need with the DUPIXENT MyWay ® program. DUPIXENT can cause serious side effects, including: The most common side effects in patients with eczema include. 89 and -1. If you’re the spouse or. Hear real patients stories of life with uncontrolled moderate-to-severe asthma and how discovering DUPIXENT® (dupilumab) impacted their journey. DUPIXENT can be used with or without topical corticosteroids. living with prurigo nodularis. Sign it in a few clicks. And very recently got laid off due to Covid-19. Nationally are Covered for 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. A quantity of Dupixent will be considered medically necessary if the above criteria are met, as indicated in the table below:. 28. 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. THIS IS NOT INSURANCE. Social Security income, unemployment insurance benefits, disability income, any other income for the household. 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. 71 for Dupixent compared to 0. 0254 Last Update: February 2023 DUP. 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. Household Income. For children aged 6 months to 5 years, it is taken as 1 injection every 4 weeks. com. Eczema. Rx: DUPIXENT® (dupilumab) (100 mg/0. Required if enrolling in the DUPIXENT MyWay. 50 for a single person. Fill out sections 5a and 5b completely to determine patient eligibility. Use DUPIXENT exactly as prescribed by your doctor. Serious adverse reactions may occur. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. Enroll now to receive emails and resources designed to help patients, caregivers and information seekers through the DUPIXENT® (dupilumab) treatment journey. If I am completing Section 5b, I authorize for my commercially insured patient one. It may be covered by your Medicare or insurance plan. I understand that. 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. Serious side effects can occur. 0156 Past Update: March 2023 DUP. 14 mL, or 300 mg/2 mL)My insurance provider covers 85% and our Canadian version of 'MyWay' pays the remainder. Serious adverse reactions may. Patients may be eligible for the DUPIXENT MyWay Copay Card if: They have a DUPIXENT prescription for an FDA-approved condition. · If the insurer does have a copay accumulator in place: the insurer pays the entire cost of the refill except for $500. Declining androgen levels correlated with increased frailty. 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. Section 5a. 06 and -1. 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. It's like $35k-$40k. So, how can you save? Manufacturer Sanofi offers Dupixent MyWay, a patient support program. In this case Dupixent myway will cover the first 13k, which is probably like 5 months. The patient must then take the following actions:I just got approved for dupixent this week however the copay is 3,000$ a month! The dupixent my way program only covers up to 13k or something like that. I've been on Dupixent for over 2 years now and it has been such a great experience keeping my eczema under control. 01. If you still have questions, you can speak with a DUPIXENT MyWay or request to join the program over the phone. Fill out sections 5a and 5b completely to determine patient eligibility. If you still have questions, you can speak with a DUPIXENT MyWay representative or request to join the program over the phone. store above 77 °F (25 °C). You don’t have to put your life on hold to fit your dosing schedule. 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. Get a Quick Start. Injection site reactions and eye conditions are the most common side effects reported and, unlike several other biologics, the risk of infection is low. 01. There is another biologic very similar to Dupixent called Adbry. 1, 2022, the gross income limit for Supplemental Nutrition Assistance Program (SNAP) eligibility in Minnesota increased from 165% to 200% of the federal poverty line for most households. 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. _____ What is your total annual household income? _____ (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. 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. Since MyWay covers 13,000 a year, that will count towards your deductible. Edit your dupixent myway enrollment form online. Dupixent is an injection under the skin (subcutaneous injection) at different injection sites. 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. ) Please refer to Section 8, Patient Certifications, for. 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. Data on file, Regeneron Pharmaceuticals, Inc. 67 mL, 200 mg/1. With of DUPIXENT MyWay Copay Card, right, commercially insured patients might pay as little as $0* copay per fill of DUPIXENT. You must also meet certain household income eligibility requirements as outlined below: 48 States and DC. will need to meet the eligibility criteria, including household income, to qualify. _____ What is your total annual household income? _____ (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Hello! Switching insurance this year and need to prepare for increasing costs of dupixent with my new insurance. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may pay as little as $0* copay per fill of DUPIXENT. Please see Important Safety Information and Prescribing Information and Patient Information on website. 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. DUPIXENT MyWay Appeal Specialists can help provide support throughout the appeal process. March 29, 2018. 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. At one point, I was getting cold sores every 2 to 3 weeks consistently. Eligible patients covered by commercial health insurance may pay as little as a $0 p copay per fill of DUPIXENT. living with prurigo nodularis. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. Dupixent MyWay pays the $500 copay. 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 knocked out the first copay out of pocket and went on the manufacturer website and applied for the dupixent my way card. 23. Program Website : Patient Assistance Applications for DUPIXENT® dupilumab therapy My Information. Step One - let's gather our materials. Clip the card and save • Save up to 80% on medications* Tell your healthcare provider about any new or worsening joint symptoms. 10 for placebo; difference between Dupixent and placebo: -2. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. 22. Your insurance has to deny twice and then you can apply for patient assistance. chevron_right. (Includes salary/wages, Social Security income, unemployment insurance benefits, disability income, any other income for the household. Learn more about programs for eligible patients who are insured, underinsured, and uninsured. Expert perspectives on management of moderate-to-severe atopic dermatitis: a multidisciplinary consensus addressing current and emerging therapies. What it is used for. After that, we will have met our family deductible. Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3 program consisting of two pivotal trials. DUPIXENT® (dupilumab) is a. 67 mL, 200 mg/1. Contact the health plan or DUPIXENT MyWay® to verify coverage for a specific patient. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. 14 mL, or 300 mg/2 mL)The Dupixent MyWay program is not available to medicare patients. Sign up or activate your card here. S. 0252 Last Update: Feb 2023 DUP. You have to game the system instead of trying to get full coverage. 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. For more information, call 1-844-DUPIXEN (T) (1-844-387-4936. According to the manufacturers, Dupixent can be dosed to a maximum daily dose as indicated below. b Data as of January 2023. Share your form with others. a ®® ® 1-844-387-9370 or Document Drop at (code: 8443879370) or Document Drop at (code: 8443879370) am pmAdditionally, Dupixent MyWay TM 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 process. Financial criteria for patient assistance. chevron_right. $125 is the amount Dupixent assistance pays. For patients with commercial insurance who are new to DUPIXENT and experiencing a. 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 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. Learn how DUPIXENT helped treat children 6 to 11 years old with their moderate-to-severe asthma. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. After that, it is taken as 1 injection every 2 weeks or every 4 weeks, depending on your age and weight. 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). Dupixent® should be given by or under the supervision of an adult in children 12 years of age and older. 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. If you are a New York prescriber, please use an original New York. DUPIXENT can be used with or without topical corticosteroids. a $85. 00 copay. Allow the medicine to warm to room temperature for 30 or 45 minutes before using it. DUPIXENT MyWay at PO Bo 22012, Charlotte, NC 2222 a 1--37-9370. 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. 23. Coverage varies by type and plan. DUPIXENT is a biologic and can help reduce your patients' use of systemic corticosteroids. ago. Dupixent will run about $3000 per month with my insurance until my maximum is met. 12. DUPIXENT® is a subcutaneous injectable prescription medicine for adults and children aged 6 months & older with uncontrolled, moderate-to-severe. Enrolled patients receive: One-on-one support from our DUPIXENT MyWay support team; Help understanding insurance coverage; Financial assistance (for eligible patients only) Help. 03. For more information and to find out if you’re eligible for support, call 844-DUPIXENT (844-387-4936) or visit the program website. Monday-Friday, 8 am-9 pm ET. 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. Connect with someone, ask questions, and learn about their experience with DUPIXENT® (dupilumab) treatment. chevron_right. Copay Card or you wish to discontinue your participation, please contact us. • Store DUPIXENT in the refrigerator at 36°F to 46°F (2°C to 8°C). For patients with commercial insurance who are new to DUPIXENT and experiencing a. Boguniewicz M, Alexis AF, Beck LA, et al. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. 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. Sign it in a few clicks. 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). Your office may choose to use a preferred specialty pharmacy to start the benefits investigation. 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. How many people live in your household? _____ Please refer to Section 8, Patient Certifications , for. Dupixent® (dupilumab) approved by FDA as the first and only treatment indicated for prurigo nodularis Dupixent significantly reduced itch and skin lesions compared to placebo in direct-to-Phase 3. 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). ) 2 Prescription InformationDUPIXENT MYWAY ENROLLMENT FORM Moderate-to-Severe Atopic Dermatitis SUBMIT COMPLETED PAGES 1 & 2 Fax: 1-844-387-9370 Document Drop: (code: 8443879370) Patient Name DOB / / Prescriber Name Prescriber Address NPI # Prescriber State License # (Required in Puerto Rico only). Dupixent MyWay pays the $500 copay. Patient and Co-pay Assistance: DUPIXENT MyWay helps eligible patients get access to therapy whether they are uninsured, lack. 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). This medicine should be given by a caregiver in children 6 months to less than 12 years of age. I give supplemental injection training to the patient and the patient’s caregiver. Support. DUPIXENT is not used to treat sudden breathing problems. Thus, the member is now $500 from hitting his deductible and $1500 from hitting his out-of-pocket maximum. With the DUPIXENT MyWay Copay Card, eligible,. 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). any time by mailing or faxing a written request to DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. DUPIXENT is 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. Income at or below: Not Published: Medical expenses can be. This medicine should be given by a caregiver in children 6 months to less than 12 years of age. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. When I was very young, I knew that I wanted to be a nurse. DUPIXENT MyWay at PO Box 220128, Charlotte, NC 28222; Fax: 1-844-387-9370. Regeneron and Sanofi are committed to helping patients in the U. Each time you fill your DUPIXENT prescription, please ensure your. The fax number is 1. And, if you're eligible, you can sign up and receive your card today. 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). DUPIXENT MyWay. 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. if speciality. 22. 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. Effective Sept. It was granted and I pay $0. 09. So, even with a "prior authorization" and a "formulary override", the cost to me is $2900 per month, or about $1450. Patient assistance program. 71 for Dupixent compared to 0. will not conduct a benefits verification. Caring. You may be able to get a 90-day supply of Dupixent. Dupixent may cause serious side effects. At one point, I was getting cold sores every 2 to 3 weeks consistently. To enroll or obtain information call 1-877-311. 80). Johns Hopkins EHP i think goes with cigna and CVS Specialty pharmacy covers. Your experience with DUPIXENT is unique, and sharing your journey can inspire and empower people facing similar challenges. A case series of 12 people prescribed Dupixent reported an average weight gain of 6. 01. S. 01. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. Learn about the DUPIXENT® (dupilumab) mechanism of action inhibiting IL-4 and IL-13 signaling in appropriate asthma patients. Program Website : Program Applications and FormsView the possible side effects of DUPIXENT in patients with uncontrolled chronic rhinosinusitis with nasal polyposis. Monday-Friday, 8 am-9 pm ET. Since 2018, DUPIXENT has been prescribed to over 100,000 asthma patients in the US. The DUPIXENT MyWay team can research each patient's situation and determine eligibility. including household income, to qualify. Assistance may be available for patients who do not have insurance. The specialty pharmacy is responsible for securing coverage on my patient’s behalf. 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. Decreased exacerbations and/or improvement in symptoms 2. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. Dupixent MyWay Program CONTACT INFO: Address:, Phone: 1-844-387-4936: Provider Phone: Fax: 1-844-387-3970: Website: Program Website: ELIGIBILITY Eligibility Info:. 0129 Last Update:. Option 1- you have to meet your deductible without Dupixent myway. The $500 payment counts towards the member’s deductible and out-of-pocket maximum. I understand that DUPIXENT MyWay may revise, change, or terminate any program services at any time without notice to me. *For patients on DUPIXENT 300 mg in a 24-week and a 52-week clinical trial vs 17% for placebo group. I just got approved thru Dupixent my way for a year of free medication. Continuation in the program is conditioned upon timely verification of income. 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. Check the liquid in the prefilled pen or syringe. 1kg to 18. 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. 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. 23. Base amount is $558. Check the liquid in the prefilled pen or syringe. THE DUPIXENT MyWay COPAY CARD. With the DUPIXENT MyWay Copay Card, eligible, commercially insured patients may payable as little while $0* copay per fill by DUPIXENT. 0156 Last Update: March 2023 DUP. Deductible is at $3k out of pocket insurance pays 80% and at $6k insurance pays 100%. for DUPIXENT® dupilumab therapy My Information. 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. Injection Support Center Injection Reminders and Tips FREQUENTLY ASKED QUESTIONS; Español. Section 5a. I wanted to go out and make a difference and help people. DUPIXENT MyWay® is a patient support program that can help with the enrollment process, offer. Please see. Subcutaneous Solution 100 mg/0. The Dupixent pre-filled syringe is available in the following strengths: 100 mg per 0. With the DUPIXENT MyWay Copay Card, eligible,. Susie16 Aug 29, 2023 • 2:03 AM. The majority of DUPIXENT patients with commercial/employer-provided insurance use the DUPIXENT MyWay ® Copay Card. If I am completing Section 5b, I authorize for my commercially insured patient one. But either way, after you or Dupixent myway meets your deductible, it should be free to you. DUPIXENT . Please see accompanying full Prescribing Information. This DUPIXENT Pre-filled Pen is a single-dose device. Approval represents the second dermatology indication for Dupixent and fifth disease indication overall in the. Using the drop. C M ET DUPIXENT MYWAY ENROLLMENT FORM Moderate-to-Severe Atopic Dermatitis SUBMIT COMPLETED PAGES 1 & 2 Fax: 1-844-387-9370 Document Drop: (code: 8443879370)The DUPIXENT MyWay Copay Card Program includes the Copay Card, the Debit Card, and any direct patient rebate, and has a combined annual maximum benefit of $13,000 per patient per calendar year. 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. I just started this week so I look forward to seeing the results. 01. The doctor's office called to say I need to call to talk about my income and expenses. form on DUPIXENT. 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. How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. Serious side effects can occur. Got off of it as soon as I realized it was getting worse with every shot after spacing them out every other month. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions. 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. Oct 26, 2022 · Dupixent MyWay Program Enrollment Form for Allergists (AD, Asthma, CRSwNP). 0252 Last Update: Feb 2023 DUP. How many people live in your household? Please refer to Section 8, Patient Certifications, for additional information about the Patient Assistance Program. chevron_right. I have read and agree to the Income Verification included in Section 8 on page 5. Browse the DUPIXENT® (dupilumab) sitemap to help you learn more about uncontrolled moderate- to-severe eczema in adults and children aged 6 months & older and navigate DUPIXENT. Some people do injections every 3 weeks, which could stretch that copay card out longer. By checking the box, I acknowledge DUPIXENT MyWay will not conduct a benefits verification. For more information, call 1-844-DUPIXENT ( 1-844-387-4936) option 1. There is currently no generic alternative to Dupixent. 02. Household Income Required if enrolling in the DUPIXENT MyWay Patient Assistance Program. Type text, add images, blackout confidential details, add comments, highlights and more. LEARN ABOUT OUR PATIENT SUPPORT PROGRAM. Injection in children 12 and older should be supervised by an adult. 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. 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. Surgery may remove your nasal polyps, but it may not treat an underlying cause of inflammation—allowing them to grow back. Compare .