Enrolling your patients in DUPIXENT MyWay
Our team can provide guidance and assistance during the insurance approval process. Support starts when your patients enroll in DUPIXENT MyWay. You can help by directing them to the DUPIXENT MyWay Enrollment Forms below. If your patients need further support, DUPIXENT MyWay Nursing Support is available as a dedicated point of contact. Watch the video for more information.
To enroll in DUPIXENT MyWay, your patients can call 1-844-DUPIXEN(T) (1-844-387-4936) or email or print and fill out an enrollment form with your assistance.
Putting the pieces together for acquiring DUPIXENT.
After you prescribe DUPIXENT, a correctly filled out DUPIXENT MyWay Enrollment Form helps ensure patient enrollments are processed without delays.
Forms are available at DUPIXENTHCP.com. Please ensure that you are filling out the correct form that corresponds to the appropriate indication.
First, allow the patient to review the Patient Authorization and Certifications. Then, ensure the patient has signed and dated twice at the top of the form where indicated, as it is vital to the process that the patient reads and agrees to both the Patient Authorization and the Certifications.
To help ensure a seamless enrollment process, ask the patient if they would like to provide their email address, mobile phone number, and to consent to receiving text messages.
Please inform patients that DUPIXENT MyWay will be contacting them through their preferred method of communication and that maintaining communication is important for them to receive support from DUPIXENT MyWay.
Ensure that the Healthcare Provider has read and agrees to the Healthcare Provider Certification, and signs and dates the prescription at the bottom.
Populate the clinical information corresponding to your patient’s diagnosis. A list of potential codes is provided within the Enrollment Form for reference. Be sure to provide only one ICD-10 code, even if the patient has comorbid disease.
Once the primary ICD-10 code is filled in and the form is completed, write the names of the patient and prescriber at the top of all pages.
DUPIXENT MyWay complements your office’s process for accessing DUPIXENT. Your office may choose to use a preferred specialty pharmacy to start the benefits investigation.
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 be responsible for securing the coverage on the patient’s behalf.
Fax the Enrollment Form with the checked box to both the specialty pharmacy and DUPIXENT MyWay. This will allow the specialty pharmacy to conduct the benefits investigation, and DUPIXENT MyWay will provide additional support to the patient.
If your office does not use a preferred specialty pharmacy, indicate that you would like DUPIXENT MyWay to conduct the benefits investigation on the patient’s behalf.
Fax the Enrollment Form to DUPIXENT MyWay. They will begin the benefits investigation and inform your office of the next steps. Please note that you will receive a confirmation fax after sending the form.
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.
Coverage support
Provides assistance navigating the insurance process.
Benefits Investigation, Prior Authorization (PA), and Appeals Support
DUPIXENT MyWay verifies your patient’s health plan coverage for DUPIXENT, as well as copay information. If a PA is required, your DUPIXENT MyWay Coordinator can help navigate the PA process. They will also help you and your patient understand the appeals process if coverage is denied.
How to access DUPIXENT
Learn how to navigate the approval and specialty pharmacy process to get your patients started on DUPIXENT.
Putting the pieces together for acquiring DUPIXENT.
DUPIXENT is covered under the pharmacy benefit plan, which requires a patient to coordinate delivery with a specialty pharmacy.
After a healthcare provider prescribes DUPIXENT, the patient schedules their delivery of DUPIXENT from the specialty pharmacy, pays the copay, coordinates the shipment, and can administer DUPIXENT themselves or receive the injection from a caregiver after appropriate training from their healthcare provider.
It’s important to understand the specialty pharmacy process and its role in obtaining DUPIXENT.
Many specialty medications, such as DUPIXENT, have longer turnaround times because of the prior authorization process.
When DUPIXENT is prescribed by a healthcare professional, you can work with the patient to complete the Enrollment Form, and then fax the Enrollment Form with all signatures, dates, and ICD-10 codes to DUPIXENT MyWay.
It is important that the patient consents to receiving communication from DUPIXENT MyWay and indicates how they would like to be contacted, whether it be via email, phone, or text.
Once enrolled, a benefits investigation to determine coverage begins.
It’s important to understand how to identify prescription drug coverage. Key points of contact for coverage are located on the card itself.
Some plans, including commercial and Medicare, may even have a separate pharmacy benefit card.
A Summary of Benefits Form will be faxed to your office within a few days, detailing the patient’s coverage—including prior authorization requirements and out-of-pocket costs. DUPIXENT MyWay will not conduct the benefits investigation, nor send a Summary of Benefits Form, for providers who have checked the specialty pharmacy box on the Enrollment Form, as this indicates that they wish the specialty pharmacy to conduct the benefits investigation.
The prior authorization information required by the patient’s insurance to approve coverage for DUPIXENT may include the patient’s history, medication, and clinical information.
It is important to note that a plan may deny prior authorization. There are several reasons for this, including incomplete documentation, administrative errors, clinical reasons or a no-coverage determination, or a plan exclusion.
In the case of a denial, you may consider writing an appeal, if appropriate, making sure to address the plan’s specific concerns. You can refer to DUPIXENTHCP.com for the appeals kit, which will provide information about the process of appealing a denial, and reference sample letters provided by DUPIXENT MyWay.
In some denial cases, a plan may require a peer-to-peer review with a medical reviewer at the health plan.
If the prior authorization is reviewed by the patient’s insurance carrier and is approved, the prescription is triaged to the specialty pharmacy for fulfillment.
It is recommended that you fax a copy of prior authorization approval to DUPIXENT MyWay to help the office staff continue the process in several ways, such as:
Initiating contact with the patient regarding the approval and sharing the specialty pharmacy name and phone number.
Advising the patient to contact the specialty pharmacy for preferred delivery location.
And reminding them that the specialty pharmacy may call them from an unknown number.
Lastly, the specialty pharmacy reviews the prescription and contacts the patient to arrange for payment and delivery. If the patient is eligible for copay assistance, the patient or caregiver can then ensure the copay assistance is applied, coordinate delivery with the specialty pharmacy, and access additional DUPIXENT MyWay support.
Once final approval and payment are received, the patient coordinates shipment to their home or their healthcare provider’s office, depending on treatment plan.
Remember to monitor and document the patient’s progress for reauthorization. DUPIXENT MyWay will also remind the healthcare professional when the authorization is up for reapproval.
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.
After you have determined DUPIXENT is appropriate for your patient and written them a prescription:
- Submit the DUPIXENT MyWay Enrollment Form
- Submit PA and Letter of Medical Necessity (optional) and include all required documentation
(eg, a copy of your chart notes with details of diagnosis, disease severity, and treatment history)
- Receive status updates from your DUPIXENT MyWay Coordinator
Approval
DUPIXENT MyWay representative arranges shipment with patient via specialty pharmacy (in network) or patient arranges shipment with specialty pharmacy (out of network).
Coverage Information
Check the formulary status of DUPIXENT in your area with our coverage tool today.
SEE FORMULARY COVERAGE DATAGet a Quick Start
For patients with commercial insurance who are new to DUPIXENT and are experiencing a coverage delay, the DUPIXENT Quick Start program may be able to help with temporary access to DUPIXENT at no cost. Ask your Field Representative for additional information.
Navigating prior authorizations & appeals
Download a complete guide regarding coverage for DUPIXENT
PRIOR AUTHORIZATION AND APPEALS GUIDESample Letters
If a prior authorization is denied, you can fill out the payers appeal form, write an appeal letter, and add supporting documentation. While sample letters are included in the above guide, you can download the corresponding Microsoft Word templates to edit to your office’s needs.
LETTER OF MEDICAL NECESSITY DENIAL CS REQUIREMENT DENIAL DUE TO SEVERITY Denial TCS/TCI/TPI THERAPY Requirement DENIAL SI REQUIREMENT DENIAL DUE TO NON-FORMULARY STATUS GENERAL MEDICAL EXCEPTIONWhen writing letters, be sure to populate an appropriate ICD-10 code matching your patient’s diagnosis. Download our reference guide to have on hand.
ICD-10 CODE REFERENCE GUIDECoverMyMeds SpecialtyPlus support is available for DUPIXENT
CoverMyMeds provides additional PA process-related support for DUPIXENT. Live support is available at 866-452-5017 or covermymeds.com
Patient access support
Copay Card
Eligible patients covered by commercial health insurance may pay as little as a $0a copay per fill of DUPIXENT (maximum of $13,000 per patient per calendar year).
Patients may be eligible for the DUPIXENT MyWay Copay Card if they:
- Have commercial insurance
- Have a DUPIXENT prescription for an
FDA-approved condition - Are a resident of the 50 United States, the District of Columbia, Puerto Rico, Guam or the USVI; and are a patient or caregiver aged 18 years or older
Send them the following link to see if they're
eligible:
Patient Assistance Program
Assistance may still be available for patients who do not have insurance
- A DUPIXENT MyWay Nurse Educator can help qualified patients explore additional options to help cover the cost of DUPIXENT
- The Patient Assistance Program may be an option if your patient is uninsured or functionally uninsured, or experiences a gap in or loss of insurance
The DUPIXENT MyWay team will research each patient’s situation and determine eligibility.
For more information, call 1-844-DUPIXEN(T) (1-844-387-4936), option 1.
aApproval is not guaranteed. Program has an annual maximum of $13,000. THIS IS NOT INSURANCE. Not valid for prescriptions paid, in whole or in part, by Medicaid, Medicare, VA, DOD, TRICARE, or other federal or state programs including any state pharmaceutical assistance programs. This program is not valid where prohibited by law, taxed or restricted. DUPIXENT MyWay reserves the right to rescind, revoke, terminate, or amend this offer, eligibility, and terms of use at any time without notice. Any savings provided by the program may vary depending on patients' out-of-pocket costs. The program is intended to help patients afford DUPIXENT. Patients may have insurance plans that attempt to dilute the impact of the assistance available under the program. In those situations, the program may change its terms. Additional terms and conditions apply.
Nursing support
Nurse Educators take a patient-centric approach to helping patients start and stay on track with therapy.
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 for patients throughout their patient journey.
Insightful tips and tools to help them along the way
One-on-one nursing support, when needed, to provide disease and DUPIXENT education and ongoing follow-up to ensure patients stay on track with DUPIXENT
Help scheduling deliveries of DUPIXENT
Reminder when eligible patients must reapply for financial support programs (Copay Card Program, Patient Assistance Program)
Supplemental injection training virtually or over the phone
Copay assistance for eligible patients
Refill and injection reminders
Supplemental injection support
Along with initial training provided by the HCP's office and support from DUPIXENT MyWay Nurse Educators, your patients will also find instructional videos, patient testimonials, and downloads in our Injection Support Center.
Available Resources
- Supplemental instructional videos will walk your patients or their caregivers through the process of administering DUPIXENT
- They can hear from other patients who have been through the process
- A mindful breathing exercise may help your patients achieve the right frame of mind to help calm their nerves
- Downloadable Instructions for Use will give your patients another resource to always have at their side