2020 Guide to Patient Support Services

Daiichi-Sankyo

Daiichi-Sankyo’s Access Central offers comprehensive reimbursement and patient support services for patients who are prescribed Injectafer (ferric carboxymaltose injection) or Turalio (pexidartinib) but are unable to afford their medication.

Injectafer is an iron replacement therapy indicated for the treatment of iron-deficiency anemia in adults who are intolerant to or have had an unsatisfactory response to oral iron replacement therapy, and in adults who have no dialysis-dependent chronic kidney disease. Injectafer provides up to 1500 mg of iron with 2 administrations. Turalio is a kinase inhibitor used for the treatment of adults with symptomatic tenosynovial giant-cell tumor associated with severe morbidity or functional limitations and is not amenable to improvement with surgery (Table).

Daiichi-Sankyo offers support services that facilitate patient access to Injectafer or to Turalio and include:

  • Financial assistance for eligible patients
  • Assistance with provider reimbursement and coding processes, such as verification of payer coverage and claims appeals.

Support Programs Injectafer Savings Program

The Injectafer Savings Program helps commercially insured or cash-­paying patients with out-of-pocket Injectafer prescription costs. Eligible insured patients may pay no more than $50 for Injectafer for the first dose and $0 for Injectafer for the second dose onwards, up to a maximum savings limit of $500 per dose, and a $1000 program limit for 2 doses.

Injectafer Patient Assistance Program

The Injectafer Patient Assistance Program is a medication replacement program that provides replacement for Injectafer free of charge to eligible patients who have no insurance coverage and are enrolled in the program.

Turalio Quick Start Program

Through the Turalio Quick Start, patients who are experiencing a 5-day delay in getting their Turalio prescription may be eligible to receive a 14-day supply of the drug at no cost.

Turalio Copay Program

Patients with private insurance will pay as little as $0 per prescription of Turalio, with a maximum annual benefit of $25,000. This program has no income requirements.

Turalio Patient Assistance Program

The Turalio Patient Assistance Program may provide Turalio at no cost to eligible patients who are uninsured or underinsured, or those who are unable to afford their out-of-pocket costs.

ELIGIBILITY

Injectafer Savings Program

To qualify for the Injectafer Savings Program, patients must:

  • Have commercial insurance or be cash-paying patients
  • Not be enrolled in Medicare, Medicaid, or other federal or state healthcare programs, or third-party payers’ programs
  • Be a resident of the United States or Puerto Rico
  • Be aged ≥18 years.

Injectafer Patient Assistance Program

To qualify for the Injectafer Patient Assistance Program, patients must:

  • Have no health insurance
  • Meet established income limits
  • Be a US citizen, legal entrant in the United States, or a permanent US resident
  • Meet income and other criteria defined by Daiichi-Sankyo.

Turalio Copay Program

To be eligible for this program, patients must:

  • Have commercial insurance
  • Not have government healthcare insurance, including Medicare, Medicaid, Medigap, Tricare, Veterans Affairs, Department of Defense, or any state-funded programs
  • To continue receiving copay assistance, patients must reapply for the program each calendar year
  • The amounts paid under this program are not eligible for reimbursement by any third party
  • Patients may be required to notify their insurance company of any benefits received under this program
  • Patients can enroll up to 30 days after the first treatment with Turalio and use a retroactive enrollment period for assistance on dates of service that took place before enrollment; the practice or patient must call an Access Central Coordinator for assistance on retroactive enrollment.

Turalio Patient Assistant Program

To be eligible for the Turalio Patient Assistant Program, patients must:

  • Have been denied coverage for Turalio
  • Be uninsured or functionally underinsured (ie, denied prior authorization or experience formulary exclusion)
  • Be unable to meet their out-of-pocket costs for Turalio and meet the required income criteria if they are enrolled in Medicare.

APPLICATION & ENROLLMENT

Injectafer Savings Program

Providers may enroll in the Injectafer Savings Program by calling the help desk (877-448-4766) and registering their office, which will allow access to the Injectafer Savings Program web-based provider portal, to facilitate the determination of patients’ eligibility and their enrollment in the program.

After enrollment, patients will receive their virtual debit card. An explanation of benefits (EOB) must be submitted to confirm Injectafer use before the copay assistance can be processed. EOBs will also need to be submitted for any subsequent doses of Injectafer.

Patients who require additional courses of therapy will need to be re-enrolled into the Injectafer Savings Program.

To receive retroactive enrollment assistance, patients must submit an Eligibility Attestation Form.

Turalio Copay Program

Providers can enroll their patients in the Turalio Copay Program by filling out the enrollment form or by faxing it to 800-823-4506 or by calling 800-850-4306.

Injectafer Patient Assistance Program

To enroll patients in the Injectafer Patient Assistance Program, the program enrollment form must be completed. Providers can access the form online, and fax it to 888-257-4673, mail it to the address on the form, or call 877-448-4766.

To request Injectafer replacement, complete the Injectafer Patient Assistance Program Product Request Form. The form can be accessed online, and faxed to 888-354-4856, or mailed to the address on the form. Providers should submit the signed form at the end of each month. Proof of citizenship or legal residency may also be required.

Turalio Patient Assistance Program

To enroll in this program, the provider or the patient must complete the patient’s eligibility form and fax it to Access Central (833-471-9988) for your patient’s eligibility to be assessed. You can also start the enrollment process via phone by calling 866-437-4669.

TABLE DAIICHI-SANKYO ONCOLOGY/SUPPORTIVE CARE DRUGS

Drugs
Indications
Patient support programs

Drug
Injectafer (ferric carboxymaltose injection)
Indications
Iron-deficiency anemia in adults who are intolerant to or have had an unsatisfactory response to oral iron replacement therapy, and in adults with non–dialysis-dependent chronic kidney disease
Patient support programs
The IV Iron Reimbursement Hotline
877-448-4766

Drug
Turalio (pexidartinib)
Indications
Treatment of symptomatic tenosynovial giant-cell tumor
Patient support programs

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