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  • Dupixent Enrollment Form 2020

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Preparing documentation is time-consuming and pricey unless you have ready-to-use fillable forms and complete them electronically. The easiest way to cope with the Dupixent Enrollment Form is to use our professional and multi-featured online editing tools. We provide you with all the essential tools for fast form fill-out and allow you to make any adjustments to your templates, adapting them to any requirements. Apart from that, you can make comments on the updates and leave notes for other parties involved.

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You or your doctor can download the enrollment form on DUPIXENT.com or call 1-844-DUPIXENT, Option 1 to enroll. Next, your prescription may have to be authorized by insurance. This is called prior authorization and is common for specialty medicines.

Why Do Insurance Companies Deny Dupixent? A shot of Dupixent can cost as much as $3,354—or more, in some cases. Your insurance company may deny your prescription for Dupixent because it is not on the formulary list, or because they don't believe the drug is medically necessary for your condition.

Dupixent (dupilumab) is used to treat certain patients with eczema, asthma, and nasal polyps. There is currently no generic alternative to Dupixent. It may be covered by your Medicare or insurance plan, but some pharmacy coupons or cash prices could help offset the cost.

There is currently no generic version of Dupixent on the market. The average retail price of Dupixent is $4,922.5 for 2, 2ML of 300MG/2ML Solution Prefilled Syringe....Average 12 Month Prices for Dupixent. PharmacyDupixent Retail PriceDupixent SingleCare PriceCVS Pharmacy$7024.21$3376.94Walmart$4092.21$3328.362 more rows

DUPIXENT is indicated for the treatment of adults and children aged 6 months and older with moderate-to-severe eczema (atopic dermatitis) whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable.

You or your doctor can download the enrollment form on DUPIXENT.com or call 1-844-DUPIXENT, option 1 to enroll. Next, your prescription may have to be authorized by insurance. This is called prior authorization and is common for specialty medicines.

Clinical requirements – Plan requires a patient to meet specific clinical criteria, e.g., to have experienced symptoms of particular severity or duration, before they can access dupilumab. Prescriber requirements – Plan requires dupilumab to be prescribed by a dermatologist, or in consultation with a dermatologist.

You can obtain the appropriate PA form through DUPIXENT MyWay®, CoverMyMeds®, or your patient's insurance provider or specialty pharmacy. Consider including a letter that explains your patient's condition in detail. This may include a letter of medical exception or a letter of medical necessity.

The criteria set forth by the manufacturers of Dupixent are; Patient is over 18 years old. Patient has moderate to severe atopic dermatitis (defined as moderate to severe erythema and moderate to severe papulation/infiltration) Body Surface Area is 10% or more.

Once coverage for DUPIXENT is approved, your patient must work with the specialty pharmacy to arrange for delivery of DUPIXENT to their home or preferred location. After final approval and payment are received, the specialty pharmacy will ship DUPIXENT to your patient's home or preferred location.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232