HELP CLEAR THE WAY WITH BIMZELX NAVIGATE®

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Group 5675



   BIMZELX Navigate helps make the treatment journey smooth from the start for your patients.

 

*For eligible commercially insured patients only. Eligible patients who have a delay or denial of coverage pay as little as $15 per dose of BIMZELX for up to two years or until the patient’s commercial insurance plan approves coverage, whichever comes first. Please see full eligibility and terms at BIMZELX.com/patient-support/navigate-benefits.

Eligible commercially insured patients may pay $5 per dose. View complete eligibility requirements and terms by clicking on the button below or by visiting BIMZELX.com/patient-support/navigate-benefits.

Nurse Navigators do not provide medical advice and will refer patients to their healthcare professional for treatment-related questions.

 

 

Full Terms and Eligibility

Full Terms and Conditions for BIMZELX Navigate® Bridge

BIMZELX Navigate® Bridge (the “Program”) provides BIMZELX® (bimekizumab-bkzx) to eligible patients for $15 per dose for up to two (2) years or until the patient’s commercial insurance plan approves coverage for the drug, whichever comes first. Eligible patients must be 18 years of age or older with commercial insurance and a valid prescription consistent with FDA-approved product labeling. For initial enrollment into the Program, the patient must be experiencing a delay in, or have been denied, coverage for BIMZELX by their commercial insurance plan. To maintain eligibility in the Program, the following are required: (1) a prior authorization request has been submitted and/or coverage remains unavailable for the patient; and (2) if the prior authorization is denied by the payer, the prescriber must submit an appeal within the first sixty (60) days of the prior authorization denial and a prior authorization must be submitted every six (6) months thereafter or documentation as may otherwise be required by the payer. Program is not available (1) to patients whose prescriptions are reimbursed, in whole or in part, under Medicare (including Medicare Part D), Medicaid, or any other federal- or state-funded health care programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico), (2) where a patient’s insurance covers the drug, (3) to uninsured or cash-paying patients, or (4) where otherwise prohibited by law. Product shall be dispensed pursuant to Program rules and federal and state laws. Patients may be asked to re-verify insurance coverage status during participation in the Program. No purchase necessary. Program is not health insurance, nor is participation a guarantee of insurance coverage. Limitations may apply. This Program cannot be combined with any other savings, free trial, or similar offer for the specified prescription. The patient, or healthcare provider on the patient’s behalf, must not submit any claim for reimbursement for product provided under this Program to any third-party payer. UCB, Inc. reserves the right to end or amend this Program without notice.

Full Terms and Conditions for BIMZELX Navigate® Savings

BIMZELX Navigate® Savings (the “Program”) provides BIMZELX® (bimekizumab-bkzx) to eligible patients with commercial insurance coverage for as little as $5 per dose. Eligible patients must be 18 years of age or older with commercial insurance coverage with a valid prescription consistent with FDA approved product labeling. The Program is not available for (1) for prescriptions that are reimbursed, in whole or in part, under Medicare (including Medicare Part D), Medicaid, or any other federal- or state-funded healthcare programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico), (2) where a patient’s commercial insurance plan reimburses for the entire cost of the drug, (3) for uninsured or cash paying patients, or (4) where otherwise prohibited by law. Product shall be dispensed pursuant to Program rules and federal and state laws. The value of the Program is exclusively for the benefit of patients and is intended to be credited in full towards patient out-of-pocket obligations and maximums, including applicable co-payments, coinsurance and deductibles. Patient may not seek reimbursement for the value of this Program from other parties, including third-party payers (i.e., any health insurance program or plan, or public payers like Medicare, Medicaid, Medigap, TRICARE, VA, and DoD). Patient is responsible for complying with any applicable limitations and requirements of their health plan related to the use of the Program. This Program cannot be combined with any other savings, free trial, or similar offer for the specified prescription. UCB, Inc. reserves the right to amend or end this Program at any time without notice. Subject to the prior sentence, this Program expires at 11:59 p.m. on December 31. Patients that meet the above requirements may re-enroll in the Program each year.

 

 

 

 

PATIENT SAVINGS/SUPPORT PROGRAM OVERVIEW

Get more information on the BIMZELX Navigate program.

 

BC CORNER

The Biologic Coordinator (BC) training portal provides helpful information such as detailed instructions on how to use the BIMZELX autoinjector and prefilled syringe.

VISIT BC CORNER

FOR SPECIALITY PHARMACY USE: BIMZELX NAVIGATE CAN HELP PATIENTS PAY AS LITTLE AS $5

We have two options for your eligible, commercially insured patients:

Pay as little as $5 once insurance coverage is approved

Pay just $15 per dose for up to 2 years while insurance coverage is pending

For eligible patients who may have difficulty paying for medication, we can help find resources to assist with cost. Visit UCB Savings to sign up patients for copay assistance, and visit the HCP BIMZELX Navigate portal for Specialty Pharmacy resources.

DISCOVER UCB SAVINGS

VISIT THE HCP NAVIGATE PORTAL

 

 

COMPREHENSIVE SUPPORT FOR STARTING PATIENTS ON BIMZELX

 

 

ENROLLMENT AND PRIOR AUTHORIZATION/APPEALS MATERIALS

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BIMZELX Patient Enrollment Form
PATIENT ENROLLMENT FORM

Get patients started on BIMZELX and enrolled in BIMZELX Navigate.

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BIMZELX Patient Enrollment Guide
PATIENT ENROLLMENT GUIDE

Explore tips on how to properly fill out a new patient enrollment form and see a sample completed form.

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BIMZELX Prior Authorization Guide
PRIOR AUTHORIZATION GUIDE

Review checklists and samples of the Prior Authorization and Letter of Medical Necessity forms.

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BIMZELX Letter of Medical Necessity_Sample
LETTER OF MEDICAL NECESSITY

Use this template to draft a Letter of Medical Necessity to accompany a Prior Authorization and/or Appeal.

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BIMZELX PA Denials Request Form
LETTER OF APPEAL

Use this letter template to draft a Letter of Appeal following a claims denial.

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BIMZELX Patient Tracker Form
PATIENT TRACKER FORM

Track patient milestones like prior authorization, appeals status, and approval dates.  

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BIMZELX Tier Exception Letter
TIER EXCEPTION LETTER

Use this template to draft a letter to request that BIMZELX be considered a preferred tier medication.

 

 

PHARMACY AND PATIENT MATERIALS

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BIMZELX Product Overview
BIMZELX PRODUCT OVERVIEW

Review key information about BIMZELX, including clinical data, safety profile, and dosing options.

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BIMZELX Injection Guide
INJECTION GUIDE

Review instructions for using the BIMZELX autoinjector and prefilled syringe.

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BIMZELX Specialty Pharmacy Reference Card
SPECIALTY PHARMACY REFERENCE CARD

Review a list of specialty pharmacy contacts and services.

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GET BIMZELX EDUCATIONAL RESOURCES FROM LEADING DERMATOLOGY EXPERTS

Visit Peer Perspectives

WANT MORE INFORMATION ABOUT BIMZELX?

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INDICATIONS

BIMZELX is indicated for the treatment of adult patients with active psoriatic arthritis, active non-radiographic axial spondyloarthritis with objective signs of inflammation, active ankylosing spondylitis, and moderate-to-severe plaque psoriasis patients who are candidates for systemic therapy or phototherapy

IMPORTANT SAFETY INFORMATION

Suicidal Ideation and Behavior

BIMZELX® (bimekizumab-bkzx) may increase the risk of suicidal ideation and behavior (SI/B). A causal association between treatment with BIMZELX and increased risk of SI/B has not been established. Prescribers should weigh the potential risks and benefits before using BIMZELX in patients with a history of severe depression or SI/B. Advise monitoring for the emergence or worsening of depression, suicidal ideation, or other mood changes. If such changes occur, advise to promptly seek medical attention, refer to a mental health professional as appropriate, and re-evaluate the risks and benefits of continuing treatment.

Infections

BIMZELX may increase the risk of infections. Do not initiate treatment with BIMZELX in patients with any clinically important active infection until the infection resolves or is adequately treated. In patients with a chronic infection or a history of recurrent infection, consider the risks and benefits prior to prescribing BIMZELX. Instruct patients to seek medical advice if signs or symptoms suggestive of clinically important infection occur. If a patient develops such an infection or is not responding to standard therapy, monitor the patient closely and do not administer BIMZELX until the infection resolves.

Tuberculosis

Evaluate patients for tuberculosis (TB) infection prior to initiating treatment with BIMZELX. Avoid the use of BIMZELX in patients with active TB infection. Initiate treatment of latent TB prior to administering BIMZELX. Consider anti-TB therapy prior to initiation of BIMZELX in patients with a past history of latent or active TB in whom an adequate course of treatment cannot be confirmed. Closely monitor patients for signs and symptoms of active TB during and after treatment.

Liver Biochemical Abnormalities

Elevated serum transaminases were reported in clinical trials with BIMZELX. Test liver enzymes, alkaline phosphatase, and bilirubin at baseline, periodically during treatment with BIMZELX, and according to routine patient management. If treatment-related increases in liver enzymes occur and drug-induced liver injury is suspected, interrupt BIMZELX until a diagnosis of liver injury is excluded. Permanently discontinue use of BIMZELX in patients with causally associated combined elevations of transaminases and bilirubin. Avoid use of BIMZELX in patients with acute liver disease or cirrhosis.

Inflammatory Bowel Disease

Cases of inflammatory bowel disease (IBD) have been reported in patients treated with IL-17 inhibitors, including BIMZELX. Avoid use of BIMZELX in patients with active IBD. During BIMZELX treatment, monitor patients for signs and symptoms of IBD and discontinue treatment if new onset or worsening of signs and symptoms occurs.

Immunizations

Prior to initiating therapy with BIMZELX, complete all age-appropriate vaccinations according to current immunization guidelines. Avoid the use of live vaccines in patients treated with BIMZELX.

MOST COMMON ADVERSE REACTIONS

Most common (≥1%) adverse reactions in plaque psoriasis include upper respiratory tract infections, oral candidiasis, headache, injection site reactions, tinea infections, gastroenteritis, Herpes Simplex infections, acne, folliculitis, other candida infections, and fatigue.

Most common (≥2%) adverse reactions in psoriatic arthritis include upper respiratory tract infections, oral candidiasis, headache, diarrhea, and urinary tract infections.

Most common (≥2%) adverse reactions in non-radiographic axial spondyloarthritis include upper respiratory tract infections, oral candidiasis, headache, diarrhea, cough, fatigue, musculoskeletal pain, myalgia, tonsillitis, transaminase increase, and urinary tract infections.

Most common (≥2%) adverse reactions in ankylosing spondylitis include upper respiratory tract infections, oral candidiasis, headache, diarrhea, injection site pain, rash, and vulvovaginal mycotic infections.

Please see the full Prescribing Information.

Most common (≥2%) adverse reactions in PsA, nr-axSpA, and AS include upper respiratory tract infections, oral candidiasis, headache, diarrhea, and urinary tract infections. Other most common (≥2%) adverse reactions specific to each indication include: urinary tract infections (PsA); cough, fatigue, musculoskeletal pain, myalgia, tonsillitis, transaminase increase, and urinary tract infections (nr-axSpA); injection site pain, rash, and vulvovaginal mycotic infections (AS).