NUEDEXTA HAS EXTENSIVE NATIONWIDE COVERAGE
- 81% of Commercial patients pay
≤ $30 for NUEDEXTA1
- 80% of Medicare patients pay ≤
$15 for their NUEDEXTA prescription1
REQUEST A SAMPLE TO START PATIENTS ON NUEDEXTA
With the NUEDEXTA Savings Card,a most commercially insured patients may qualify to pay as little as $0† for a 90 day prescription of NUEDEXTA or $30 for a 30 day supply.
aRestrictions apply. Those eligible for any state or federally funded prescription programs, including Medicare, Medicaid, Medigap, VA, DOD, or TriCare, are not eligible for this program.
*Available to qualifying privately insured patients. Restrictions apply.
†Restrictions apply. Most commercially insured patients pay as little as $0 for a 90-day supply or $30 for a 30-day supply. Benefit cap applies regardless of copay amount.
Avanir Pharmaceuticals is committed to helping patients get
the therapy they need through Advanced Patient Services*
The Advanced Patient Services program is designed to help patients and caregivers appropriately navigate the complexities of the managed care landscape to obtain NUEDEXTA. Professionally trained and experienced Reimbursement Specialists are committed to helping with eligibility for coverage, cost, and formulary authorization if necessary.
*Some services are limited to on-label diagnosis.
- More than 3500 patient cases successfully completed for NUEDEXTA in the last year1
- 95% Average approval rate1
One-Stop Access and Benefits Support
Prior Authorization and Formulary Exception Support
Patient Assistance Programs (PAP)
Referrals to Independent Foundations
Home Delivery Option
What You Need to Get Patients Started
APS Enrollment Form:
Prescriber Section and Patient Section completed and signed
Patient Insurance Information
ICD-10 Diagnosis Code†‡
Copy of Prescription:
if requesting Home Delivery
- Restrictions apply. Those eligible for any state or federally funded prescription programs, including Medicare, Medicaid, Medigap, VA, DOD, or TriCare, are not eligible for this program.
- Some services are limited to on-label diagnosis codes.
- ICD-10-CM codes submitted to the payer must be determined by the provider/physician and accurately describe the diagnosis for which the patient receives NUEDEXTA treatment, represent codes at the highest level of specificity, and reflect the contents of any clinical notes and/or chart documentation.
*Not all patients are eligible for coverage.