Cost Savings and Insurance Coverage for NUEDEXTA
Considerable cost savings and insurance coverage available for many commercial patients1,2
- 83% of commercially insured patients pay ≤ $30 for a NUEDEXTA prescription1
- NUEDEXTA has preferred brand coverage for more than 100 million commercial lives2
Extensive nationwide Medicare coverage3
- 78% of Medicare Part D patients pay ≤ $15 for a NUEDEXTA prescription4,a
- NUEDEXTA is covered by >99% of all Medicare plans nationwide, including:3
- Medicare Prescription Drug Plans (PDP)
- Medicare Advantage Plans (MA)
- Special Needs Plans (SN)
aJanuary 2018 - December 2020.
Data Sources: 1. IQVIA, LAAD Dataset; January, 2018 - December, 2020; Commercially Insured; N=249k total claims. 2. Decision Resources Group. NUEDEXTA Preferred Commercial Coverage. January 14, 2019. 3. Decision Resources Group. NUEDEXTA Medicare Coverage. January 14, 2019. 4. IQVIA, LAAD Dataset; January, 2018 - December, 2020; Medicare Insured; N=628k total claims.
NUEDEXTA Co-Pay Savings Card
You can help reduce the cost of NUEDEXTA for many of your commercially insured patients by sharing this card with them.
NUEDEXTA CO-PAY SAVINGS PROGRAM:
Your commercially insured patients may pay as little as $0* for their NUEDEXTA 90-day prescription
- Applies to both new prescription and refills
- Patients who are eligible for any state or federally funded prescription programs, including Medicare, Medicaid, Medigap, VA, DOD, or TriCare, are not eligible for this program
NUEDEXTA Sample Request Form
Request a sample to start your patients on NUEDEXTA. Eligible healthcare providers can request a free 10-day sample of NUEDEXTA for appropriate patients.
Note: Most patients see best results after 12 weeks.5,6
NUEDEXTA Prior Authorization
Some insurance providers and Medicare Part D plans may require prior authorization (PA) for the patients or residents for whom you prescribe NUEDEXTA. Each health plan will determine the PA criteria for its formulary. There are 4 common pieces of documentation generally requested by plans as part of their PA process to ensure that NUEDEXTA is being used safely and appropriately. These are:
- Documentation of primary diagnosis of PBA: ICD-10-CM diagnosis code: F48.2*
- Documentation of underlying conditions in which PBA may occur
- Documentation that NUEDEXTA is not contraindicated for the patient; please refer to Important Safety Information
- Medical or clinical history document
- For reauthorization: Usually at the start of the year, documentation of symptom improvement and/or improvement to the CNS-LS scores maybe required
*For your reference only. ICD-10-CM codes submitted to health plans/payers must be determined by provider and accurately describe the diagnosis of the patient.
The resources below can help support you and your patients through the prior authorization process.
NUEDEXTA Connect: Tailored support to help your patients throughout their treatment journey
NUEDEXTA Connect partners with CoverMyMedsb to streamline prior authorizations for providers and pharmacists and provide many other patient support services — to help remove access barriers to therapy.
AVAILABLE SUPPORT b
- Benefits verification
- Prior authorization and formulary exception support
- Support from Case Managers
- Easy-to-initiate co-pay assistance and information on financial support*
- Free product for uninsured and underinsured patients†
- Referrals to independent foundations
- Helpful information about taking NUEDEXTA
*Restrictions apply. Most commercially insured patients pay as little as $0 for a 90-day supply or $20 for a 30-day supply. Patients who are eligible for any state or federally funded prescription programs, including Medicare, Medicaid, Medigap, VA, DOD, or TriCare, are not eligible for this program.
For information on additional support, visit our Patient Assistance page.
Monday through Friday | 8 AM – 8 PM ET
Create a free account or log in to your existing account at CoverMyMeds.com. You can start a NUEDEXTA Connect enrollment or seamlessly submit, track, and manage prior authorization requests.