2020 Guide to Patient Support Services

Helsinn Therapeutics

Helsinn Therapeutics offers the Helsinn Cares program that supports access, reimbursement, and assistance for patients who are prescribed Helsinn Therapeutics oncology medication, including Akynzeo (netupitant and palonosetron) or Valchlor (mechlorethamine gel). Akynzeo is indicated for the prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV). Valchlor is indicated for the topical treatment of stage IA/IB mycosis fungoides-type cutaneous T-cell lymphoma in patients who have received skin-directed therapy (Table).

HELSINN CARES SERVICES

Helsinn Cares provides several services for patients who have been prescribed Akynzeo or Valchlor.

Akynzeo Support Services

Akynzeo Pay $0 Savings Program and Akynzeo Capsule Savings Card offer eligible patients who have commercial insurance a $0 copay on each prescription, with an $1800 annual limit. For cash-paying patients, Helsinn will pay up to $150 per prescription, for a maximum of $1800 annually.

Helsinn Cares Patient Assistance Program provides Akynzeo at no cost to uninsured and underinsured patients, as well as Medicare Part D beneficiaries who meet the eligibility requirements.

Reimbursement Support Resources and Patient and Caregiver Access Resources provide support and resources to healthcare professionals, patients, and caregivers for Akynzeo reimbursement, including confirming benefit coverage and facilitating prior authorizations or appeals (HelsinnReimbursement.com).

Valchlor Support Services

Valchlor Support provides information and resources about starting treatment, refills, and financial support. Valchlor Support reimbursement specialists can assist patients with initial prescription enrollment and insurance verification, scheduling of Valchlor shipments to the patient’s home, refill reminders, and financial assistance for eligible patients.

Valchlor Co-pay Program

Patients with private insurance who are prescribed Valchlor may be eligible for a $10 copay for each prescription fill of Valchlor through the Valchlor co-pay program.

Uninsured and underinsured patients who are prescribed Valchlor may be eligible for the Patient Assistance Program or for alternative funding resources.

Helsinn Cares Patient Assistance Program

This program provides Akynzeo capsules or injection, or Valchlor, at no cost to underinsured and uninsured patients and for Medicare Part D beneficiaries who meet the eligibility requirements for this program.

Akynzeo Capsule Savings Card is available for eligible patients who have commercial insurance. Helsinn will pay up to $50 copay savings for each prescription of Akynzeo capsules.

ELIGIBILITY

Akynzeo Pay $0 Savings Program

To be eligible for the Akynzeo Pay $0 Savings Program, patients must have commercial insurance and must:

  • Have a prescription for Akynzeo
  • Not be enrolled in state or federal healthcare programs, including Medicare, Medicaid, Medigap, VA, DoD, or TRICARE
  • Live within the United States.

No activation or enrollment is required for this program. The savings card can be downloaded directly from AkynzeoSavingsProgram.com.

Helsinn Cares Patient Assistance Program

To determine eligibility for this program, patients must be enrolled in Helsinn Cares and must also:

  • Have a prescription for Akynzeo or for Valchlor
  • Be a US resident, including Puerto Rico, Guam, and the US Virgin Islands
  • Have a mailing address that is not a PO Box
  • Be uninsured or underinsured, with no insurance coverage for Akynzeo or for Valchlor
  • If insured, have had prior authorization and 1 appeal denied (if ­applicable)
  • Meet income criteria with appropriate documentation.

Valchlor Co-pay Program

Patients eligible for coverage under the Valchlor Co-pay Program must meet the following requirements:

  • Be aged ≥18 years
  • Be a resident of the United States or Puerto Rico
  • Have private insurance
  • Not be insured by a federal- or state-subsidized insurance program.

APPLICATION & ENROLLMENT

Akynzeo Support

Physicians must enroll their patients in Helsinn Cares to avail them of the Akynzeo Capsule ­Savings Card program and the ­Helsinn Cares Patient Assistance Program. Completion of the Helsinn Cares Patient Support Program Patient Enrollment Form is required.

The form must be filled out in black ink and faxed to 844-357-4669. Financial documentation is required for enrollment in the Helsinn Cares Patient Assistance Program, including a 1040 tax return, SSA-1099, W-2, Social Security benefit statement, unemployment or disability statement, or 1 month of paycheck stubs.

Valchlor Support

To enroll in Valchlor Support, call 855-482-5245.

TABLE HELSINN ONCOLOGY SUPPORTIVE CARE DRUGS

Drugs
Indications
Patient support programs

Drug
Akynzeo (netupitant and palonosetron) capsules
Indications
Prevention of acute/delayed nausea and vomiting associated with initial and repeated use of chemotherapy, including emetogenic agents
Patient support programs

Drug
Valchlor (mechlorethamine) gel
Indications
Topical treatment of stage IA/IB mycosis fungoides-type cutaneous T-cell lymphoma after skin-directed therapy
Patient support programs

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