Jazz Pharmaceuticals

Patient Support Services Guide 2018


Patient Assistance
888-837-4397
855-589-9367

Jazz Pharmaceuticals, through its JumpStart Program, offers patients support for its hematology/oncology drugs—Defitelio (defibrotide sodium), Erwinaze (asparaginase Erwinia chrysanthemi), and Vyxeos (dauno­rubicin and cytarabine) liposome (Table).

Defitelio is indicated for the treatment of patients with hepatic VOD (veno-occlusive disease) associated with renal or pulmonary dysfunction after hematopoietic stem-cell transplantation.

Erwinaze is indicated as a component of a multiagent chemotherapeutic regimen for the treatment of patients with acute lymphoblastic leukemia who are hypersensitive to Escherichia coli–derived asparaginase.

Vyxeos is indicated for adults with newly diagnosed therapy-related acute myeloid leukemia (t-AML) and for AML with myelodysplasia-related changes (AML-MRC).

The JumpStart Program

The JumpStart Program provides patients who are prescribed Defitelio, Erwinaze, or Vyxeos access to these medications through several financial assistance options. A patient assistance program is also offered for these 3 medications.

Eligibility

To be eligible for the JumpStart Program, a patient must:

  • Be a legal US resident
  • Have a valid prescription for Defitel­io or for Erwinaze for indicated uses
  • Receive treatment on an outpatient basis
  • Have no insurance coverage or no coverage for Erwinaze, Defitelio, or Vyxeos.

In addition, the patient must provide proof of income, including ≥1 of these documents—a copy of a current federal income tax return, W-2 forms, yearly benefit statement (Social Security form 1099), pay stubs, and bank statements for 3 months for all earners in the household. For more information about eligibility and assistance, please contact JumpStart specialists at 888-837-4397 for Defitelio or Erwinaze, and at 855-589-9367 for Vyxeos.

Application & Enrollment

Completed JumpStart forms may be submitted by:

  • Fax: 877-256-2430
  • Mail: JumpStart Program, 214 W Main Street, Gardner, KS 66030.

Table Jazz Pharmaceuticals Oncology Drugs

Drugs
Indications
Patient support programs

Drug
Defitelio (defibrotide sodium)
Indication
Adult and pediatric patients with hepatic VOD (veno-occlusive disease) associated with renal or pulmonary dysfunction after hematopoietic stem-cell transplantation
Patient support program

Drug
Erwinaze (asparaginase Erwinia chrysanthemi)
Indication
Acute lymphoblastic leukemia for a patient who is allergic to other asparaginase treatment
Patient support program

Drug
Vyxeos (daunorubicin and cytarabine) liposome
Indication
Adults with newly diagnosed therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (AML-MRC)
Patient support program