Patient Guide to Support Services

Daiichi-Sankyo

Injectafer Patient Assistance Program
877-448-4766
Injectafer Savings Program
866-741-7276

Daiichi-Sankyo offers comprehensive reimbursement and patient support services for patients who are prescribed Injectafer (ferric carboxymaltose injection) but are unable to afford it.

Injectafer is an iron replacement therapy indicated for the treatment of iron-deficiency anemia in adults who are intolerant to or have had an unsatisfactory response to oral iron replacement therapy, and in adults who have no dialysis-dependent chronic kidney disease (Table). Injectafer provides up to 1500 mg of iron with 2 administrations.

Daiichi-Sankyo offers support services that facilitate patient access to Injectafer and include:

  • Financial assistance for eligible patients
  • Assistance with provider reimbursement and coding processes, such as verification of payer coverage and claims appeals.

Support Programs Injectafer Savings Program

The Injectafer Savings Program helps commercially insured or cash-paying patients with out-of-pocket Injectafer prescription costs. Eligible insured patients may pay no more than $50 for Injectafer for the first dose and $0 for Injectafer for the second dose onwards, up to a maximum savings limit of $500 per dose, and a $1000 program limit coverage for up to 2 doses.

Injectafer Patient Assistance Program

The Injectafer Patient Assistance Program is a medication replacement program that provides replacement for Injectafer free of charge to eligible patients who have no insurance coverage and are enrolled in the program.

Eligibility

Injectafer Savings Program

To qualify for the Injectafer Savings Program, patients must:

  • Have commercial insurance or be cash-paying patients
  • Not be enrolled in Medicare, Medicaid, or other federal or state healthcare programs, or third-party payers’ programs
  • Be a resident of the United States or Puerto Rico
  • Be aged ≥18 years.

Injectafer Patient Assistance Program

To qualify for the Injectafer Patient Assistance Program, patients must:

  • Have no health insurance
  • Not be eligible for private or public insurance or financing
  • Be a US citizen, legal entrant in the United States, or a permanent US resident
  • Meet income and other criteria defined by Daiichi Sankyo.

Application & Enrollment

Injectafer Savings Program

Providers may enroll in the Injectafer Savings Program by calling the Help Desk (866-741-7276) and registering their office, which will allow access to the Injectafer Savings Program web-based provider portal, to facilitate the determination of patients’ eligibility and their enrollment in the program.

After enrollment, patients will receive their virtual debit card. An explanation of benefits (EOB) must be submitted to confirm Injectafer use before the copay assistance can be processed. EOBs will also need to be submitted for any subsequent doses of Injectafer.

Patients who require additional courses of therapy will need to be re-enrolled into the Injectafer Savings Program. To receive retroactive enrollment assistance, patients must submit an Eligibility Attestation Form.

Injectafer Patient Assistance Program

Providers—hospitals, physicians, or infusion centers—may apply to the Injectafer Patient Assistance Program on behalf of their patients. To enroll patients in the Injectafer Patient Assistance Program, the program enrollment form must be completed. Providers can access the form online and fax it to 888-354-4856, mail it to the address on the form, or call 877-448-4766.

To request Injectafer replacement, complete the Injectafer Patient Assistance Program Product Request Form. The form can be accessed online and faxed to 888-354-4856, or mailed to the address on the form. Providers should submit the signed form at the end of each month. Proof of citizenship or legal residency may also be required.

Table Daiichi-Sankyo Oncology Supportive Care Drug

Drug
Indications
Patient support programs

Drug
Injectafer (ferric carboxymaltose injection)
Indication
Iron-deficiency anemia in adults who are intolerant to or have had an unsatisfactory response to oral iron replacement therapy, and in adults with non–dialysis-dependent chronic kidney disease
Patient support programs
The IV Iron Reimbursement Hotline
877-448-4766

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