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PRALUENT Coverage Support
Getting patients started on PRALUENT

PRALUENT has broad coverage across commercial insurance and Medicare

PRALUENT: Available at a 60% lower list price
Programs to help patients pay for PRALUENT
Commercially Insured Patients
AS LITTLE AS $0 COPAY FOR PRALUENT*
If eligible, your patients can use the MyPRALUENT* Copay Card to pay the out-of-pocket costs for their PRALUENT treatment, including deductibles, copays, and coinsurance (up to a maximum assistance of $5,500 each year). Terms and conditions apply.
  • The MyPRALUENT Copay Card can be used yearly
  • Patients can submit for reimbursement if they paid their copay in full within 90 days

*Eligible patients with commercial insurance not funded through a government healthcare program such as Medicare, Medicaid, or TRICARE subject to program terms and restrictions.

†Subject to a maximum copay assistance amount from MyPRALUENT® of $5,500 a year.
 
Eligibility requirements
  • People with commercial or private insurance (not funded through a government healthcare program such as Medicare and similar programs)
  • Are 18 years of age or older
  • Have a valid prescription for PRALUENT for an approved indication
  • Reside in the 50 United States, the District of Columbia, or Puerto Rico
Please note: There are no income requirements to be eligible for the Copay Card.
Uninsured or Medicare patients
Uninsured or Medicare Part D patients who meet income restrictions.
Are your patients eligible? Download the form now or call 1-844-855-PASS (1-844-855-7277)
Extra Help Program
If your patients are faced with limited income and resources, there's a US government-funded program that may help pay some of their Medicare prescription drug costs. It's called the Extra Help Program and it offers:
  • Reduced Medicare Part D premiums
  • No cost share in the coverage gap or "donut hole"
  • Lower drug copays

Clinical documentation and prior authorization (PA) tips
Many health plans require a PA for PRALUENT. Here are some helpful tips to keep in mind when gathering your patient’s clinical information and preparing a PA submission.
Items to include when submitting a PA
Statement of Medical Necessity
Clinical documentation
Completed and signed plan-specific prior authorization form
Important patient information to collect
  • Specific ICD-10 codes and details to support your patient’s diagnosis
  • Complete history of lipid-lowering therapy, including doses, frequency, and dates of use
  • Be sure to include proof of maximally tolerated high-intensity statin(s) if required
  • Also note if your patient tried and failed on ezetimibe
  • Contraindications or any intolerance/adverse reactions to lipid-lowering therapies
  • Lab work within the last 30 days showing lipid profile test results
  • Documentation of family history and any comorbid conditions
  • Proof of lifestyle modification (e.g., diet, exercise, smoking cessation counseling)
Prior Authorization Tips for PRALUENT
Before submitting any documentation to the health plan, be sure that it’s accurate and up to date to avoid unnecessary denials.

Solutions are available to help your patients get started
iAssist, CoverMyMeds, and MyPRALUENT® provide a range of services and support to help you get your patients started on PRALUENT. Choose the option that works best for you and your office.

iAssist is an electronic platform that simplifies access to help get PRALUENT to appropriate patients. This free, all-in-one tool:

  • Sends prescriptions and completed prior authorization forms directly to the pharmacy and payer
  • May help reduce incomplete prior authorization submission
  • Facilitates easy access to MyPRALUENT patient support
Sanofi and Regeneron have teamed up with CoverMyMeds, a secure, HIPAA-compliant online tool that automates prior authorization requests for most health plans and PBMs at most pharmacies—at no cost.
 

MyPRALUENT provides nurse phone support for access and coverage questions

  • Benefits investigations
  • Prior authorization and appeals
  • Specialty pharmacy triage
To request support, contact MyPRALUENT at 1‑844‑PRALUENT (1‑844‑772‑5836).

GET HELP WITH COVERAGE

Contact a Reimbursement Specialist for on-demand assistance

PATIENT SUPPORT & RESOURCES

Download resources to help get your patients started on PRALUENT

Download resources to help get your patients started on PRALUENT

HELP KEEP PATIENTS ON TRACK

Learn how MyPRALUENT® Patient Services can support your patients

Learn how MyPRALUENT® Patient Services can support your patients

DOSING INFORMATION
  • The recommended starting dose of PRALUENT is 75 mg once every 2 weeks administered subcutaneously or alternatively 300 mg once every 4 weeks (monthly) for patients who prefer less frequent dosing. The majority of patients achieve sufficient LDL-C reduction with the 75 mg dosage. If the LDL-C response is inadequate, the dosage may be adjusted to the maximum dosage of 150 mg administered every 2 weeks
INDICATIONS AND USAGE

PRALUENT (alirocumab) is indicated:

  • to reduce the risk of myocardial infarction, stroke, and unstable angina requiring hospitalization in adults with established cardiovascular disease.
  • as an adjunct to diet, alone or in combination with other lipid-lowering therapies (e.g., statins, ezetimibe), for the treatment of adults with primary hyperlipidemia (including heterozygous familial hypercholesterolemia) to reduce low-density lipoprotein cholesterol (LDL-C).
IMPORTANT SAFETY INFORMATION
  • PRALUENT is contraindicated in patients with a history of a serious hypersensitivity reaction to PRALUENT, including hypersensitivity vasculitis and hypersensitivity reactions requiring hospitalization
  • Hypersensitivity reactions (e.g., pruritus, rash, urticaria), including some serious events (e.g., hypersensitivity vasculitis and hypersensitivity reactions requiring hospitalization), have been reported with PRALUENT treatment. If signs or symptoms of serious allergic reactions occur, discontinue treatment with PRALUENT, treat according to the standard of care, and monitor until signs and symptoms resolve
  • The most commonly occurring adverse reactions in clinical trials in primary hyperlipidemia (including heterozygous familial hypercholesterolemia (HeFH)) (≥5% of patients treated with PRALUENT and occurring more frequently than with placebo) are nasopharyngitis, injection site reactions, and influenza
  • The most commonly occurring adverse reactions in the cardiovascular outcomes trial (>5% of patients treated with PRALUENT and occurring more frequently than placebo) were non-cardiac chest pain, nasopharyngitis, and myalgia
  • In the primary hyperlipidemia (including HeFH) clinical trials, local injection site reactions including erythema/redness, itching, swelling, and pain/tenderness were reported more frequently in patients treated with PRALUENT 75 mg and/or 150 mg every 2 weeks (7.2% versus 5.1% for PRALUENT and placebo, respectively). Few patients discontinued treatment because of these reactions (0.2% versus 0.4% for PRALUENT and placebo, respectively), but patients receiving PRALUENT had a greater number of injection site reactions, had more reports of associated symptoms, and had reactions of longer average duration than patients receiving placebo
  • The once-monthly (Q4W) 300mg dosing regimen had a higher rate of local injection site reactions as compared to PRALUENT 75mg Q2W or placebo (16.6%, 9.6%, and 7.9%, respectively) in a trial in which all patients received an injection of drug or placebo every 2 weeks to maintain the blind. The discontinuation rate due to injection site reactions was 0.7% in the 300 mg Q4W arm and 0% in the other 2 arms
  • In a cardiovascular outcomes trial, local injection site reactions were reported in 3.8% of patients treated with PRALUENT versus 2.1% patients treated with placebo, and led to permanent discontinuation in 0.3% of patients versus <0.1% of patients, respectively
  • In the primary hyperlipidemia trials, liver-related disorders (primarily related to abnormalities in liver enzymes) were reported in 2.5% of patients treated with PRALUENT and 1.8% of patients treated with placebo, leading to treatment discontinuation in 0.4% and 0.2% of patients, respectively. Increases in serum transaminases to greater than 3 times the upper limit of normal occurred in 1.7% of patients treated with PRALUENT and 1.4% of patients treated with placebo
  • In the primary hyperlipidemia trials, the most common adverse reactions leading to treatment discontinuation in patients treated with PRALUENT were allergic reactions (0.6% versus 0.2% for PRALUENT and placebo, respectively) and elevated liver enzymes (0.3% versus <0.1%)
  • PRALUENT is a human monoclonal antibody. As with all therapeutic proteins, there is a potential for immunogenicity with PRALUENT

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SAUS.PRL.19.02.1357f Last Update: May 2019

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IMPORTANT SAFETY INFORMATION
  • PRALUENT is contraindicated in patients with a history of a serious hypersensitivity reaction to PRALUENT, including hypersensitivity vasculitis and hypersensitivity reactions requiring hospitalization
  • Hypersensitivity reactions (e.g., pruritus, rash, urticaria), including some serious events (e.g., hypersensitivity vasculitis and hypersensitivity reactions requiring hospitalization), have been reported with PRALUENT treatment. If signs or symptoms of serious allergic reactions occur, discontinue treatment with PRALUENT, treat according to the standard of care, and monitor until signs and symptoms resolve