adcirca patient assistance program enrollment form

What is the Adcirca co-pay assistance program?

ADCIRCA ® (tadalafil) Co-pay Assistance Program ADCIRCA Co-Pay Assistance Card For patients with commercial or private insurance plans, we offer a co-pay card to help patients cover some of their out-of-pocket expenses.

How do I get a referral for Adcirca (tadalafil)?

If you have any questions about completing the referral form, contact ASSIST at 1-877-UNITHER (1-877-864-8437), Monday - Friday, 8:30am to 7:00pm ET. ADCIRCA (tadalafil) is a prescription medication used to treat pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability.

What is Adcirca?

Adcirca (tadalafil) is a member of the agents for pulmonary hypertension drug class and is commonly used for Pulmonary Hypertension. This Adcirca price guide is based on using the Drugs.com discount card which is accepted at most U.S. pharmacies.

What is the cost of Adcirca 20 mg?

Adcirca (tadalafil) is a member of the agents for pulmonary hypertension drug class and is commonly used for Pulmonary Hypertension. The cost for Adcirca oral tablet 20 mg is around $4,363 for a supply of 60 tablets, depending on the pharmacy you visit.

How long does it take for Adcirca to be discontinued?

For patients on ADCIRCA therapy that require treatment with ritonavir, ADCIRCA should be discontinued at least 24 hours prior to starting ritonavir. For patients on ritonavir therapy that require treatment with ADCIRCA, start ADCIRCA at 20 mg once a day.

Is tadalafil safe for pregnant women?

Special Populations (Pregnant or Expecting Pregnancy): Limited data from case series with tadalafil use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes. Pregnant women with untreated pulmonary arterial hypertension are at risk for heart failure, stroke, preterm delivery, and maternal and fetal death.

Can you take Adcirca with rifampin?

Use of ADCIRCA with potent inducers of CYP3A, such as rifampin, should be avoided. Potential Drug Interactions: ADCIRCA contains the same ingredient (tadalafil) as Cialis ®, which is used to treat erectile dysfunction (ED) and the signs and symptoms of benign prostatic hyperplasia (BPH).

Is Adcirca safe for renal patients?

Special Populations ( Renal or He patic Impairment): The use of ADCIRCA is not recommended for patients with severe renal or hepatic impairment. Please see Full Prescribing Information for dosing recommendations for patients with mild to moderate renal or hepatic impairment

Can you use adcipirca with nitrates?

CONTRAINDICATIONS. Nitrates and Guanylate Cyclase (GC) Stimulators: Do not use ADCIRCA in patients taking medicines that contain nitrates or guanylate cyclase stimulators (such as riociguat), as the combination could cause a sudden, unsafe drop in blood pressure.

What is the drug ADCIRCA?

ADCIRCA is a type of medication called a phosphodiesterase 5 inhibitor (PDE-5i) that can cause blood vessels to widen, which may result in a decrease in blood pressure. If you have heart-disease or any problems with low blood pressure, tell your healthcare provider before taking ADCIRCA, as these conditions may be affected by the action of ADCIRCA

What is AdciRCA used for?

ADCIRCA (tadalafil) is a prescription medication used to treat pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability. Studies establishing effectiveness included predominately patients with NYHA Functional Class II–III symptoms and etiologies of idiopathic or heritable PAH (61%) or PAH associated with connective tissue diseases (23%).

Is Adcirca safe for lungs?

If you have ever had blockage in the veins of your lungs, known as pulmonary veno-occlusive disease (PVOD), ADCIRCA is not recommended for you

Can you take Adcirca with nitrates?

Do not take ADCIRCA if you take any medications that contain nitrates (often used for chest pain) or guanylate cyclase stimulators, as the combination could cause a sudden, unsafe drop in blood pressure

What is the drug ADCIRCA?

ADCIRCA is a type of medication called a phosphodiesterase 5 inhibitor (PDE-5i) that can cause blood vessels to widen, which may result in a decrease in blood pressure. If you have heart-disease or any problems with low blood pressure, tell your healthcare provider before taking ADCIRCA, as these conditions may be affected by the action of ADCIRCA

What is AdciRCA used for?

ADCIRCA (tadalafil) is a prescription medication used to treat pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability. Studies establishing effectiveness included predominately patients with NYHA Functional Class II–III symptoms and etiologies of idiopathic or heritable PAH (61%) or PAH associated with connective tissue diseases (23%).

Is Adcirca safe for lungs?

If you have ever had blockage in the veins of your lungs, known as pulmonary veno-occlusive disease (PVOD), ADCIRCA is not recommended for you

Does United Therapeutics offer free medication?

United Therapeutics offers a free medication program for uninsured and underinsured patients who meet eligibility requirements.

Can you take Adcirca with nitrates?

Do not take ADCIRCA if you take any medications that contain nitrates (often used for chest pain) or guanylate cyclase stimulators, as the combination could cause a sudden, unsafe drop in blood pressure

What is Accredo checklist?

Accredo has developed a checklist to assist you in completing the required clinical documentation for insurance approval for your PAH patients. This checklist is a tool to help remind you everything you need to submit along with the therapy referral form. Our experience has shown that patients get approved quicker when all of the required documentation is submitted along with the referral form. In certain instances we may require additional supporting documentation when there is a presence of other disease comorbidities for example.

Do you need to submit a checklist with a referral?

Please note: the checklist is only a tool and is not required to be submitted along with the referral form and the clinical documentation.

How long does it take for a patient to get reimbursement for a copay?from praluenthcp.com

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 are subject to program terms and restrictions.

What is the extra help program?from praluent.com

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.

What to know before submitting documentation to health plan?from praluenthcp.com

Before submitting any documentation to the health plan, be sure that it’s accurate and up to date to avoid unnecessary denials.

Do you have to have income to get a copay card?from praluent.com

Please note: There are no income requirements to be eligible for the Copay Card.

Do you need a PA for paluent?from praluenthcp.com

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.

Can you use my PRALUENT card for out of pocket?from praluent.com

If eligible, you can use the MyPRALUENT ® Copay Card to pay your out-of-pocket costs for your PRALUENT treatment, including deductibles, copays, and coinsurance (up to a maximum assistance of $3,500 each year). Terms and conditions apply. †

What is Adcirca used for?

Adcirca (tadalafil) is a member of the agents for pulmonary hypertension drug class and is commonly used for Pulmonary Hypertension.

How much does a free drug card save?

The free Drugs.com Discount Card works like a coupon and can save you up to 80% or more off the cost of prescription medicines, over-the-counter drugs and pet prescriptions.

Is Adcirca a generic?

Prices are for cash paying customers only and are not valid with insurance plans. A generic version of Adcirca is available, see tadalafil prices. This Adcirca price guide is based on using the Drugs.com discount card which is accepted at most U.S. pharmacies.

Contraindications

Warnings and Precautions

Special Populations and Potential Drug Interactions