What is the patient support program for Eliquis® (apixaban)?
The patient support program for ELIQUIS®(apixaban) (the “Program”) is designed to provide you with reimbursement support services. To participate in the Program we will need to receive, use, and disclose your personal information. Please read this form carefully and contact Bristol Myers Squibb
How to edit Eliquis patient assistance form?
PDF editor permits you to help make changes to your Eliquis Patient Assistance Form from the internet connected gadget, personalize it based on your requirements, indicator this in electronic format and also disperse differently. Turn your records into enforceable documents by making and implementing your signature with one click.
How do I get a prescription for Eliquis?
or complete the online form at: www.bms.com/dpo/us/request Click here for U.S. Full Prescribing Information, including Boxed WARNINGSand Medication Guide, or visit ELIQUIS.com. The patient or his/her representative must be provided with a copy of this Patient Authorization and Agreement Form after it has been signed.
What is the Eliquis co-pay program?
Eligible patients who present an activated Co-pay Card together with a valid prescription for ELIQUIS at participating pharmacies may pay as little as $10 per 30-day supply (up to 74 tablets for the first fill and up to 60 tablets for all subsequent fills) for up to 24 months, subject to a maximum annual benefit of $3800.
How do you qualify for free eliquis?
You may be eligible for the Free 30-Day Trial Offer for ELIQUIS® (apixaban) if:You have not previously filled a prescription for ELIQUIS;You have a valid 30-day prescription for ELIQUIS;You are being treated with ELIQUIS for an FDA-approved indication that an HCP has planned for more than 35 days of treatment;More items...
Does Bristol Myers Squibb have a patient assistance program?
The Bristol Myers Squibb Patient Assistance Foundation (BMSPAF) is an independent, charitable organization that helps eligible patients who need temporary help obtaining the medicines listed on this website.
Who is the manufacturer for eliquis?
Bristol-Myers Squibb Co.Brand Name: Eliquis® Generic Name: apixaban Manufacturer: Bristol-Myers Squibb Co. with nonvalvular atrial fibrillation.
Does Pfizer have a patient assistance program?
Pfizer Patient Assistance Program Provides free Pfizer medicines to eligible patients through their doctor's office or at home. To qualify, patients must: Have a valid prescription for the Pfizer medicine for which they are seeking assistance.
Is Eliquis made by Pfizer?
Sales of Eliquis, which Bristol-Myers co-developed with Pfizer, rose 22% to $1.93 billion and made up about 30% of the Bristol-Myers' total revenues in the latest reported quarter. Eliquis is an approved treatment to reduce the risk of stroke in patients with irregular heartbeat or atrial fibrillation.
Does Walgreens accept Eliquis co pay card?
Valid at all major chains including Walgreens, CVS Pharmacy, Target, WalMart Pharmacy, Duane Reade and 65,000 pharmacies nationwide.
Is Eliquis going generic in 2022?
As the original manufacturers, they own a patent that prevents generics from being introduced until the patent expires. That patent was extended from February 2023 to November 2026. Both drug makers say that's when generics can be made available.
Why is Eliquis being recalled?
Eliquis was recalled on June 10th, 2017, due to a possible packaging error. It was found that a bottle labeled as Eliquis 5 mg contained 2.5 mg tablets, a lower strength. Receiving the wrong strength of Eliquis could potentially cause severe adverse effects like a blood clot, stroke, or death.
What is the cheapest alternative to Eliquis?
Warfarin (Coumadin, Jantoven). Warfarin is a comparable generic drug that can cost as little as $4 with a GoodRx discount.
What is Xelsource?
Psoriatic Arthritis. • XELJANZ/XELJANZ XR (tofacitinib) is indicated for the treatment of adult patients with active psoriatic arthritis who have had an inadequate response or intolerance to methotrexate or other disease-modifying antirheumatic drugs (DMARDs).
Does Viatris have a patient assistance program?
The Viatris Patient Assistance Program provides certain medicines for free to patients with demonstrated financial need. Viatris is committed to helping patients get the treatments they need, when and where they need them.
What is Pfizer enCompass?
Pfizer enCompass offers various services to patients including reimbursement support for insured patients; co-pay assistance for eligible commercially insured patients who cannot afford their co-pays, co-insurances, or deductibles; and a free medicine patient assistance program for eligible uninsured or underinsured ...
What can I do if I can't afford eliquis?
If your insurance doesn't cover Eliquis, talk to your healthcare provider about filing an appeal for coverage. They may be able to submit a letter that explains why you need coverage for Eliquis. Or you can ask your provider about similar medication options that are covered by your plan.
What is simple fill?
Simplefill is a full-service prescription assistance company that is dedicated to making. prescribed medications affordable for our members. ARE YOU... one of the millions. of Americans who.
How do I apply for eliquis?
Prescription Coverage Assistance Call Tap to call 1-855-ELIQUIS (354-7847) from Monday – Friday, 8 AM – 8 PM (ET). Live specialists are here to: Help you find out if ELIQUIS is covered by your insurance plan. Determine if you are eligible for assistance paying for ELIQUIS.
How do I contact Bristol Myers Squibb?
Contact UsCustomer and Community Relations. 1-800-332-2056. (toll free U.S. only)Report Side Effects or Product Quality Complaints. 1-800-721-5072. (toll free U.S. only)Medical Information Contact Center. 1-800-321-1335. (toll free U.S. only) Mon - Fri 8am - 8pm ET.
What is Eliquis used for?
ELIQUIS is indicated to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (NVAF). ELIQUIS is indicated for the prophylaxis of deep vein thrombosis (DVT), which may lead to pulmonary embolism (PE), in patients who have undergone hip or knee replacement surgery.
How much does Eliquis cost?
Eligible patients who present an activated Co-pay Card together with a valid prescription for ELIQUIS at participating pharmacies may pay as little as $10 per 30-day supply (up to 74 tablets for the first fill and up to 60 tablets for all subsequent fills) for up to 24 months, subject to a maximum annual benefit of $3800. Other restrictions may apply. Patient is responsible for applicable taxes, if any.
How long is the Eliquis trial?
You may be eligible for the Free 30-Day Trial Offer for ELIQUIS®(apixaban) if: You have not previously filled a prescription for ELIQUIS; You have a valid 30-day prescription for ELIQUIS; You are being treated with ELIQUIS for an FDA-approved indication that an HCP has planned for more than 35 days of treatment;
How long after a catheter removal can you give Eliquis?
The next dose of ELIQUIS should not be administered earlier than 5 hours after the removal of the catheter. The risk may also be increased by traumatic or repeated epidural or spinal puncture. If traumatic puncture occurs, delay the administration of ELIQUIS for 48 hours.
Is Eliquis a copay?
The Co-pay Card for ELIQUIS is not health insurance.
How to contact McKesson Pharmacy?
To the pharmacist:For processing assistance, please call McKesson Pharmacy Support at 1-866-279-4730.
How long is the free trial for a new patient?
Free 30-day trial offer for first-time patients and
What is Eliquis used for?
ELIQUIS (apixaban) is a prescription medicine used to treat blood clots in the veins of your legs (deep vein thrombosis) or lungs (pulmonary embolism), and reduce the risk of them occurring again . ELIQUIS (apixaban) is a prescription medicine used to reduce the risk of forming a blood clot in the legs and lungs of people who have just had hip ...
What are the symptoms of eliquis?
or bleeding. Tell your doctor right away if you have any of these signs or symptoms (especially in your legs and feet) when taking ELIQUIS: Tingling. Numbness.
How many different tablets are there for Eliquis?
ELIQUIS is available in two different tablets. Your doctor or healthcare provider will determine what dose is right for you.
Can you refill Eliquis after knee replacement?
When leaving the hospital following hip or knee replacement, be sure that you will have ELIQUIS available to avoid missing any doses. ELIQUIS is available in two different tablets. Your doctor or healthcare provider will determine what dose is right for you.
Can Eliquis cause bleeding?
Bleeding. ELIQUIS can cause bleeding, which can be serious, and rarely may lead to death. This is because ELIQUIS is a blood thinner medicine that reduces blood clotting. While taking ELIQUIS, you may bruise more easily and it may take longer than usual for any bleeding to stop.
Can you stop Eliquis before surgery?
ELIQUIS may need to be stopped prior to surgery or a medical or dental procedure. Your doctor will tell you when you should stop taking ELIQUIS and when you may start taking it again. If you have to stop taking ELIQUIS, your doctor may prescribe another medicine to help prevent a blood clot from forming.
Can you breastfeed with Eliquis?
Tell your doctor if you are pregnant or breastfeeding, or planning to become pregnant or breastfeed. You and your doctor should decide if you will take ELIQUIS or breastfeed. You should not do both.
What is prior authorization for Eliquis?
Prior authorization: If your insurance plan needs prior authorization before approving coverage of ELIQUIS, live specialists can help coordinate the process among your doctors, insurer, and pharmacist, and get the paperwork submitted.
What is a formulary exception?
Formulary exception requests: A formulary is an insurance company’s list of covered medications. Some insurance plans may not cover ELIQUIS, or will ask that a formulary exception request be submitted. Our live specialists can provide general information regarding the exception process to help you and your healthcare prescriber. If your prescriber is unable to get ELIQUIS approved, and if you are eligible, we will refer you to other co-pay assistance programs or the patient assistance program.
Available medicines
Find out if the medicine your doctor prescribed is available through the Bristol Myers Squibb Patient Assistance Foundation.
Eligibility
Complete a brief assessment to see if you might be eligible for assistance.
How to apply
We'll need some information from both you and your doctor to process your application.
