Avsola

(infliximab)

AVSOLA 100 MG Injection

Dosage & administration

* Prior to treatment, ensure appropriate personnel and medication are available to treat reactions (e.g., hypersensitivity) that occur during infusion and shortly after infusion.
* AVSOLA is administered by intravenous infusion for at least 2 hours with an in-line filter.
* Crohn's Disease: 5 mg/kg at 0, 2 and 6 weeks, then every 8 weeks. Some adult patients who initially respond to treatment may benefit from increasing the dose to 10 mg/kg every 8 weeks if they later lose their response.
* Pediatric Crohn's Disease (≥6 years old): 5 mg/kg at 0, 2 and 6 weeks, then every 8 weeks.
* Ulcerative Colitis: 5 mg/kg at 0, 2 and 6 weeks, then every 8 weeks.
* Pediatric Ulcerative Colitis (≥6 years old): 5 mg/kg at 0, 2 and 6 weeks, then every 8 weeks.
* Rheumatoid Arthritis: In conjunction with methotrexate, 3 mg/kg at 0, 2 and 6 weeks, then every 8 weeks. Some patients may benefit from increasing the dose up to 10 mg/kg every 8 weeks or treating as often as every 4 weeks.
* Ankylosing Spondylitis: 5 mg/kg at 0, 2 and 6 weeks, then every 6 weeks.
* Psoriatic Arthritis and Plaque Psoriasis: 5 mg/kg at 0, 2 and 6 weeks, then every 8 weeks.

drug label

Avsola prescribing information

Contact Medical Science Liaison Report Adverse Event

prior authorization

Avsola prior authorization resources

Most recent Avsola prior authorization forms

View By Payer

Verified: Sep 04, 2023Highmark BCBS Northeastern NY - Outpatient Infliximab Prior Authorization Form (Medical Benefit)

Verified: Sep 04, 2023Highmark BCBS Western NY - Outpatient Infliximab Prior Authorization Form (Medical Benefit)

Verified: Oct 03, 2023Highmark BCBS West Virginia - Outpatient Infliximab Prior Authorization Form (Medical Benefit)

Verified: Oct 03, 2023Highmark BCBS Delaware - Outpatient Infliximab Prior Authorization Form (Medical Benefit)

Verified: Oct 03, 2023Highmark BCBS Central PA - Outpatient Infliximab Prior Authorization Form (Medical Benefit)

Verified: Oct 02, 2023Highmark BCBS Western PA - Outpatient Infliximab Prior Authorization Form (Medical Benefit)

Verified: Sep 27, 2023Cigna - Infliximab Biosimilar Prior Authorization Form

Verified: Sep 26, 2023Blue Cross Blue Shield of Michigan - Infliximab Products Prior Authorization Form (Medical Benefit)

Verified: Sep 21, 2023Aetna - Avsola Prior Authorization Form

Verified: Sep 19, 2023Aetna - Medicare Part B Avsola Prior Authorization Form

PDFComplete Letter of Medical Necessity

PDFCoverage Authorization Appeals

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Benefits investigation

PDFBenefits Investigation Form

Benefits Investigation - Online

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Reimbursement help (FRM)

OTHERReceive Assistance from an FRM Regarding Reimbursement Information

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financial assistance

Avsola financial assistance options

Co-pay savings program

commercial only

Enroll in Patient Savings Program

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Overview

Reduce patient OOP costs for drug (and occasionally for drug administration/infusion costs or drug-related test costs)

Patient benefit

A portion (or all) of patient OOP (deductible, copay), typically up to monthly and/or annual max

Patient eligibility

Patient must enroll or activate (may permit HCPs to enroll on patient’s behalf for HCP-administered drugs)
Generally, must have commercial insurance (rarely, may permit uninsured patients to use)
May never be used with government insurance

How to sign up

Cards may be downloadable digital cards or hard copies
Some pharmacos offer debit cards with pre-loaded copay benefit
Typically, available through multiple channels (e.g., rep to HCP to patient; pharmacy to patient; patient via website, Hub live agent, or copay vendor (live agent or IVR); patient and HCP via Hub enrollment form)
Some HCP-administered product programs permit HCPs to enroll on a patient’s behalf through via Hub form

Foundation programs

under insured

no insurance

goverment insurance

65+

OTHERAmgen Patient Assistance Program Eligibility

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Overview

Charitable 501(c)(3) organizations provide direct cost-sharing and other support (e.g., travel, counseling) through disease-state funds to indigent patients on first-come first-served basis
These organizations may receive financial contributions from drug manaufacturers for particular disease-state funds that cannot provide funds directly to patients - the foundation must be independent/unaligned

Patient benefit

Patients apply for grants that cover a portion (or all) of their out-of-pocket costs (deductibles and co-pays) until the grant is exhausted

Patient eligibility

Patients must apply and meet eligibility criteria including income level (typically a multiple of federal poverty line), specific diagnosis, insurance status, etc.

How to sign up

Patients submit proof of out-of-pocket drug costs to charities for reimbursement

patient education

Avsola patient education

Getting started on Avsola

To share resource; ask patient to:

1.Pull out phone

2.Open camera

3.Scan QR code with camera

4.Tap link