What is the dosage of Besponsa?

Besponsa is available in 1 dosages, including 0.9 mg Injection

What does Besponsa treat?

Besponsa treats Precursor Cell Lymphoblastic Leukemia-Lymphoma

What is Besponsa made of?

Besponsa contains inotuzumab ozogamicin which is a CD22-directed Immunoconjugate

How is Besponsa administered?

Besponsa is administered as a Injectable

What is Besponsa mechanism of action?

Besponsa mechanism of action is CD22-directed Antibody Interactions

Besponsa Prescribing & Dosing Schedule

Dosage & Administration

* Administer by intravenous infusion only. (2.1)
* Pre-medicate with a corticosteroid, antipyretic, and antihistamine prior to all infusions.
* Dosing regimens for Cycle 1 and subsequent cycles, depending on the response to treatment, are shown below. See full prescribing information for dosing details.

* For patients who achieve a CR or a CRi, and/or to allow for recovery from toxicity, the cycle length may be extended up to 28 days (i.e., 7-day treatment-free interval starting on Day 21).
	Day 1	Day 8	Day 15
Dosing regimen for Cycle 1
All patients:
Dose	0.8 mg/m2	0.5 mg/m2	0.5 mg/m2
Cycle length	21 days *
Dosing regimen for subsequent cycles depending on response to treatment
Patients who have achieved a CR or CRi:
Dose	0.5 mg/m2	0.5 mg/m2	0.5 mg/m2
Cycle length	28 days
Patients who have not achieved a CR or CRi:
Dose	0.8 mg/m2	0.5 mg/m2	0.5 mg/m2
Cycle length	28 days

* See full prescribing information for instructions on reconstitution of lyophilized powder, and preparation and administration of reconstituted drug.

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Besponsa Prior Authorization Resources

Most recent state uniform prior authorization forms

Verified: Sep 24, 2024Arizona - Uniform Prior Authorization Form

Verified: Sep 24, 2024Colorado - Uniform Prior Authorization Form

Verified: Sep 24, 2024Hawaii - Uniform Prior Authorization Form

Verified: Sep 24, 2024Illinois - Uniform Prior Authorization Form

Verified: Sep 24, 2024Indiana - Uniform Prior Authorization Form

Verified: Sep 24, 2024Louisiana - Uniform Prior Authorization Form

Verified: Sep 24, 2024Minnesota - Uniform Prior Authorization Form

Verified: Sep 24, 2024New Hampshire - Uniform Prior Authorization Form

Verified: Sep 24, 2024New Mexico - Uniform Prior Authorization Form

Verified: Sep 24, 2024Oregon - Uniform Prior Authorization Form

Verified: Sep 24, 2024Texas - Uniform Prior Authorization Form

Verified: Oct 05, 2024Washington - Uniform Prior Authorization Form

Verified: Oct 05, 2024Wisconsin - Uniform Prior Authorization Form

Appeals Checklist

Coverage Authorization Appeal

Formulary Exception Letter

Complete Letter of Medical Necessity

PA Checklist

Benefits investigation

Pfizer Oncology Together Form

Pfizer Oncology Together Form - Spanish

Reimbursement help (FRM)

Receive Assistance from an FRM Regarding Reimbursement Information

Besponsa Preferred Pharmacy

Pharmacy List

Besponsa Financial Assistance Options

Copay 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

Pfizer Oncology Together Form

Pfizer Oncology Together Form - Spanish

Pfizer Patient Assistance Program

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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 copays) 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.