Besremi

(ropeginterferon alfa-2b)

BESREMi 500 MCG in 1 ML Prefilled Syringe

Dosage & administration

* Recommended starting dose: 100 mcg by subcutaneous injection every 2 weeks (50 mcg if receiving hydroxyurea).
* Increase the dose by 50 mcg every 2 weeks (up to a maximum of 500 mcg) until hematological parameters are stabilized ( 2.1)
* Interrupt or discontinue dosing if certain adverse reactions occur ( 2.3, 5)

biomarker testing

Besremi clinical details

Genetic testing requirements were obtained from the NCCN guidelines for each cancer type.

drug label

Besremi prescribing information

Contact Medical Science Liaison Report Adverse Event

prior authorization

Besremi prior authorization resources

OTHERComplete Letter of Medical Necessity

OTHERCoverage Authorization Appeals

OTHERFormulary Exception Letter

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Benefits investigation

PDFPharmaEssentia SOURCE Enrollment Form

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Reimbursement help (FRM)

Receive Assistance from an FRM Regarding Reimbursement Information

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pharmacy

Besremi preferred pharmacy

PDFPharmacy List

financial assistance

Besremi financial assistance options

Co-pay savings program

commercial only

PDFPharmaEssentia SOURCE Enrollment Form

OTHEREnroll 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

Bridge program

commercial only

PDFPharmaEssentia SOURCE Enrollment Form

OTHERBridge Program

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Overview

Provide patient immediate access to therapy during an insurance delay (typically new starts; some may cover change in insurance)
Limited time/ fill (typically 7-30 days; some may offer additional fill for continued delay up to certain limit)

Patient benefit

100% free (outside of insurance)

Patient eligibility

HCP must enroll patient
May be limited to commercially insured patients (i.e., no government beneficiaries); some programs may allow government beneficiaries

How to sign up

Typically HCP assisted enrollment (via form)

Foundation programs

under insured

no insurance

goverment insurance

65+

PDFPharmaEssentia SOURCE Enrollment Form

OTHERPatient 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 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

Besremi patient education

Getting started on Besremi

BRAND PAGEInstructions For Use: Polycythemia Vera

ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link

BRAND PAGEInstructions For Use: Polycythemia Vera - Spanish

ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link

VIDEOInstructions For Use: Polycythemia Vera

ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link

To share resource; ask patient to:

1.Pull out phone

2.Open camera

3.Scan QR code with camera

4.Tap link

Patient toolkit

BRAND PAGEAbout Besremi

ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link

BRAND PAGESide Effects

ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link

OTHERPatient Resources

ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link

PDFPatient Brochure

ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link

PDFPatient Brochure - Spanish

ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link

PDFDoctor Discussion Guide

ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link

PDFPharmEssentia SOURCE Patient Guide

ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link

PDFLetter of Medical Necessity for Travel

ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link

Learn More

Other resources

Learn More

Besremi FAQs

How is the dosage of Besremi?Besremi is available in 1 dosages, including 0.5 mg/ml Prefilled Syringe 1 ml

What does Besremi treat?Besremi treats Polycythemia Vera

How Is Besremi Administered?Besremi is administered as a Injectable

FAQ Data Source

Besremi

Dosage & administration

biomarker testing

Besremi clinical details

drug label

Besremi prescribing information

prior authorization

Besremi prior authorization resources

Benefits investigation

Reimbursement help (FRM)

pharmacy

Besremi preferred pharmacy

financial assistance

Besremi financial assistance options

Co-pay savings program

Bridge program

Foundation programs

patient education

Besremi patient education

Getting started on Besremi

Patient toolkit

Other resources

people also ask

Besremi FAQs