Botox
(botulinum toxin type A)Botox 100 UNT InjectionBotox 200 UNT Injection
Dosage & administration
drug label
Botox prescribing information
samples
Request Botox samples
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Is my patient elegible for Botox samples?
- Your rep will communicate with you how to receive samples, when you can receive samples, the amount and more.
How do I find out who my Botox rep is?
- Not sure who your local Botox pharma rep is? Reach out to Allergan, Inc. and they can help you identify your rep.
prior authorization
Botox prior authorization resources
Most recent Botox prior authorization forms
View By PayerVerified: Sep 04, 2023Highmark BCBS Northeastern NY - Outpatient Botulinum Toxin Prior Authorization Form (Medical Benefit)
Verified: Sep 04, 2023Highmark BCBS Western NY - Outpatient Botulinum Toxin Prior Authorization Form (Medical Benefit)
Verified: Sep 03, 2023Highmark BCBS West Virginia - Outpatient Botulinum Toxin Prior Authorization Form (Medical Benefit)
Verified: Sep 03, 2023Highmark BCBS Delaware - Outpatient Botulinum Toxin Prior Authorization Form (Medical Benefit)
Verified: Sep 03, 2023Highmark BCBS Central PA - Outpatient Botulinum Toxin Prior Authorization Form (Medical Benefit)
Verified: Sep 02, 2023Highmark BCBS Western PA - Outpatient Botulinum Toxin Prior Authorization Form (Medical Benefit)
Verified: Oct 02, 2023Blue Cross Blue Shield of Michigan - FEP Botox Prior Authorization Form (Medical Benefit)
Verified: Sep 27, 2023Cigna - Botox Prior Authorization Form
Learn More
If available, these templates are provided by the brand to help you navigate insurance, especially with newer drugs.
Reimbursement help (FRM)
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Some brands offer a field reimbursement manager who will work with your clinical staff and preferred pharmacy to help make sure patients don't fall through the cracks.
financial assistance
Botox financial assistance options
Co-pay savings program
commercial only
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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
patient education
Botox patient education
Getting started on Botox
To share resource; ask patient to:
1.Pull out phone
2.Open camera
3.Scan QR code with camera
4.Tap link
Patient toolkit
OTHERReceiving Treatment: Chronic Migraine
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
PDFDoctor Discussion Guide: Chronic Migraine
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
OTHERReceiving Treatment: Adult Spasticity
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
BRAND PAGEAbout Botox: Pediatric Spasticity
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
OTHERReceiving Treatment: Pediatric Spasticity
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
OTHERPatient Resources: Pediatric Spasticity
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
OTHERPatient Resources: Cervical Dystonia
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
BRAND PAGEAbout Botox: Overactive Bladder
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
OTHERPatient Resources: Overactive Bladder
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
OTHERDoctor Discussion Guide: Overactive Bladder
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
BRAND PAGEAbout Botox: Overactive Bladder Due To Neurologic Condition
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
OTHERReceiving Treatment: Overactive Bladder Due To Neurologic Condition
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
BRAND PAGESide Effects: Overactive Bladder Due To Neurologic Condition
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link