Defitelio

(defibrotide)
2.5 ML defibrotide sodium 80 MG/ML Injection [Defitelio]
NO BLACK BOX WARNING

Dosage & administration

drug label

Defitelio prescribing information

Need to report a Defitelio issue?

ONLINE FORM
Report adverse event
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prior authorization

Defitelio Prior authorization resources

NOT PROVIDED BY BRAND
Complete Letter of Medical Necessity

NOT PROVIDED BY BRAND
Coverage Authorization Request

NOT PROVIDED BY BRAND
Coverage Authorization Appeals
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Benefits investigation

NOT PROVIDED BY BRAND
Benefits investigation resources
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Reimbursement help (FRM)

Receive Assistance from an FRM Regarding Reimbursement Information
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financial assistance

Defitelio Financial assistance options

Co-pay savings program

commercial only

NOT PROVIDED BY BRAND
Enroll in Patient Savings Program
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Bridge program

commercial only
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Foundation programs

under insured
no insurance
goverment insurance
65+
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patient education

Defitelio Patient education

Getting started on Defitelio

NOT PROVIDED BY BRAND
Instructions For Use: VOD/SOS

Patient toolkit

NOT PROVIDED BY BRAND
Not Provided By Brand
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Can't find what you're looking for?

Our trained staff can help you:
Please note:
  • Access to a Field Reimbursement Manager (FRM) or Medical Science Liaison (MSL) varies by brand and may require talking with your rep first.
  • Samples are provided at the discretion of the brand.
  • We are unable to collect Protected Health Information (PHI), fill out forms, or submit them on your behalf.