Preparation of DYSPORT Solution for Administration
Cervical Dystonia
• Initial dose is 500 Units given intramuscularly as a divided dose among the affected muscles • Re-treatment every 12 to 16 weeks or longer, as necessary, based on return of clinical symptoms with doses administered between 250 and 1000 Units to optimize clinical benefit • Re-treatment should not occur in intervals of less than 12 weeks • Titrate in 250 Unit steps according to patient's response
Glabellar Lines
* Administer a total dose of 50 Units, divided in five equal aliquots of 10 Units each, intramuscularly to affected muscles to achieve clinical effect * Re-treatment should be administered no more frequently than every 3 months
Spasticity in Adults
* Select dose based on muscles affected, severity of spasticity, and treatment and adverse reaction history botulinum toxins * Dosing for upper limb spasticity: between 500 Units and 1000 Units * Dosing for lower limb spasticity: up to 1500 Units * The maximum recommended total dose per treatment session (upper and lower limb combined) in adults is 1500 Units * Re-treatment, based on return of clinical symptoms, should not occur in intervals of less than 12 weeks
Spasticity in Pediatric Patients
* Select dose based on the affected muscle, severity of spasticity, and treatment and adverse reaction history with all botulinum toxins. * Recommended dosing for upper limb spasticity: 8 Units/kg to 16 Units/kg per limb. The maximum recommended total dose administered per treatment session must not exceed 16 Units/kg or 640 Units, whichever is lower. * Recommended dosing for lower limb spasticity: 10 Units/kg to 15 Units/kg per limb. Total dose per treatment session must not exceed 15 Units/kg for unilateral lower limb injections, 30 Units/kg for bilateral injections, or 1000 Units, whichever is lower. * The maximum recommended total dose per treatment session is 30 Units/kg or 1000 Units, whichever is lower. Re-treatment, based on return of clinical symptoms, should not occur in intervals of less than 3 months.
drug label
Dysport prescribing information
Need to report a Dysport issue?
ONLINE FORMReport adverse event
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You can report a Dysport adverse event on MedWatch, the FDA's medical product safety reporting program for health professionals, patients and consumers.
prior authorization
Dysport Prior authorization resources
Complete Letter of Medical Necessity
Coverage Authorization Request
Coverage Authorization Appeals
Med D Tier Exception
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If available, these templates are provided by the brand to help you navigate insurance, especially with newer drugs.
Benefits investigation
Ipsen Cares Enrollment Form
Ipsen Cares Enrollment Form - Online
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Benefits investigations are conducted to determine whether a therapy is covered under a patient's insurance, if a prior authorization is required, and which specialty pharmacies are preferred.
Reimbursement help (FRM)
NOT PROVIDED BY BRANDReimbursement help (FRM) resources
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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
Dysport Financial assistance options
Co-pay savings program
commercial only
Ipsen Cares Enrollment Form
Ipsen Cares Enrollment Form - Online
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
Bridge program
commercial only
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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+
Ipsen Care 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 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
Dysport Patient education
Getting started on Dysport
NOT PROVIDED BY BRANDInstructions For Use: Cervical Dystonia
NOT PROVIDED BY BRANDInstructions For Use: Adult Spasticity
NOT PROVIDED BY BRANDInstructions For Use: Pediatric Spasticity
Patient toolkit
Doctor Discussion Guide
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
About Dysport: Adult Spasticity
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Patient Resources: Adult Spasticity
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
About Dysport: Cervical Dystonia
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Patient Resources: Cervical Dystonia
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
About Dysport: Pediatric Spasticity
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Patient Resources: Pediatric Spasticity
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Learn More
Other resources brands publish to help support patients and caregivers.
people also ask
Dysport FAQs
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