Elahere Prescribing & Dosing Schedule

Dosage & Administration Drug label Prior authorization Pharmacy Financial assistance Patient education People also ask

Elahere(mirvetuximab soravtansine-gynx)

ELAHERE 100 MG in 20 ML Injection

Dosage & Administration

* Administer ELAHERE as an intravenous infusion only after dilution in 5% Dextrose Injection, USP. ELAHERE is incompatible with normal saline.
* The recommended dose of ELAHERE is 6 mg/kg adjusted ideal body weight administered as an intravenous infusion every 3 weeks until disease progression or unacceptable toxicity.
* Premedicate with a corticosteroid, antihistamine, and antipyretic.
* Premedicate with an antiemetic, ophthalmic topical steroids, and lubricating eye drops.
* See full Prescribing Information for preparation and administration instructions and dose modifications for adverse reactions.

drug label

Elahere Prescribing Information

Report Adverse Event

prior authorization

Elahere Prior Authorization Resources

Most recent state uniform prior authorization forms

Verified: Jul 26, 2024Arizona - Uniform Prior Authorization Form

Verified: Jul 26, 2024Colorado - Uniform Prior Authorization Form

Verified: Jul 26, 2024Hawaii - Uniform Prior Authorization Form

Verified: Jul 26, 2024Illinois - Uniform Prior Authorization Form

Verified: Jul 26, 2024Indiana - Uniform Prior Authorization Form

Verified: Jul 26, 2024Louisiana - Uniform Prior Authorization Form

Verified: Jul 26, 2024Minnesota - Uniform Prior Authorization Form

Verified: Jul 26, 2024New Hampshire - Uniform Prior Authorization Form

Verified: Jul 26, 2024New Mexico - Uniform Prior Authorization Form

Verified: Jul 26, 2024Oregon - Uniform Prior Authorization Form

Verified: Jul 26, 2024Texas - Uniform Prior Authorization Form

Verified: Jul 07, 2024Washington - Uniform Prior Authorization Form

Verified: Jul 07, 2024Wisconsin - Uniform Prior Authorization Form

Complete Letter of Medical Necessity

Coverage Authorization Appeals

Benefits investigation

Elahere Support Services Patient Enrollment Form

Reimbursement help (FRM)

Receive Assistance from an FRM Regarding Reimbursement Information

pharmacy

Elahere Preferred Pharmacy

Pharmacy List

financial assistance

Elahere Financial Assistance Options

Copay savings program

Elahere Support Services Patient Enrollment Form

Enroll in Patient Savings Program

Learn More

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

Elahere Support Services Patient Enrollment Form

Elahere Patient Assistance Program

Learn More

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.

How to sign up

Patients submit proof of out-of-pocket drug costs to charities for reimbursement

patient education

Elahere Patient Education

To share resource; ask patient to:

1.Pull out phone

2.Open camera

3.Scan QR code with camera

4.Tap link