Empliciti

(elotuzumab)

Empliciti 300 MG InjectionEmpliciti 400 MG Injection

NO BLACK BOX WARNING

Dosage & administration

* With lenalidomide and dexamethasone: 10 mg/kg administered intravenously every week for the first two cycles and every 2 weeks thereafter until disease progression or unacceptable toxicity. (2.1)
* With pomalidomide and dexamethasone: 10 mg/kg administered intravenously every week for the first two cycles and 20 mg/kg every 4 weeks thereafter until disease progression or unacceptable toxicity. (2.2)
* Premedicate with dexamethasone, diphenhydramine, ranitidine and acetaminophen. (2.3)

biomarker testing

Empliciti clinical details

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

drug label

Empliciti prescribing information

Contact Medical Science Liaison Report Adverse Event

prior authorization

Empliciti prior authorization resources

Most recent Empliciti prior authorization forms

View By Payer

Updated: May 30, 2023Cigna - Empliciti Prior Authorization Form

Updated: May 24, 2023Aetna - Empliciti Prior Authorization Form

Updated: May 23, 2023Aetna - Medicare Part B Empliciti Prior Authorization Form

PDFComplete Letter of Medical Necessity

PDFCoverage Authorization Appeals

PDFCommercial Claim Denial Appeal/Redetermination Letter

PDFMedically Unlikely Edit (MUE) Appeal Letter

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Benefits investigation

PDFEmpliciti Enrollment Form

PDFEmpliciti Enrollment Form - Spanish

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Reimbursement help (FRM)

OTHERReceive Assistance from an FRM Regarding Reimbursement Information

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financial assistance

Empliciti financial assistance options

Co-pay savings program

commercial only

PDFEmpliciti Enrollment Form

PDFEmpliciti Enrollment Form - Spanish

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

Foundation programs

under insured

no insurance

goverment insurance

65+

PDFEmpliciti Enrollment Form

PDFEmpliciti Enrollment Form - Spanish

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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

Empliciti patient education

Getting started on Empliciti

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 Empliciti

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

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Other resources

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Empliciti FAQs

How is the dosage of Empliciti?Empliciti is available in 2 dosages, including 300 mg Injection and 400 mg Injection

What does Empliciti treat?Empliciti treats Multiple Myeloma

What is Empliciti made of?Empliciti contains elotuzumab which is a SLAMF7-directed Immunostimulatory Antibody

How Is Empliciti Administered?Empliciti is administered as a Injectable

What Are The Empliciti Mechanism Of Action?Empliciti mechanism of action is SLAMF7-directed Antibody Interactions

FAQ Data Source

Empliciti

Dosage & administration

biomarker testing

Empliciti clinical details

drug label

Empliciti prescribing information

prior authorization

Empliciti prior authorization resources

Most recent Empliciti prior authorization forms

Benefits investigation

Reimbursement help (FRM)

financial assistance

Empliciti financial assistance options

Co-pay savings program

Foundation programs

patient education

Empliciti patient education

Getting started on Empliciti

Patient toolkit

Other resources

people also ask

Empliciti FAQs