Fabhalta(iptacopan)
FABHALTA 200 MG Oral Capsule

Dosage & Administration

200 mg orally twice daily with or without food.

Get Your Patient on Fabhalta

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Fabhalta Prior Authorization Resources

Most recent state uniform prior authorization forms

Verified: Sep 24, 2024Arizona - Uniform Prior Authorization Form
Verified: Sep 24, 2024Colorado - Uniform Prior Authorization Form
Verified: Sep 24, 2024Hawaii - Uniform Prior Authorization Form
Verified: Sep 24, 2024Illinois - Uniform Prior Authorization Form
Verified: Sep 24, 2024Indiana - Uniform Prior Authorization Form
Verified: Sep 24, 2024Louisiana - Uniform Prior Authorization Form
Verified: Sep 24, 2024Minnesota - Uniform Prior Authorization Form
Verified: Sep 24, 2024New Hampshire - Uniform Prior Authorization Form
Verified: Sep 24, 2024New Mexico - Uniform Prior Authorization Form
Verified: Sep 24, 2024Oregon - Uniform Prior Authorization Form
Verified: Sep 24, 2024Texas - Uniform Prior Authorization Form
Verified: Oct 05, 2024Washington - Uniform Prior Authorization Form
Verified: Oct 05, 2024Wisconsin - Uniform Prior Authorization Form
Coverage Authorization Appeals
Coverage Authorization Request
Complete Letter of Medical Necessity
PA & Appeals Kit

Benefits investigation

Fabhalta Start Form

Fabhalta Preferred Pharmacy

Pharmacy List

Fabhalta Financial Assistance Options

Copay savings program

Enroll in Patient Savings Program
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Bridge program

Bridge Program
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Fabhalta PubMed™ News

Fabhalta Patient Education

To share resource; ask patient to:
1.Pull out phone
2.Open camera
3.Scan QR code with camera
4.Tap link

Patient toolkit

About Fabhalta
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Side Effects
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Patient Resources
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link

Fabhalta FAQs

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FAQ Data Source