Gammagard Liquid Prescribing & Dosing Schedule

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Gammagard Liquid(immunoglobulin G, human)

GAMMAGARD 10 % in 10 ML Injection

Dosage & Administration

PI: Intravenous (IV)

Dose	Initial Infusion Rate	Maintenance Infusion Rate
300 to 600 milligram (mg)/kg every 3 to 4 weeks based on clinical response	0.5milliliter (mL)/kg/hr (0.8 mg/kg/min) for 30 minutes	Increase every 30minutes (if tolerated) up to 5 mL/kg/hr (8 mg/kg/min)

Subcutaneous (SC)

Dose	Initial Infusion Rate	Maintenance Infusion Rate
Initial Dose is 1.37 × previous intravenous dose divided by # of weeks between intravenous doses. Maintenance dose is based on clinical response and target IgG trough level.	40 kg BW and greater: 30 mL/site at 20 mL/hr/site Under 40 kg BW: 20 mL/site at 15 mL/hr/site	40 kg BW and greater: 30 mL/site at 20 to 30 mL/hr/site Under 40 kg BW: 20 mL/site at 15 to 20 mL/hr/site

MMN: Intravenous (IV)

Dose	Initial Infusion Rate	Maintenance Infusion Rate
Dose range 0.5 to 2.4 gram/kg/month based on clinical response	0.5mL/kg/hr (0.8 mg/kg/min)	Infusion rate may be advanced if tolerated to 5.4 mL/kg/hr (9 mg/kg/min)

CIDP: Intravenous (IV)

Dose	Initial Infusion Rate	Maintenance Infusion Rate
Induction dose is 2 g/kg in divided doses over 2 to 5 consecutive days, followed by maintenance infusions. Maintenance dose is 1 g/kg in divided doses over 1 to 4 consecutive days, every 3 weeks.	0.5 mL/kg/hr (0.8 mg/kg/min)	Infusion rate may be increased if tolerated up to 5.4 mL/kg/hr (9 mg/kg/min)

* Ensure patients with pre-existing renal insufficiency are not volume depleted; discontinue GAMMAGARD LIQUID if renal function deteriorates.
* For patients at risk of renal dysfunction or thrombotic events, administer GAMMAGARD LIQUID at minimum infusion rate practicable.

drug label

Gammagard Liquid Prescribing Information

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prior authorization

Gammagard Liquid Prior Authorization Resources

Most recent state uniform prior authorization forms

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

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

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

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

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

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

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

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

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

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

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

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

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

Benefits investigation

Gammagard Liquid Start Form

Reimbursement help (FRM)

Receive Assistance from an FRM Regarding Reimbursement Information

financial assistance

Gammagard Liquid Financial Assistance Options

Copay savings program

Gammagard Liquid Start Form

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

patient education

Gammagard Liquid Patient Education

To share resource; ask patient to:

1.Pull out phone

2.Open camera

3.Scan QR code with camera

4.Tap link