Imlygic

(herpesvirus 1, human)

1 ML talimogene laherparepvec 1000000 UNT/ML Injection [Imlygic]1 ML talimogene laherparepvec 100000000 UNT/ML Injection [Imlygic]

NO BLACK BOX WARNING

Dosage & administration

* Administer IMLYGIC by injection into cutaneous, subcutaneous, and/or nodal lesions.

* Recommended starting dose is up to a maximum of 4 mL of IMLYGIC at a concentration of 106 (1 million) plaque-forming units (PFU) per mL. Subsequent doses should be administered up to 4 mL of IMLYGIC at a concentration of 108 (100 million) PFU per mL.

biomarker testing

Imlygic clinical details

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

drug label

Imlygic prescribing information

Contact Medical Science Liaison Report Adverse Event

prior authorization

Imlygic prior authorization resources

Most recent Imlygic prior authorization forms

View By Payer

Updated: May 31, 2023Cigna - Imlygic Prior Authorization Form

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

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

PDFCoverage Authorization Appeals

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Benefits investigation

PDFBenefit Verification

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Reimbursement help (FRM)

Receive Assistance from an FRM Regarding Reimbursement Information

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financial assistance

Imlygic financial assistance options

Co-pay savings program

commercial only

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

Foundation programs

under insured

no insurance

goverment insurance

65+

OTHERAmgen Safety Net Foundation 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

Imlygic patient education

Getting started on Imlygic

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 Imlygic

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

OTHERReceiving Imlygic

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

OTHERPatient Resources

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

PDFPatient Brochure

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

Learn More

Other resources

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Imlygic FAQs

How is the dosage of Imlygic?Imlygic is available in 2 dosages, including 1,000,000 unt/ml Injection 1 ml and 100,000,000 unt/ml Injection 1 ml

What does Imlygic treat?Imlygic treats Melanoma

How Is Imlygic Administered?Imlygic is administered as a Injectable

FAQ Data Source

Imlygic

Dosage & administration

biomarker testing

Imlygic clinical details

drug label

Imlygic prescribing information

prior authorization

Imlygic prior authorization resources

Most recent Imlygic prior authorization forms

Benefits investigation

Reimbursement help (FRM)

financial assistance

Imlygic financial assistance options

Co-pay savings program

Foundation programs

patient education

Imlygic patient education

Getting started on Imlygic

Patient toolkit

Other resources

people also ask

Imlygic FAQs