Klisyri Prescribing & Dosing Schedule

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

Klisyri(tirbanibulin)

Klisyri 1 % Topical Ointment

NO BOXED WARNING

Dosage & Administration

* For topical use; not for oral or ophthalmic use. ( 2)
* Apply KLISYRI to the treatment field on the face or scalp once daily for 5 consecutive days using 1 unit-dose packet per application. ( 2)

drug label

Klisyri Prescribing Information

Report Adverse Event

prior authorization

Klisyri 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

pharmacy

Klisyri Preferred Pharmacy

Pharmacy List

financial assistance

Klisyri Financial Assistance Options

Copay savings program

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

patient education

Klisyri 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

Patient Brochure

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

Klisyri FAQs

How is the dosage of Klisyri?Klisyri is available in 1 dosages, including 1% Ointment

What does Klisyri treat?Klisyri treats

What is Klisyri made of?Klisyri contains tirbanibulin which is a Microtubule Inhibitor

How Is Klisyri Administered?Klisyri is administered as a Topical

FAQ Data Source

Dosage & Administration

Dosage & Administration

drug label

Klisyri Prescribing Information

prior authorization

Klisyri Prior Authorization Resources

Most recent state uniform prior authorization forms

pharmacy

Klisyri Preferred Pharmacy

financial assistance

Klisyri Financial Assistance Options

Copay savings program

patient education

Klisyri Patient Education

Patient toolkit

people also ask

Klisyri FAQs