Dosage & Administration Biomarker testing Drug label Prior authorization Financial assistance

Lupron

(leuprolide)

1.5 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]

NO BOXED WARNING

Dosage & administration

LUPRON DEPOT 11.25mg for 3-month administration, given as a single intramuscular injection.

LUPRON DEPOT 11.25 mg has different release characteristics than LUPRON 3.75 mg and is dosed differently.

* Do not substitute LUPRON DEPOT 11.25 mg for LUPRON DEPOT 3.75 mg.

* Do not administer LUPRON DEPOT 11.25 mg more frequently than every 3 months.

* Do not give a fractional dose of the LUPRON DEPOT 11.25 mg, as it is not equivalent to the same dose of the LUPRON DEPOT 3.75 mg monthly formulation.

Reconstitute LUPRON DEPOT 11.25 mg prior to use.

Endometriosis:

* LUPRON DEPOT 11.25 mg administered as a single intramuscular (IM) injection once every three months for up to two injections (6 months of therapy). LUPRON DEPOT may be administered alone or in combination with daily 5 mg tablet of norethindrone acetate (add-back).

* If endometriosis symptoms recur after initial course of therapy, retreatment for no more than six months may be considered but only with the addition of norethindrone acetate add-back therapy. Do not re-treat with LUPRON DEPOT 11.25 mg alone.

Fibroids:

* Recommended dose of LUPRON DEPOT 11.25 mg is one IM injection.

biomarker testing

Lupron clinical details

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

drug label

Lupron prescribing information

Report Adverse Event

prior authorization

Lupron prior authorization resources

Most recent Lupron prior authorization forms

View By Payer

Verified: Nov 27, 2023Cigna - Gonadotropin-releasing Hormone (GnRH) Antagonists Prior Authorization Form

Verified: Nov 20, 2023Aetna - Lupron Depot Prior Authorization Form

Verified: Nov 19, 2023Aetna - Medicare Part B Lupron Depot Prior Authorization Form

Letter of Medical Necessity: Central Precocious Puberty (CPP)

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Benefits investigation

Lupron Depot Support PLUS Enrollment Form: Advanced Prostate Cancer

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financial assistance

Lupron financial assistance options

Co-pay savings program

commercial only

Enroll in Patient Savings Program: Endometriosis

Enroll in Patient Savings Program: Uterine Fibroids

Enroll in Patient Savings Program: Central Precocious Puberty (CPP)

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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+

AbbVie Assist Patient Assistance Foundation Eligibility

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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

Lupron patient education

To share resource; ask patient to:

1.Pull out phone

2.Open camera

3.Scan QR code with camera

4.Tap link