Dosage & Administration Drug label Prior authorization Financial assistance PubMed™ News

Opdualag

(nivolumab / relatlimab)

Opdualag 240 MG / 80 MG in 20 ML Injection

NO BOXED WARNING

Dosage & administration

* Adult patients and pediatric patients 12 years of age or older who weigh at least 40 kg: 480 mg nivolumab and 160 mg relatlimab intravenously every 4 weeks. (2)
* Administer OPDUALAG as an intravenous infusion over 30 minutes. (2)
* See full Prescribing Information for dosage modifications for adverse reactions (2.2) and preparation and administration instructions for the injection (2.3).

drug label

Opdualag prescribing information

Contact Medical Science Liaison Report Adverse Event

prior authorization

Opdualag prior authorization resources

Most recent Opdualag prior authorization forms

View By Payer

Verified: Apr 07, 2024Kaiser Foundation Health Plan - Chronic High-Dose Opioid Therapy Prior Authorization Form Washington

Verified: Apr 01, 2024Highmark BCBS Northeastern NY - Medicare Prescription Drug Medication Request Form

Verified: Apr 01, 2024Highmark BCBS Northeastern NY - Short Acting Opioid Prior Authorization Form

Verified: Apr 01, 2024Highmark BCBS Western NY - Specialty Drug Prior Authorization Form

Verified: Apr 01, 2024Highmark BCBS Western NY - Non-Formulary Drug Coverage Prior Authorization Form

Most recent state uniform prior authorization forms

Verified: Mar 28, 2024Arizona - Uniform Prior Authorization Form

Verified: Mar 28, 2024Colorado - Uniform Prior Authorization Form

Verified: Mar 28, 2024Hawaii - Uniform Prior Authorization Form

Verified: Mar 28, 2024Illinois - Uniform Prior Authorization Form

Verified: Mar 28, 2024Indiana - Uniform Prior Authorization Form

Verified: Mar 28, 2024Louisiana - Uniform Prior Authorization Form

Verified: Mar 28, 2024Minnesota - Uniform Prior Authorization Form

Verified: Mar 28, 2024New Hampshire - Uniform Prior Authorization Form

Verified: Mar 28, 2024New Mexico - Uniform Prior Authorization Form

Verified: Mar 28, 2024Oregon - Uniform Prior Authorization Form

Verified: Mar 28, 2024Texas - Uniform Prior Authorization Form

Complete Letter of Medical Necessity

Coverage Authorization Appeals

Commercial Claim Denial Appeal/Redetermination Letter

Medically Unlikely Edit (MUE) Appeal Letter

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Benefits investigation

Opdualag Enrollment Form

Opdualag Enrollment Form - Spanish

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Reimbursement help (FRM)

Receive Assistance from an FRM Regarding Reimbursement Information

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Financial Assistance

Financial Assistance Programs

Opdualag retails for $766 per dose without insurance or financial assistance.Depending on your patient's insurance situation and other eligibility criteria, they may be able to get Opdualag for significantly less. Review the program information below to determine what program can offer your patient the most benefits.

CoPay Card Program$0 Co Pay

Available for

commercial

Program Details

Program Expires Calendar Year

Forms

Opdualag Enrollment Form

Opdualag Enrollment Form - Spanish

Enroll in Patient Savings Program

PubMed™ | Opdualag

Opdualag PubMed™ News

patient education

Opdualag patient education

To share resource; ask patient to:

1.Pull out phone

2.Open camera

3.Scan QR code with camera

4.Tap link