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

Pomalyst(pomalidomide)

Pomalyst 1 MG Oral Capsule

Dosage & Administration

* MM: 4 mg per day taken orally on Days 1 through 21 of repeated 28-day cycles until disease progression . Refer to section 14.1 for dexamethasone dosing
* KS: 5 mg per day taken orally on Days 1 through 21 of repeated 28-day cycles until disease progression or unacceptable toxicity .
* Modify the dosage for certain patients with renal impairment or hepatic impairment

drug label

Pomalyst Prescribing Information

Contact Medical Science Liaison

Report Adverse Event

prior authorization

Pomalyst Prior Authorization Resources

Most recent state uniform prior authorization forms

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

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

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

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

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

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

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

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

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

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

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

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

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

Complete Letter of Medical Necessity

Coverage Authorization Appeals

Commercial Claim Denial Appeal/Redetermination Letter

Medically Unlikely Edit (MUE) Appeal Letter

Benefits investigation

Pomalyst Enrollment Form

Pomalyst Enrollment Form - Spanish

Reimbursement help (FRM)

Receive Assistance from an FRM Regarding Reimbursement Information

pharmacy

Pomalyst Preferred Pharmacy

Pharmacy List

Financial Assistance

Financial Assistance Programs

Pomalyst retails for $1,151 per dose without insurance or financial assistance.Depending on your patient's insurance situation and other eligibility criteria, they may be able to get Pomalyst for significantly less. Review the program information below to determine what program can offer your patient the most benefits.

Copay Card Program$0 Copay

Available for

commercial

Program Details