Radicava

(edaravone)

100 ML edaravone 0.3 MG/ML Injection [Radicava]edaravone 21 MG/ML Oral Suspension [Radicava]

NO BLACK BOX WARNING

Dosage & administration

* RADICAVA: The recommended dosage is 60 mg administered as an intravenous infusion over 60 minutes ( 2.1)
* RADICAVA ORS: The recommended dosage is 105 mg (5 mL) taken orally or via feeding tube in the morning after overnight fasting. Food should not be consumed for 1 hour after administration except water ( 2.1, 2.3)
* For RADICAVA and RADICAVA ORS:
* Initial treatment cycle: daily dosing for 14 days followed by a 14- day drug-free period ( 2.1)
* Subsequent treatment cycles: daily dosing for 10 days out of 14- day periods, followed by 14-day drug-free periods ( 2.1)

drug label

Radicava prescribing information

Contact Medical Science Liaison Report Adverse Event

prior authorization

Radicava prior authorization resources

Most recent Radicava prior authorization forms

View By Payer

Verified: Oct 02, 2023Blue Cross Blue Shield of Michigan - FEP Radicava Prior Authorization Form (Medical Benefit)

Verified: Sep 28, 2023Cigna - Radicava Prior Authorization Form

Verified: Sep 26, 2023Blue Cross Blue Shield of Michigan - Radicava Prior Authorization Form (Medical Benefit)

Verified: Sep 21, 2023Aetna - Radicava Prior Authorization Form

Verified: Sep 21, 2023Aetna - Medicare Part B Radicava Prior Authorization Form

PDFComplete Letter of Medical Necessity

PDFCoverage Authorization Appeals

PDFFormulary Exception Letter

PDFExceptions & Appeals Checklist

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Benefits investigation

PDFRadicava Enrollment Form

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Reimbursement help (FRM)

OTHERReceive Assistance from an FRM Regarding Reimbursement Information

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pharmacy

Radicava preferred pharmacy

PDFPharmacy List

financial assistance

Radicava financial assistance options

Co-pay savings program

commercial only

PDFEnroll in Patient Savings Program

PDFOut of Pocket Reimbursement Form

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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+

PDFRadicava Enrollment Form

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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.