Sarclisa

(isatuximab)

Sarclisa 100 MG in 5 ML InjectionSarclisa 500 MG in 25 ML Injection

NO BLACK BOX WARNING

Dosage & administration

* Premedicate with dexamethasone, acetaminophen, H2 antagonists, and diphenhydramine.
* The recommended dose of SARCLISA is 10 mg/kg as an intravenous infusion every week for 4 weeks followed by every 2 weeks until disease progression or unacceptable toxicity. See full prescribing information for drugs used in combination and schedule.

biomarker testing

Sarclisa clinical details

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

drug label

Sarclisa prescribing information

Contact Medical Science Liaison Report Adverse Event

prior authorization

Sarclisa prior authorization resources

Most recent Sarclisa prior authorization forms

View By Payer

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

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

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

PDFComplete Letter of Medical Necessity

PDFCoverage Authorization Appeals

PDFLetter of Medical Exception

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Benefits investigation

PDFCareAssist Enrollment Form

PDFCareAssist Enrollment Form - Spanish

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Reimbursement help (FRM)

OTHERReceive Assistance from an FRM Regarding Reimbursement Information

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pharmacy

Sarclisa preferred pharmacy

PDFPharmacy List

financial assistance

Sarclisa financial assistance options

Co-pay savings program

commercial only

PDFCareAssist Enrollment Form

PDFCareAssist Enrollment Form - Spanish

Enroll in Patient Savings Program

OTHERReimbursement Request (For Out of Pocket Claims)

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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+

PDFCareAssist Enrollment Form

PDFCareAssist Enrollment Form - Spanish

OTHERCareAssist Patient Assistance Program

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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

Sarclisa patient education

Getting started on Sarclisa

To share resource; ask patient to:

1.Pull out phone

2.Open camera

3.Scan QR code with camera

4.Tap link