Tzield

(teplizumab)

Tzield 2 MG in 2 ML Injection

NO BLACK BOX WARNING

Dosage & administration

* Confirm Stage 2 T1D by documenting at least two positive pancreatic islet autoantibodies in those who have dysglycemia without overt hyperglycemia using an oral glucose tolerance test (OGTT) or alternative method if appropriate and OGTT is not available .
* In patients who meet criteria for a diagnosis of Stage 2 type 1 diabetes, ensure the clinical history of the patient does not suggest type 2 diabetes .
* Prior to initiating TZIELD, obtain a complete blood count and liver enzyme tests. Use of TZIELD is not recommended in patients with certain laboratory abnormalities .
* Must dilute TZIELD in 0.9% Sodium Chloride Injection, USP. See full prescribing information for detailed preparation and administration instructions .
* Premedicate with: (1) a nonsteroidal anti-inflammatory drug (NSAID) or acetaminophen, (2) an antihistamine, and/or (3) an antiemetic before each TZIELD dose for at least the first 5 days of the 14-day treatment course .
* Administer TZIELD by intravenous infusion (over a minimum of 30 minutes) once daily for 14 days. See full prescribing information for the dosing schedule .

drug label

Tzield prescribing information

Report Adverse Event

prior authorization

Tzield prior authorization resources

Most recent Tzield prior authorization forms

View By Payer

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

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

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

OTHERComplete Letter of Medical Necessity

OTHERCoverage Authorization Appeals

PDFPA Guide

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Benefits investigation

PDFPrevention Bio Compass Tzield Patient Start Form

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pharmacy

Tzield preferred pharmacy

PDFPharmacy List

financial assistance

Tzield financial assistance options

Co-pay savings program

commercial only

PDFPrevention Bio Compass Tzield Patient Start Form

OTHEREnroll in Patient Savings Program

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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

patient education

Tzield patient education

Getting started on Tzield

To share resource; ask patient to:

1.Pull out phone

2.Open camera

3.Scan QR code with camera

4.Tap link

Patient toolkit

BRAND PAGEAbout Tzield

ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link

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Other resources

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Tzield FAQs

How is the dosage of Tzield?Tzield is available in 1 dosages, including 1 mg/ml Injection 2 ml

What does Tzield treat?Tzield treats Type 1 Diabetes Mellitus

How Is Tzield Administered?Tzield is administered as a Injectable

FAQ Data Source

Tzield

Dosage & administration

drug label

Tzield prescribing information

prior authorization

Tzield prior authorization resources

Most recent Tzield prior authorization forms

Benefits investigation

pharmacy

Tzield preferred pharmacy

financial assistance

Tzield financial assistance options

Co-pay savings program

patient education

Tzield patient education

Getting started on Tzield

Patient toolkit

Other resources

people also ask

Tzield FAQs