Uplinza Prescribing & Dosing Schedule

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

Uplinza (inebilizumab-cdon)

UPLIZNA 3 Vial Kit

NO BOXED WARNING

Dosage & Administration

* Hepatitis B virus, quantitative serum immunoglobulins, and tuberculosis screening is required before the first dose

* Prior to every infusion:
* Determine if there is an active infection

* Premedicate with a corticosteroid, an antihistamine, and an antipyretic

* UPLIZNA must be diluted in 250 mL of 0.9% Sodium Chloride Injection, USP prior to administration

* UPLIZNA is administered as an intravenous infusion titrated to completion, approximately 90 minutes. The recommended dose is:
* Initial dose: 300 mg intravenous infusion followed two weeks later by a second 300 mg intravenous infusion

* Subsequent doses (starting 6 months from the first infusion): single 300 mg intravenous infusion every 6 months

* Monitor patients closely during the infusion and for at least one hour after completion of the infusion

drug label

Uplinza Prescribing Information

Contact Medical Science Liaison

Report Adverse Event

prior authorization

Uplinza 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

PA Considerations

PA Checklist

Appeals Checklist

Benefits investigation

Uplinza Patient Enrollment Form

Uplinza Patient Enrollment Form - Online

Reimbursement help (FRM)

Receive Assistance from an FRM Regarding Reimbursement Information

pharmacy

Uplinza Preferred Pharmacy

Pharmacy List

financial assistance

Uplinza Financial Assistance Options

Copay savings program

Uplinza Patient Enrollment Form

Uplinza Patient Enrollment Form - Online

Enroll in Patient Savings Program

Learn More

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

Bridge program

Uplinza Patient Enrollment Form

Uplinza Patient Enrollment Form - Online

Starter Bridge Program

Learn More

Overview

Provide patient immediate access to therapy during an insurance delay (typically new starts; some may cover change in insurance)
Limited time/ fill (typically 7-30 days; some may offer additional fill for continued delay up to certain limit)

Patient benefit

100% free (outside of insurance)

Patient eligibility

HCP must enroll patient
May be limited to commercially insured patients (i.e., no government beneficiaries); some programs may allow government beneficiaries

How to sign up

Typically HCP assisted enrollment (via form)

patient education

Uplinza Patient Education

To share resource; ask patient to:

1.Pull out phone

2.Open camera

3.Scan QR code with camera

4.Tap link