Valchlor Prescribing & Dosing Schedule | PrescriberPoint

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

Valchlor(mechlorethamine)

VALCHLOR 0.016 % Topical Gel

NO BOXED WARNING

Dosage & Administration

Dosage & Administration

* For topical dermatological use only .
* Apply a thin film once daily to affected areas of the skin .

drug label

Valchlor Prescribing Information

Contact Medical Science Liaison

Report Adverse Event

prior authorization

Valchlor Prior Authorization Resources

Most recent state uniform prior authorization forms

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

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

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

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

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

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

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

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

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

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

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

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

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

Benefits investigation

Valchlor Patient Intake and Prescription Form

financial assistance

Valchlor Financial Assistance Options

Copay savings program

Valchlor Patient Intake and Prescription Form

Enroll in Patient Savings Program

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

Valchlor Patient Education

Getting started on Valchlor

Instructions For Use: Mycosis Fungoides-type Cutaneous T-cell Lymphoma (MF-CTCL)

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

To share resource; ask patient to:

1.Pull out phone

2.Open camera

3.Scan QR code with camera

4.Tap link

Patient toolkit

Patient Brochure

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

How To Store Valchlor

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

Patient Resources

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

people also ask

Valchlor FAQs

How is the dosage of Valchlor?Valchlor is available in 1 dosages, including 0.016% Gel

What does Valchlor treat?Valchlor treats Hodgkin Disease, Mycosis Fungoides, Neoplasm Metastasis and Malignant Pleural Effusion

What is Valchlor made of?Valchlor contains mechlorethamine which is a Alkylating Drug

How Is Valchlor Administered?Valchlor is administered as a Topical

What Are The Valchlor Mechanism Of Action?Valchlor mechanism of action is Alkylating Activity

FAQ Data Source