Viltepso Prescribing & Dosing Schedule

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

Viltepso(viltolarsen)

VILTEPSO 250 MG in 5 mL Injection

NO BOXED WARNING

Dosage & Administration

* Serum cystatin C, urine dipstick, and urine protein-to-creatinine ratio should be measured before starting VILTEPSO.
* Recommended dosage is 80 milligrams per kilogram of body weight once weekly.
* Administer as an intravenous infusion over 60 minutes.
* If the volume of VILTEPSO required is less than 100 mL, dilution in 0.9% Sodium Chloride Injection, USP, is required.

drug label

Viltepso Prescribing Information

Report Adverse Event

prior authorization

Viltepso 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

Benefits investigation

NS Support Patient Start Form

Patient Authorization Form: To be used with NS Start Form

financial assistance

Viltepso Financial Assistance Options

Copay savings program

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

Foundation programs

Patient Assistance Program Application

Learn More

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 copays) 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

Viltepso Patient Education

To share resource; ask patient to:

1.Pull out phone

2.Open camera

3.Scan QR code with camera

4.Tap link

Patient toolkit

About Viltepso

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

Patient Brochure

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

Infusion Overview Brochure

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

Viltepso FAQs

How is the dosage of Viltepso?Viltepso is available in 1 dosages, including 250 mg/5ml Injection 5 ml

What does Viltepso treat?Viltepso treats Duchenne Muscular Dystrophy

How Is Viltepso Administered?Viltepso is administered as a Injectable

FAQ Data Source

Dosage & Administration

Dosage & Administration

drug label

Viltepso Prescribing Information

prior authorization

Viltepso Prior Authorization Resources

Most recent state uniform prior authorization forms

Benefits investigation

financial assistance

Viltepso Financial Assistance Options

Copay savings program

Foundation programs

patient education

Viltepso Patient Education

Patient toolkit

people also ask

Viltepso FAQs