Dosage & Administration Drug label Samples Prior authorization Pharmacy Financial assistance

Xembify

(immunoglobulin G)

Xembify 20 % (1 GM in 5 ML) InjectionXembify 20 % (10 GM in 50 ML) Injection

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Dosage & administration

For subcutaneous infusion only.

Before switching to XEMBIFY, obtain the patient’s serum IgG trough level to guide subsequent dose adjustments.

Dose ( 2.1)

* Switching from immune globulin intravenous (human), 10% (IVIG) to XEMBIFY: calculate the dose by using a dose adjustment factor (1.37)

* Weekly: Begin XEMBIFY one week after last IVIG infusion.
* Establish initial weekly dose by converting the monthly (or every 3 weeks) IVIG dose into an equivalent weekly dose and increasing it using a dose adjustment factor (1.37).

Initial weekly = Prior IVIG dose (in grams) × 1.37
dose (grams) Number of weeks between IVIG doses

* Frequent dosing (2-7 times per week): Divide the calculated weekly dose by the desired number of times per week.
* Switching from immune globulin subcutaneous (human) treatment (IGSC): Weekly dose (grams) should be the same as the weekly dose of prior IGSC treatment (grams).

Administration
Infusion sites: up to 6 infusion sites simultaneously, with at least 2 inches (5 cm) between sites avoiding bony prominences. Rotate sites for each administration

drug label

Xembify prescribing information

Contact Medical Science Liaison Report Adverse Event

prior authorization

Xembify prior authorization resources

Most recent Xembify prior authorization forms

View By Payer

Verified: Dec 01, 2023Blue Cross Blue Shield of Michigan - FEP Immune Globulin Replacement Therapy SC Prior Authorization Form (Medical Benefit)

Verified: Nov 27, 2023Cigna - Intravenous Immune Globulin (IVIG) -SCIG Prior Authorization Form

Verified: Nov 25, 2023Blue Cross Blue Shield of Michigan - IVIG Prior Authorization Form (Medical Benefit)

Verified: Nov 20, 2023Aetna - Xembify Prior Authorization Form

Verified: Nov 19, 2023Aetna - Medicare Part B Immunoglobulin Prior Authorization Form

Complete Letter of Medical Necessity

Coverage Authorization Appeals

Formulary Exception Letter

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Benefits investigation

Xembify Connextions - Prescription Referrral Form

Xembify Connextions - Patient Consent Form

Xembify Connexions Program Patient Authorization Form - Online

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pharmacy

Xembify preferred pharmacy

Pharmacy List

financial assistance

Xembify financial assistance options

Co-pay savings program

commercial only

Xembify Connextions - Patient Consent Form

Xembify Connexions Program Patient Authorization Form - Online

Enroll 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

Foundation programs

under insured

no insurance

goverment insurance

65+

Xembify Connextions Patient Assistance Program Application

Patient Assistance Program – Prescriber Therapy Attestation

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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

Xembify patient education

Getting started on Xembify

Instructions For Use: Primary Humoral Immunodeficiency Disease (PIDD)

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

About Xembify

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

View How to Take Xembify Infusion

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

Patient Brochure - Spanish

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

Xembify Patient Connextions Brochure

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

Learn More

Xembify FAQs

How is the dosage of Xembify?Xembify is available in 4 dosages, including 200 mg/ml Injection 10 ml, 200 mg/ml Injection 20 ml, 200 mg/ml Injection 5 ml and 200 mg/ml Injection 50 ml

What does Xembify treat?Xembify treats Immunologic Deficiency Syndromes

How Is Xembify Administered?Xembify is administered as a Injectable

FAQ Data Source

Xembify

Dosage & administration

drug label

Xembify prescribing information

prior authorization

Xembify prior authorization resources

Most recent Xembify prior authorization forms

Benefits investigation

pharmacy

Xembify preferred pharmacy

financial assistance

Xembify financial assistance options

Co-pay savings program

Foundation programs

patient education

Xembify patient education

Getting started on Xembify

Patient toolkit

people also ask

Xembify FAQs