Upper limb spasticity, cervical dystonia, and blepharospasm: the optimum dose, frequency, and number of injection sites in the treated muscle(s) should be based on severity and prior treatment response in patients previously treated with botulinum toxin; individualize dosing for each patient:
* Upper Limb Spasticity in Adults: the recommended total dose is up to 400 Units, divided among affected muscles * Upper Limb Spasticity in Pediatric Patients, excluding spasticity caused by cerebral palsy: the recommended total dose is 8 Units/kg (maximum 200 Units) per single upper limb or 16 Units/kg (maximum 400 U) in both upper limbs, divided among affected muscles * Cervical Dystonia: the recommended initial dose is 120 Units per treatment session * Blepharospasm: the recommended initial dose is 50 Units (25 Units per eye)
Glabellar Lines: the recommended dose is 20 Units per treatment session, divided into five equal intramuscular injections of 4 Units each (two injections in each corrugator muscle and one injection in the procerus muscle; wait a minimum of three months before retreatment
Reconstituted XEOMIN:
* Is intended for intramuscular or intraglandular injection in the parotid and submandibular glands only * Use for only one injection session and for only one patient * Instructions are specific for 50 Unit, 100 Unit, and 200 Unit vials * Store in a refrigerator (2°C to 8°C) and use within 24 hours
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Xeomin prescribing information
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samples
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Your rep will communicate with you how to receive samples, when you can receive samples, the amount and more.
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prior authorization
Xeomin Prior authorization resources
Complete Letter of Medical Necessity
NOT PROVIDED BY BRANDCoverage Authorization Request
Coverage Authorization Appeals
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If available, these templates are provided by the brand to help you navigate insurance, especially with newer drugs.
Benefits investigation
Benefit Investigation Support
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Benefits investigations are conducted to determine whether a therapy is covered under a patient's insurance, if a prior authorization is required, and which specialty pharmacies are preferred.
Reimbursement help (FRM)
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Some brands offer a field reimbursement manager who will work with your clinical staff and preferred pharmacy to help make sure patients don't fall through the cracks.
financial assistance
Xeomin Financial assistance options
Co-pay savings program
commercial only
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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
Bridge program
commercial only
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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)
Foundation programs
under insured
no insurance
goverment insurance
65+
Xeomin Patient Assistance Program Application
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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
Xeomin Patient education
Getting started on Xeomin
NOT PROVIDED BY BRANDInstructions For Use - Upper Limb Spasticity
NOT PROVIDED BY BRANDInstructions For Use - Cervical Dystonia
NOT PROVIDED BY BRANDInstructions For Use - Blepharospasm
NOT PROVIDED BY BRANDInstructions For Use - Chronic Sialorrhea (Adults)
NOT PROVIDED BY BRANDInstructions For Use - Chronic Sialorrhea (Pediatrics)
NOT PROVIDED BY BRANDInstructions For Use - Upper Limb Spasticity (excluding spasticity caused by cerebral palsy) in Pediatrics
Patient toolkit
Patient Stories - Adults
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
Patient Stories - Pediatric
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
About Xeomin
ASK PATIENT TO: Open Camera on Phone Scan QR Code & Tap Link
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Other resources brands publish to help support patients and caregivers.
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Access to a Field Reimbursement Manager (FRM) or Medical Science Liaison (MSL) varies by brand and may require talking with your rep first.
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