Zepzelca(lurbinectedin)
ZEPZELCA 4 MG Injection
NO BOXED WARNING

Dosage & Administration

Get Your Patient on Zepzelca

See your patient's specific prior authorization requirements including coverage restrictions and step therapies
Insurance Carrier
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Zepzelca Prior Authorization Resources

Most recent state uniform prior authorization forms

Verified: Sep 24, 2024Arizona - Uniform Prior Authorization Form
Verified: Sep 24, 2024Colorado - Uniform Prior Authorization Form
Verified: Sep 24, 2024Hawaii - Uniform Prior Authorization Form
Verified: Sep 24, 2024Illinois - Uniform Prior Authorization Form
Verified: Sep 24, 2024Indiana - Uniform Prior Authorization Form
Verified: Sep 24, 2024Louisiana - Uniform Prior Authorization Form
Verified: Sep 24, 2024Minnesota - Uniform Prior Authorization Form
Verified: Sep 24, 2024New Hampshire - Uniform Prior Authorization Form
Verified: Sep 24, 2024New Mexico - Uniform Prior Authorization Form
Verified: Sep 24, 2024Oregon - Uniform Prior Authorization Form
Verified: Sep 24, 2024Texas - Uniform Prior Authorization Form
Verified: Oct 05, 2024Washington - Uniform Prior Authorization Form
Verified: Oct 05, 2024Wisconsin - Uniform Prior Authorization Form

Benefits investigation

JazzCares Enrollment Form
JazzCares Enrollment Form - Online
JazzCares Patient Authorization Form
JazzCares Patient Authorization Form - Online

Reimbursement help (FRM)

Receive Assistance from an FRM Regarding Reimbursement Information

Zepzelca Financial Assistance Options

Copay savings program

JazzCares Patient Authorization Form
JazzCares Patient Authorization Form - Online
Enroll in Patient Savings Program
JazzCares Enrollment Form
JazzCares Enrollment Form - Online
Learn More

Foundation programs

JazzCares Patient Authorization Form
JazzCares Patient Authorization Form - Online
Patient Assistance Program
JazzCares Enrollment Form
JazzCares Enrollment Form - Online
Learn More

Zepzelca PubMed™ News

Zepzelca 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

Patient Brochure
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
About Zepzelca
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Side Effects
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
View How to Take Zepzelca
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

Zepzelca FAQs