For US Healthcare Professionals
I am a
Rheumatology Specialist
For US Healthcare Professionals
Full Prescribing Information
Education and resources
designed with
your patients in mind
For your office
Enrollment and Prescription Form
This form is the first step to understanding your patient’s insurance coverage and enrolling the patient in TREMFYA withMe.
TREMFYA® Prior Authorization Checklist
Reminders and tips when completing prior authorizations for your patients.
Sample Letter of Exception
To document the request for a payer to cover a nonformulary product or when step therapy through other treatments is required.
Sample Letter of Medical Necessity
To document rationale as to why a payer’s formulary products may not be clinically appropriate for a patient. May also be used when a payer does not have a known coverage policy in effect.
TREMFYA withMe Delay and Denial Support
A resource that provides a detailed guide on how to get support in the event of a coverage delay or denial for your commercially insured patients.
Sample Letter of Appeal
To document and request a payer review a denied coverage determination for TREMFYA®, such as prior authorization or exception request denials.
Business Associate Agreement
Complete this Business Associate Agreement (BAA) one time only to allow you to request verification of patients’ insurance benefits without requiring individual Patient Authorization.
Patient Authorization
If no BAA is on file, you must secure Patient Authorization for each patient. Use this form or have the patient complete the Patient Authorization Form (PAF). TREMFYA withMe cannot accept any patient without an executed BAA or Patient Authorization on file.
TREMFYA withMe Specialty Pharmacy List
Quick reference guide to Specialty Pharmacy partners within the TREMFYA withMe program.
Access & Affordability Resources
Tools & resources that help navigate payer processes and support getting your patients started on TREMFYA®.
For your patients
Patient Brochure
A patient-friendly overview of product information for TREMFYA® in active PsA.
TREMFYA withMe
TREMFYA withMe can help verify insurance coverage for your patients, provide reimbursement information, find financial assistance options for eligible patients, and provide ongoing support to help patients start and stay on TREMFYA®.
TREMFYA withMe Patient Brochure
A resource to help explain the benefits of TREMFYA withMe to your patients.
TREMFYA withMe Savings Program
Eligible commercially insured patients pay $5 per injection. Maximum program benefit per calendar year shall apply. Terms expire at the end of each calendar year and may change. See program requirements at TremfyawithMeSavings.com.
Patient Affordability Options
Discover options that may help make TREMFYA® more affordable for your patients. Download this resource to help your patients learn about cost support options.
TREMFYA withMe Delay and Denial Support
A resource that provides a detailed guide on how to get support in the event of a coverage delay or denial for your commercially insured patients.
Full Prescribing Information and Instructions for Use in Spanish
For Spanish-speaking patients, this document includes the full Prescribing Information, Medication Guide, and Instructions for Use (IFU).
TREMFYA withMe is limited to education for patients about TREMFYA®, its administration, and/or their disease, and is not intended to provide medical advice, replace a treatment plan from the patient’s doctor or nurse, or provide case management services.
Injection demonstration
videos
Watch these easy-to-follow injection demonstration videos for TREMFYA®.
The injection demonstration videos are not meant to replace the IFU that is supplied with TREMFYA®. Instruct patients to read the IFU before using their TREMFYA® prefilled syringe or One-Press injector and each time they get a refill. Please see the full Instructions for Use (IFU) for TREMFYA®.
TREMFYA® is intended for use under the guidance and supervision of a physician. Patients may self-inject with TREMFYA® after physician approval and proper training.
One-Press injector demonstration video
Prefilled syringe demonstration video
