Confidence in Coverage, Cost, and Support on the Path to Repatha® Access

Getting Started with Repatha®

Your Amgen Team
is Here to Help

For support & resources, call
your Repatha® representative or
1-844-REPATHA.

1. Gather clinical documentation

  • Diagnosis details (chart notes)

  • Recent lipid panel including LDL with dates, usually within 30 days

  • History of other lipid-lowering therapy (chart notes)

2. Submit prior authorization (PA)

  • Follow the same process you normally follow for PAs

  • Payers typically require PA form and supporting clinical documentation

  • You can access PA requirements and forms at RepathaCoverage.com

  • If you need help getting started, specialty pharmacies in the Repatha® network can help

3. Contact us for support

  • The plan may request additional information for approval. Call your Repatha® representative and we can help

NEXT:Coverage

Repatha® is the #1 prescribed PCSK9 inhibitor and is covered by most insurance plans1,2,*,†

91%

of adults are covered

for Repatha®
in the US2,†

~44,000

patients have

received
Repatha®1,‡

*Based on IMS (TRx) data for the period of September 11, 2015 to June 2, 2017.

Repatha® is on the formulary of the plans of 91% of adults with prescription drug coverage. Based on reported coverage as of March, 2017. Source: Managed Markets Insights & Technology.

Based on IMS (NBRx) data for the period of September 11, 2015 to June 2, 2017. These data include only dispensed scripts.

NEXT:Cost

Amgen is Committed to Helping Patients Access Their Medicines

Commercial Commercial Commercial
National Medicare Part D National Medicare Part D National Medicare Part D

For patient assistance, call 1-844-REPATHA

*Eligibility Criteria―Open to patients with a Repatha® prescription who have commercial insurance. Patients may not seek reimbursement for value received from the Repatha® Copay Card from any third-party payers, including a flexible spending account or a healthcare savings account. This program is not open to patients receiving prescription reimbursement under any federal, state or government-funded healthcare program, such as Medicare, Medicare Advantage, Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), the Department of Defense (DoD) or TRICARE® or where prohibited by law. If at any time patients begin receiving prescription drug coverage under any such federal, state, or government-funded healthcare program, patients will no longer be able to use this card and you must call 1-844-REPATHA to stop participation. Restrictions may apply. Offer subject to change or discontinuation without notice.

LIS = low-income subsidy.

NEXT:Clinical Documentation

Your Amgen team can help through the payer approval process

Repatha® requires a prior authorization (PA) and is typically filled through a specialty pharmacy

Diagnosis Details (Chart Notes)

  • For patients with primary hyperlipidemia and clinical ASCVD or FH: primary & secondary ICD-10 codes

  • For patients with FH: diagnostic criteria used (eg, Simon Broome, Dutch Lipid Clinical Network)

Recent Lipid Panel Including LDL Labs with Dates

  • Typically in the last 30 days; if the patient has tried Repatha®, remember to include PRE- and POST-Repatha® LDL levels

History of Other Lipid-Lowering Treatment (Chart Notes)

  • Chart notes (EMR) indicating current treatment, history of statins and other lipid-lowering drugs (maximum dosage and dates/duration for each treatment)

Review Repatha®
Documentation Pocket Guide

for documentation checklists and
additional details.

Download

Specific plan requirements may vary: additional clinical information and documentation may be required.

NEXT:Support

Amgen is here to help your patients start and stay on Repatha®

Insurance Support

Your Amgen team offers resources for insurance support, including:

Prior Authorization
(PA) process

In-office support from the
Repatha® Access Specialists

You can also call 1-844-REPATHA
to speak with a live counselor

Patient & Prescription Reminders

  • Once approved, don’t forget to send the prescription to the specialty pharmacy, which may be mandated by the patient’s payer

  • Remind your commercially insured patients that they pay no more than $5 per month with the Repatha® Copay Card*–patients must visit Repatha.com or call 1‑844‑REPATHA to activate their card

  • Inform your patients to expect a call from the pharmacy so they can coordinate payment, financial assistance, and delivery

  • Schedule follow-up to check lab results and patient progress

Rely on RepathaReady® to help your patients get on the path with Repatha®

Call 1-844-REPATHA for patient support, including:

  • Patient support & injection training from RepathaReady® nurses

  • Repatha® copay enrollment

  • Medication reminders

  • Emails and resources to help patients start and stay on therapy

  • Free needle disposal kits mailed to your patient’s door

*Eligibility Criteria―Open to patients with a Repatha® prescription who have commercial insurance. Patients may not seek reimbursement for value received from the Repatha® Copay Card from any third-party payers, including a flexible spending account or a healthcare savings account. This program is not open to patients receiving prescription reimbursement under any federal, state or government-funded healthcare program, such as Medicare, Medicare Advantage, Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), the Department of Defense (DoD) or TRICARE® or where prohibited by law. If at any time patients begin receiving prescription drug coverage under any such federal, state, or government-funded healthcare program, patients will no longer be able to use this card and you must call 1-844-REPATHA to stop participation. Restrictions may apply. Offer subject to change or discontinuation without notice.

NEXT:Getting Started
NEXT:Repatha® Transition Program

Repatha® Patient Transition Program

The Repatha® Patient Transition Program can help you transition your patients from Praluent® (alirocumab) to Repatha®

Amgen is committed to supporting continuity of care and addressing the needs of patients and healthcare providers following the market withdrawal of Praluent®. Repatha® is FDA-approved for all patients who currently take Praluent® and can be used to safely and effectively treat these patients.

How Amgen can help you and your patients

The Repatha® Patient Transition Program offers several resources to help practices and patients transition to Repatha®:

In-office access support from Repatha® Access Specialists

Patient support and injection training from the RepathaReady® Nurses

Flexibility to fill Repatha® prescriptions at any pharmacy where Repatha® is stocked

Dedicated call center support at 1‑844‑REPATHA (‍1‑844‑737‑2842) offering:

  • Streamlined insurance support

  • Repatha® Copay Card and other financial assistance

How to help your Praluent® patients switch to Repatha® with the Repatha® Patient Transition Program

Identify and contact your Praluent® patients who are appropriate for Repatha®

  • Download the Patient Transition Tracker

  • Discuss with the patient transitioning to Repatha®

  • Confirm the specialty pharmacy that will be used to fill Repatha® prescriptions

  • Remind eligible commercially insured patients to sign up for the Repatha® Copay Card by calling 1-844-REPATHA (1-844-737-2842) or visiting Repatha.com

Submit a new Repatha® prescription to the patient’s specialty pharmacy

  • When submitting a new Repatha® prescription, utilize the PA Update Cover Letter stating to the payer that the patient was previously on Praluent®

  • Resources are available from your Amgen representative or by calling 1‑844‑REPATHA (‍1‑844‑737‑2842)

Follow up with the specialty pharmacy and/or the patient to ensure continuity of treatment with Repatha®

  • The specialty pharmacy can help with payer documentation and financial assistance for Repatha®

Contact your Amgen representative for assistance with the Repatha® Patient Transition Program. RepathaReady® offers support services for patients and providers.

Phone: 1‑844‑REPATHA
(‍1‑844‑737‑2842)
9 AM – 9 PM ET, Monday – Friday

Fax: 1‑855‑737‑2842

Repatha® Patient Transition Program Patient Tracker

Download

Repatha® Patient Transition Program PA Update Cover Letter

Download

NEXT:Getting Started

See Next

References: 1. Data on file, Amgen; 2017. 2. Data on file, Amgen; 2017. 3. Centers for Medicare and Medicaid Services. Announcement of Calendar Year (CY) 2017 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter. April 2016.
https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Announcement2017.pdf. Accessed May 17, 2017. 4. Kaiser Family Foundation. The Medicare Part D Prescription Drug Benefit. September 2016. http://files.kff.org/attachment/Fact-Sheet-The-Medicare-Part-D-Prescription-Drug-Benefit. Accessed May 3, 2017.

IMPORTANT SAFETY INFORMATION

See More

Contraindication: Repatha® is contraindicated in patients with a history of a serious hypersensitivity reaction to Repatha®.

Allergic reactions: Hypersensitivity reactions (e.g. rash, urticaria) have been reported in patients treated with Repatha®, including some that led to discontinuation of therapy. If signs or symptoms of serious allergic reactions occur, discontinue treatment with Repatha®, treat according to the standard of care, and monitor until signs and symptoms resolve.

Adverse reactions: The most common adverse reactions (> 5% of Repatha®-treated patients and more common than placebo) were: nasopharyngitis, upper respiratory tract infection, influenza, back pain, and injection site reactions.

In a 52-week trial, adverse reactions led to discontinuation of treatment in 2.2% of Repatha®-treated patients and 1% of placebo-treated patients. The most common adverse reaction that led to Repatha® treatment discontinuation and occurred at a rate greater than placebo was myalgia (0.3% versus 0% for Repatha® and placebo, respectively).

Adverse reactions from a pool of the 52-week trial and seven 12-week trials:
Local injection site reactions occurred in 3.2% and 3.0% of Repatha®-treated and placebo-treated patients, respectively. The most common injection site reactions were erythema, pain, and bruising. The proportions of patients who discontinued treatment due to local injection site reactions in Repatha®-treated patients and placebo-treated patients were 0.1% and 0%, respectively.

Allergic reactions occurred in 5.1% and 4.7% of Repatha®-treated and placebo-treated patients, respectively. The most common allergic reactions were rash (1.0% versus 0.5% for Repatha® and placebo, respectively), eczema (0.4% versus 0.2%), erythema (0.4% versus 0.2%), and urticaria (0.4% versus 0.1%).

Neurocognitive events were reported in less than or equal to 0.2% in Repatha®-treated and placebo-treated patients.

In a pool of placebo- and active-controlled trials, as well as open-label extension studies that followed them, a total of 1,988 patients treated with Repatha® had at least one LDL‑C value < 25 mg/dL. Changes to background lipid-altering therapy were not made in response to low LDL-C values, and Repatha® dosing was not modified or interrupted on this basis. Although adverse consequences of very low LDL-C were not identified in these trials, the long-term effects of very low levels of LDL-C induced by Repatha® are unknown.

Musculoskeletal adverse reactions were reported in 14.3% of Repatha®-treated patients and 12.8% of placebo-treated patients. The most common adverse reactions that occurred at a rate greater than placebo were back pain (3.2% versus 2.9% for Repatha® and placebo, respectively), arthralgia (2.3% versus 2.2%), and myalgia (2.0% versus 1.8%).

Immunogenicity: Repatha® is a human monoclonal antibody. As with all therapeutic proteins, there is a potential for immunogenicity with Repatha®.

INDICATION
Repatha® is indicated as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with heterozygous familial hypercholesterolemia (HeFH) or clinical atherosclerotic cardiovascular disease (CVD), who require additional lowering of low density lipoprotein cholesterol (LDL-C).

The effect of Repatha® on cardiovascular morbidity and mortality has been published. Inclusion of the results in the approved labeling is under evaluation with the FDA.

Please see full Prescribing Information.

Back to Top