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Getting PRALUENT® (alirocumab)

Not an actual patient. Individual results may vary.

Understanding your role in the approval process

It may take time to get your PRALUENT. The information below will walk you through the process and provide you with what you need to get started.

When your doctor prescribes you PRALUENT, your health plan (insurance) may require your doctor to submit a prior authorization (PA) form to make sure you meet the requirements to get your prescription covered by your insurance provider.

Each health plan has their own prior authorization criteria for approval. It is important to understand your role as you, your doctor, and your pharmacy work to get your prescription approved.

Before you start

Know:

  • Your insurance information (insurance plan, member ID, group number)
  • Your pharmacy benefit manager (PBM) information (eg, CVS Caremark, Express Scripts, OptumRx)
  • Your prescription information

Do:

Make sure your insurance and pharmacy information is up to date. Click here to download our checklist of what you’ll need.

Enroll in our MyPRALUENT® Patient Support Program to help with getting PRALUENT and to receive support once you have PRALUENT. To enroll, follow the link above or call 1-844-PRALUENT (1-844-772-5836) and press 1 to speak to a care specialist.*

During the process

Know:

That there may be an out-of-pocket cost for PRALUENT. Click here to learn about financial resources that may be able to help.

Do:

Give your doctor or pharmacy the medical information they request. Your doctor will complete and submit a prior authorization form to your health plan for approval. It may take several days for approval and additional time to receive PRALUENT once you’ve been approved.

Talk to your doctor about the information they need to submit a prior authorization form.

What if you or your doctor receives a denial from your insurance company?

Know:

Why the request was denied by discussing it with your doctor.

Do:

Discuss your ability to appeal the decision. Your doctor can submit a letter of appeal to your health plan to seek approval. You can also be your own best advocate. Call your health plan and discuss your situation.

In large health plans from July 2015 to July 2016, over 35% of prescriptions that were at first denied were later approved during the appeals process, so be sure to ask your doctor to appeal.

How else can you make your voice heard?

Know:

What your rights are. Healthcare laws include rights and protections to help make coverage fairer and easier to understand. Click here to download a resource for help navigating the insurance and approval process for PRALUENT.

Do:

Find your state’s National Association of Insurance Commissioners contact information. Explore information on drug coverage in your state.

Be aware that a handful of states have laws (called “step therapy override legislation”) that may help certain people get access to specialty medications like PRALUENT.

After approval

Know:

If PRALUENT will be sent directly to your home through a specialty pharmacy or if you will pick it up at your local pharmacy. Some health plans require that you use a specialty pharmacy to provide your prescription. If that is the case, you should know which pharmacy it is and be on the lookout for any phone calls from them.

Now would also be a good time to learn more about the $0 Copay Card offer and other financial support options that may be available to you. Certain eligibility requirements must be met.

Do:

For delivery to your home

  • The pharmacy will call you to make sure they have your correct address and ask that you be home for the delivery (PRALUENT requires refrigeration). Be sure to answer your phone so that you can get their calls. Be aware that you may not recognize their number on caller ID
  • The pharmacy may collect a copay from you (a credit card may be required). Be sure to ask if they can help you with additional support

To pick up

Subject to a maximum copay assistance amount from MyPRALUENT® of $5,500 a year.

Eligible patients with commercial insurance not funded through a government healthcare program such as Medicare, Medicaid, or TRICARE subject to program terms and restrictions.

The MyPRALUENT® Patient Support Program can help with your prescription needs, from injection training to follow-up appointments and reapprovals.

Annual PRALUENT approval

Since PRALUENT is a specialty medication, you and your doctor will have to repeat the steps above once a year to make sure that your insurance continues to cover your prescription.

Changing your insurance

If you change your health insurance plan, please let your doctor know. You will have to complete the steps above again to make sure that your new insurance covers PRALUENT.

Questions? Call 1-844-PRALUENT (1-844-722-5836) and press 1 to speak with a care specialist.*

*Available Monday to Friday 8:00 AM to 11:00 PM EST and Saturday to Sunday 8:00 AM to 8:00 PM EST.

Preparing for your next visit

Click below for help in navigating the insurance and approval process for PRALUENT.

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Important Safety Information

Do not use PRALUENT if you are allergic to alirocumab or to any of the ingredients in PRALUENT.

Before starting PRALUENT, tell your healthcare provider about all your medical conditions, including allergies, and if you are pregnant or plan to become pregnant or if you are breastfeeding or plan to breastfeed.

Tell your healthcare provider or pharmacist about any prescription and over-the-counter medicines you are taking or plan to take, including natural or herbal remedies.

PRALUENT can cause serious side effects, including allergic reactions that can be severe and require treatment in a hospital. Call your healthcare provider or go to the nearest emergency room right away if you have any symptoms of an allergic reaction, including a severe rash, redness, severe itching, a swollen face, or trouble breathing.

The most common side effects of PRALUENT include: redness, itching, swelling, or pain/tenderness at the injection site, symptoms of the common cold, and flu or flu-like symptoms. Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

Talk to your healthcare provider about the right way to prepare and give yourself a PRALUENT injection and follow the "Instructions for Use" that comes with PRALUENT.

You may report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

What is PRALUENT® (alirocumab)?

PRALUENT is an injectable prescription medicine called a PCSK9 inhibitor. PRALUENT is used along with diet and maximally tolerated statin therapy in adults with heterozygous familial hypercholesterolemia (an inherited condition that causes high levels of LDL) or atherosclerotic heart problems, who need additional lowering of LDL cholesterol.

The effect of PRALUENT on heart problems such as heart attacks, stroke, or death is not known.

It is not known if PRALUENT is safe and effective in children.

Click here for Full Prescribing Information for PRALUENT.

Click here to learn more about Sanofi's commitment to fighting counterfeit drugs.

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Important Safety Information

Do not use PRALUENT if you are allergic to alirocumab or to any of the ingredients in PRALUENT.

Before starting PRALUENT, tell your healthcare provider about all your medical conditions, including allergies, and if you
are pregnant or plan to become pregnant or if you are breastfeeding or plan to breastfeed.

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