Wherever they are, we meet them there

CUVITRU is covered similarly to other treatments for PI, but requirements may vary by plan 

The first question your patients may have is whether their health insurance covers CUVITRU and how much it will cost.

Benefits investigation

A benefits investigation can uncover these answers. Call the patient’s health plan on their behalf to determine coverage and out-of-pocket costs. Be sure to have your patient’s full insurance information to get the process started.

Clarify a health plan’s prior authorization requirements and prevent any treatment access delays

Depending on a patient’s medical or prescription drug benefit, you may be required to submit a prior authorization (PA) before your patient can receive treatment with CUVITRU. Each health plan has different requirements, so it’s always good to call and confirm their policy. 

Appeals process

Sometimes PAs do get denied. You and your patient are able to appeal the decision and it’s important to understand why it was denied in the first place. Some common reasons for denial:

• Missing or inaccurate information
• Step-edit requirement
• Incorrect diagnosis code(s) submitted
• Billed to the wrong benefit (ie, medical vs pharmacy)
• Site of care for infusion is not preferred/not covered
• Not covered on the formulary

Takeda Patient Support^* Co-Pay Assistance Program

If a patient is prescribed CUVITRU and needs co-pay assistance, you can direct the patient to enroll in Takeda Patient Support. The co-pay assistance program can cover up to 100% of your patient’s out-of-pocket co-pay costs, if they’re eligible.^*† A support specialist can review your patient’s coverage and determine eligibility.

^*Must meet eligibility requirements.

^†IMPORTANT NOTICE: The Takeda Patient Support Co-Pay Assistance Program (the Program) is not valid for prescriptions eligible to be reimbursed, in whole or in part, by Medicaid, Medicare (including Medicare Part D), Tricare, Medigap, VA, DoD, or other federal or state programs (including any medical or state prescription drug assistance programs). No claim for reimbursement of the out-of-pocket expense amount covered by the Program shall be submitted to any third party payer, whether public or private. The Program cannot be combined with any other rebate/coupon, free trial, or similar offer. Co-payment assistance under the Program is not transferable.The Program only applies in the United States, including Puerto Rico and other U.S. territories, and does not apply where prohibited by law, taxed, or restricted. This does not constitute health insurance. Void where use is prohibited by your patient’s insurance provider. If your patient’s insurance situation changes, they must notify the Program immediately at 1-855-268-1825. Coverage of certain administration charges will not apply for patients residing in states where it is prohibited by law. Takeda reserves the right to rescind, revoke, or amend the Program at any time without notice.

Reimbursement support

CUVITRU offers helpful resources so that your office can sort through the complexities of the reimbursement process. Find downloadable resources and information needed to process billing and diagnostic codes and claim forms.

Find comprehensive resources that provide support for your patients. 

Explore comprehensive resources for your patients to help support them with their CUVITRU treatment.