Northera Blue Flamingo
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Coverage and support for eligible patients

Northera Blue Flamingo
Access & assistance icon

Coverage and support for eligible patients

Medicare Part D - coverage

Assistance is available when you prescribe NORTHERA® (droxidopa)

NORTHERA is covered for most Medicare Part D patients1*

Medicare Part D provides prescription drug coverage for Medicare patients. Part D coverage is optional. Patients need to enroll in a Medicare Prescription Drug Plan or a Medicare Advantage Plan to take advantage of Part D benefits.2*

Medicare payers require a prior authorization (PA) or step therapy ~95% of the time1
Every Part D plan is different, and many elements can impact a patient’s prescription costs3†
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Because of the difference in plans, and coverage phases, the amount your patients pay at the beginning of the year could be different by year’s end.
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Visit the Centers for Medicare & Medicaid Services website, www.cms.gov, for additional information about Medicare Part D.
Below are 2 resources that may allow eligible Part D patients to lower their costs4
  • Plans that provide supplemental coverage during the coverage gap
  • State Pharmaceutical Assistance Programs

Any information regarding Medicare Part D plans is not intended to imply disease prevalence or appropriate patients for treatment with NORTHERA; Lundbeck is not providing this information to influence HCPs’ independent medical judgments regarding patients for whom NORTHERA may be appropriate.

*Coverage may be subject to PA or trial and failure of prior therapy. Lundbeck does not control the Medicare program and does not make any guarantees with regard to coverage or Medicare plan terms.

HCPs and patients are responsible for complying with applicable plan requirements, and may want to contact a plan directly to confirm its specific requirements.

The coverage gap (“donut hole”) is a phase of Medicare Part D plans that begins after the total costs spent by both the patient and health plan reach a certain threshold.3

Medicare Part D – Extra Help

Eligible Medicare Part D patients may be able to access NORTHERA at a low cost

“Extra Help” with prescription drug costs

Medicare Part D’s Extra Help, also known as the Low-Income Subsidy (LIS) program, assists patients with limited income or resources by covering some or most of their Medicare prescription drug costs.

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With Extra Help, patients can receive:
  • Prescription drug coverage
  • Pay a lower deductible (or none at all)
  • Receive a lower required cost share during the coverage gap and the catastrophic coverage phases

Lundbeck does not control the Medicare or LIS programs and does not make any guarantees with regard to coverage, Medicare Part D plan terms, or the LIS program. Any information about the LIS program is not intended to imply disease prevalence or appropriate patients for treatment with NORTHERA.

Lundbeck does not control the Medicare or LIS programs and does not make any guarantees with regard to coverage, Medicare Part D plan terms, or the LIS program. Any information about the LIS program is not intended to imply disease prevalence or appropriate patients for treatment with NORTHERA.

Qualifying for Extra Help

Patients who are “dual eligible” (qualify for both Medicare and Medicaid), or who receive Supplemental Security Income, are automatically enrolled in Extra Help. Others can apply for Extra Help by2:

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Visiting2: SocialSecurity.gov
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Calling Social Security2 at 1-800-772-1213

Eligibility for full or partial Extra Help benefits is based on their income and assets in relation to the federal poverty level.

 

This information is subject to change. Medicare and LIS are not Lundbeck programs, and Lundbeck is not guaranteeing the availability or details of LIS or any Medicare plan. The programs and Part D plans have many nuances that are not necessarily reflected on this website. These nuances could impact program eligibility and coverage details for individual patients.

Commercial insurance

Over 90% of patients with commercial insurance have coverage for NORTHERA5

Commercial insurance may be available to help patients pay for their medications. Please note the following:

  • Coverage for medications, including NORTHERA, varies from plan to plan
  • Not all commercial plans include prescription coverage
  • Some plans require that patients use an ”in-network” pharmacy when filling prescriptions 
  • HCPs and patients are responsible for complying with applicable plan requirements and may want to contact a plan directly to confirm its specific requirements
Commercial payers require prior authorization or step therapy 83% of the time5

Northera Support Center (NSC)

The NSC is available for eligible patients

The NSC is able to assist eligible patients in obtaining access to NORTHERA through a specialty pharmacy. Upon receipt of a completed NORTHERA Treatment Form, the NSC provides the following support to eligible patients§:

Insurance Coverage Information

Insurance coverage information
  • Coordinates with the patient’s insurance provider to confirm coverage information for NORTHERA
  • Contacts both you and the patient to provide insurance coverage information for NORTHERA
  • Informs patients of the NORTHERA Commercial Copay Assistance Program, including information about any other financial assistance that may be available

StarterRx Program

The StarterRx Program
  • Provides a one-time 30-day-supply shipment to new, eligible, commercially insured patients age 17 and older with a valid NORTHERA prescription and who have an on-label diagnosis

Support Available

Ongoing support
  • Coordinates delivery of your patients’ initial NORTHERA prescription with the specialty pharmacy
  • Available to answer certain frequently asked questions throughout your patients’ treatment
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The NSC is available toll-free at: 1-844-601-0101 Monday through Friday, 8 AM to 8 PM ET
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The NSC can help get patients started with NORTHERA. Complete the NORTHERA Treatment Form and fax it to the NSC at: 1-844-601-0102

§Terms and Conditions for all NORTHERA patient support programs can be found here.

Complete Terms and Conditions for the StarterRx Program are available here, and Informational Support is available here, respectively.

NORTHERA Commercial Copay Assistance Program

Commercially insured patients age 17 and older with a valid NORTHERA prescription may be eligible for copay assistance through the NORTHERA Commercial Copay Assistance Program

Pay as little as $10 a month for your Northera prescription
  • Patients are not eligible for this assistance if they are uninsured or if the prescription is eligible to be reimbursed, in whole or in part, by any state or federal health care programs, including but not limited to Medicare or Medicaid, Medigap, VA, DOD, or TRICARE
  • Patients must pay at least $10 for each 30-day prescription
  • A maximum benefit limit may also apply; patients should confirm their out-of-pocket cost with their specialty pharmacy
For information on eligibility and how to obtain commercial copay assistance, please contact the Northera Support Center toll-free at: 1-844-601-0101 Monday through Friday, 8 AM to 8 PM ET, or

See complete Terms and Conditions for the Commercial Copay Assistance Program.

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We want to help you stay connected. Sign up for email updates with information about nOH and NORTHERA as they become available.

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See additional resources including upcoming events and informational videos.

References:

1. MMIT on Medicare Patients. August 10, 2018 data. Accessed August 10, 2018. 2. Centers for Medicare & Medicaid Services. https://www.medicare.gov/pubs/pdf/10050-Medicare-and-You.pdf. Accessed February 21, 2019. 3. Centers for Medicare & Medicaid Services. Revised June 2018. https://www.medicare.gov/sites/default/files/2018-07/11109-your-guide-to-medicare-prescrip-drug-cov.pdf. Accessed September 18, 2018. 4. Centers for Medicare & Medicaid Services. 6 ways to lower your coverage gap costs. https://www.medicare.gov/part-d/costs/coverage-gap/ways-to-lower-drug-costs.html. Accessed March 26, 2019. 5. MMIT on Commercial Patients. August 21, 2018 data. Accessed August 21, 2018.

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NORTHERA CONNECT:

Please see Important Safety Information, including Boxed Warning for supine hypertension.

For more information, see the full Prescribing Information.

Indications and Usage

NORTHERA (droxidopa) is indicated for the treatment of orthostatic dizziness, lightheadedness, or the “feeling that you are about to black out” in adult patients with symptomatic neurogenic orthostatic hypotension (nOH) caused by primary autonomic failure (Parkinson’s disease [PD], multiple system atrophy, and pure autonomic failure), dopamine beta-hydroxylase deficiency, and non-diabetic autonomic neuropathy. Effectiveness beyond 2 weeks of treatment has not been established. The continued effectiveness of NORTHERA should be assessed periodically.

Important Safety Information

WARNING: SUPINE HYPERTENSION

Monitor supine blood pressure prior to and during treatment and more frequently when increasing doses. Elevating the head of the bed lessens the risk of supine hypertension, and blood pressure should be measured in this position. If supine hypertension cannot be managed by elevation of the head of the bed, reduce or discontinue NORTHERA.

CONTRAINDICATIONS

  • NORTHERA is contraindicated in patients who have a history of hypersensitivity to the drug or its ingredients.

WARNINGS AND PRECAUTIONS

  • Supine Hypertension: NORTHERA therapy may cause or exacerbate supine hypertension in patients with nOH, which may increase the risk of cardiovascular events if not well managed, particularly stroke.
  • Hyperpyrexia and Confusion: Cases of a symptom complex resembling neuroleptic malignant syndrome (NMS) have been reported with NORTHERA use during post-marketing surveillance. Observe patients carefully when the dosage of NORTHERA is changed or when concomitant levodopa is reduced abruptly or discontinued, especially if the patient is receiving neuroleptics. NMS is an uncommon but life-threatening syndrome characterized by fever or hyperthermia, muscle rigidity, involuntary movements, altered consciousness, and mental status changes. The early diagnosis of this condition is important for the appropriate management of these patients.
  • Ischemic Heart Disease, Arrhythmias, and Congestive Heart Failure: NORTHERA therapy may exacerbate existing ischemic heart disease, arrhythmias, and congestive heart failure. Careful consideration should be given to this potential risk prior to initiating therapy.
  • Allergic Reactions: Hypersensitivity reactions, including anaphylaxis, angioedema, bronchospasm, urticaria, and rash have been reported in post-marketing experience, with some resulting in emergency treatment. If a hypersensitivity reaction occurs, discontinue the drug and initiate appropriate therapy.
  • This product contains FD&C Yellow No. 5 (tartrazine), which may also cause allergic-type reactions (including bronchial asthma) in certain susceptible persons. Although the overall incidence of FD&C Yellow No. 5 (tartrazine) sensitivity in the general population is low, it is frequently seen in patients who also have aspirin hypersensitivity.

ADVERSE REACTIONS

  • The most common adverse reactions (>5% and ≥3% difference compared to placebo) were headache, dizziness, nausea, and hypertension.

DRUG INTERACTIONS

  • Administering NORTHERA in combination with other agents that increase blood pressure (e.g., norepinephrine, ephedrine, midodrine, and triptans) would be expected to increase the risk for supine hypertension.
  • Dopa-decarboxylase inhibitors may require dose adjustments for NORTHERA.
  • The concomitant use of selective MAO-B inhibitors, such as rasagiline or selegiline, was permitted in the NORTHERA clinical trials. However, based on mechanism of action, the use of non-selective MAO inhibitors and linezolid should be avoided as there is a potential for increased blood pressure when taken with NORTHERA.

USE IN SPECIFIC POPULATIONS

  • There are no available data on use of NORTHERA in pregnant women and risk of major birth defects or miscarriage. Because of the potential for serious adverse reactions, including reduced weight gain in breastfed infants, advise a woman not to breastfeed during treatment with NORTHERA.
  • The safety and effectiveness of NORTHERA in pediatric patients have not been established. No overall differences in safety or effectiveness were observed between patients aged 75 years and older and younger patients in clinical trials, but greater sensitivity of some older individuals cannot be ruled out.
  • Clinical experience with NORTHERA in patients with severe renal function impairment (GFR <30 mL/min) is limited; therefore, dosing recommendations cannot be provided for these patients.

For more information, please see the full Prescribing Information, including Boxed Warning for supine hypertension.