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Click ‘Get Form’ to open the Udenyca (-cbqv) Precertification Request in the editor.
Begin by filling out the 'Patient Information' section. Enter the patient's first and last name, address, phone numbers, weight, and height. Ensure all fields are completed legibly.
Proceed to the 'Insurance Information' section. Input the Aetna Member ID, Group number, date of birth, and any other coverage details if applicable.
In the 'Prescriber Information' section, provide details about the prescribing physician including their name, contact information, and specialty.
Complete the 'Dispensing Provider/Administration Information' by indicating where Udenyca will be administered and providing relevant provider details.
Fill in the 'Product Information' with dosage and directions for use of Udenyca.
In the 'Clinical Information' section, answer all required questions regarding patient conditions and treatment history thoroughly.
Finally, review all entries for accuracy before submitting your request. Use our platform's features to save or print your completed form as needed.

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What is the biosimilar for Neulasta?

Pegfilgrastim (Neulasta, Fulphila, Fylnetra, Nyvepria, Stimufend, Udenyca, Ziextenzo) is a man-made version of granulocyte colony-stimulating factor (G-CSF), which is a growth factor produced by your body. G-CSF stimulates your bone marrow to produce a type of white blood cell, called neutrophils.

What kind of medication is UDENYCA?

A drug that is a form of and is used to prevent infection in adults and children with neutropenia (a lower-than-normal number of white blood cells) caused by some types of chemotherapy.

When should UDENYCA be given?

UDENYCA is administered the day after chemotherapy and is usually prescribed with every chemotherapy cycle. For example, if you have 6 cycles of chemotherapy, you may receive 6 doses of UDENYCA. dose of UDENYCA, talk to your healthcare team about next steps.

What is the other name for UDENYCA?

UDENYCA is a biosimilar of the medication Neulasta (pegfilgrastim).

Is UDENYCA the same as Neulasta?

UDENYCA was confirmed to be highly similar to Neulasta (pegfilgrastim), with no clinically meaningful differences. * The assays used to assess immunogenicity for UDENYCA were highly sensitive and demonstrated no treatment-emergent neutralizing antibodies in more than 300 subjects.