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Benlysta gateway enrollment form

Benlysta enrollment form 2025

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The document is a two-page form for patients seeking assistance with BENLYSTA (belimumab), including benefits verification, co-pay assistance, and patient assistance programs. It requires personal, insurance, and physician information, along with patient authorization for the collection and use of medical information. Patients must sign to enroll in reimbursement support and may also opt into an educational program called BENLYSTA Connects.

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2013	4 Satisfied (40 Votes)

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How is supplied?

may be administered as an intravenous infusion or as a subcutaneous injection. Vials are intended for intravenous use only (not for subcutaneous use) and autoinjectors and prefilled syringes are intended for subcutaneous use only (not for intravenous use).

Who qualifies for ?

is a prescription medicine for adults with active systemic lupus erythematosus (SLE or lupus) or active lupus nephritis on other lupus medicines. IV is approved in children aged 5 years and older with SLE on other lupus medicines.

Does insurance cover ?

Do Medicare prescription drug plans cover ? Yes. 98% of Medicare prescription drug plans cover this drug.

benlysta gateway phone number

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Is a form of chemo?

Is a chemotherapy? No, is not chemotherapy its a biologic therapy, delivered either through an IV infusion or as a self-injection. It works by reducing certain cells in your immune system that can make lupus active.

Does suppress immune system?

targets specific immune cells, rather than the blanket approach of other therapies which suppress the entire immune system.

Is a long term medication?

Conclusion: Belimumab added to standard therapy was generally well-tolerated over the 4-year treatment period in patients with SLE, which suggests that belimumab can be administered long term with an acceptable safety profile.

How much does cost per year?

sells for an estimated annual price of $42,270, according to ICER, which when compared with the drugs effectiveness, comes to $148,550 per QALY.

Is considered chemotherapy?

Belimumab () is a specific lupus drug that doctors use in combination with other medications, such as and steroids. Belimumab helps treat mild to moderate lupus that affects the skin, joints, and other organs. It is not a chemotherapy drug.

Benlysta enrollment form 2025

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How to edit Benlysta enrollment form online

See more benlysta enrollment form versions

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Is it safe to sign my [KEY] electronically?

How to manage my [KEY] from Gmail?

How is supplied?

Who qualifies for ?

Does insurance cover ?

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Is a form of chemo?

Does suppress immune system?

Is a long term medication?

How much does cost per year?

Is considered chemotherapy?

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