COSENTYX® CONNECT SUPPORT PROGRAM
What is COSENTYX® Connect?
COSENTYX® Connect is a
support program designed to make onboarding
seamless and efficient for patients
and HCPs by providing helpful services:
Benefits Verification
Investigate coverage obstacles and take action
Obstacles may include lack of coverage, prior authorization (PA) denial, or step therapy
Facilitate PA process
Our team can help initiate PA requests or letters of appeal directly with your office and/or have your office follow up with your patient's health plan regarding PA status
Many health plans will allow up to 3 levels of PA denial appeals
Savings Options
Co-Pay offer* for eligible † privately insured patients
- Helps patients save on their out-of-pocket costs for BOTH COSENTYX and infusion administration
- Get patients started using the COSENTYX Start Form or by signing them up in the Co-Pay Portal
- Once the Explanation of Benefits has been received, you can submit a Co-Pay Claim Form electronically or by fax
Acquisition Support
Guidance on appropriate distributors and specialty pharmacies ‡
- Our team can help your office understand the authorized distributors available to order the IV formulation of COSENTYX
- COSENTYX® Connect also can determine if there are any specialty pharmacy requirements
Billing & Coding
Support with understanding relevant reimbursement codes
- Our team is here to help your office understand the appropriate codes
- Our Billing & Coding Guide also provides a comprehensive overview of the available codes
- Offices should contact third-party health plans for specific information on their coding, coverage, and payment policies
*Limitations apply. Valid only for those with private insurance. Program provides up to $16,000 annually for the cost of COSENTYX and up to $150 per infusion (up to $1,950 annually) for the cost of administration. Co-pay support for infusion administration cost not available in Rhode Island or Massachusetts. Offer not valid under Medicare, Medicaid, or any other federal or state program. Novartis reserves the right to rescind, revoke, or amend this program without notice. See complete Terms & Conditions for details.
†Certain payers have carve-outs that restrict utilization of manufacturer support programs.
‡Novartis does not recommend the use of any particular distributor or specialty pharmacy.
HCP, healthcare professional.
What is the Start Form?
The Start Form coordinates patient insurance coverage for, access to, and receipt of COSENTYX.
The Start Form also serves as an enrollment channel for the patient into COSENTYX® Connect.
The Start Form requires important information that must be filled out by both the HCP and the patient, which includes the patient’s prescription, patient insurance, and patient and HCP signatures.
If you have questions about the Start Form, please contact your Access & Reimbursement Manager (ARM) or call 1-844-COSENTYX (1-844-267-3689).
Start FormHCP, healthcare professional.
What is an Access & Reimbursement Manager (ARM), and how can they
help me?
COSENTYX ARMs are experienced professionals with strong knowledge of the insurance landscape, who work with the COSENTYX® Connect team and your office to help navigate your patients’ health plan coverage.
ARMs can support your office by:
-
Addressing local and regional insurance landscape and coverage obstacles
-
Serving as a liaison between the customer and COSENTYX® Connect throughout the reimbursement journey
-
Educating customers about COSENTYX® Connect and product access process
SAVINGS OPTIONS
How can patients on the IV formulation of COSENTYX get started
with the Co-Pay offer?
The COSENTYX Co-Pay offer* helps your eligible† privately insured patients with their out-of-pocket costs of COSENTYX and infusion administration.*
Get patients started using the COSENTYX Start Form or by signing them up in the Co-Pay Portal link below. Once the Explanation of Benefits (EOB) has been received, you can submit a Co-Pay Claim Form electronically or by fax.
Co-Pay Portal for you to enroll eligible† IV patients*Limitations apply. Valid only for those with private insurance. Program provides up to $16,000 annually for the cost of COSENTYX and up to $150 per infusion (up to $1,950 annually) for the cost of administration. Co-pay support for infusion administration cost not available in Rhode Island or Massachusetts. Offer not valid under Medicare, Medicaid, or any other federal or state program. Novartis reserves the right to rescind, revoke, or amend this program without notice. See complete Terms & Conditions for details.
†Certain payers have carve-outs that restrict utilization of manufacturer support programs.
INSURANCE COVERAGE
Are there differences in insurance coverage for the IV formulation
compared with the subcutaneous (SC) formulation?
The IV formulation of COSENTYX is typically covered under the medical benefit, whereas the SC formulation is typically covered under the pharmacy benefit. Be sure to determine individual patient insurance coverage by conducting a benefits investigation, with which the COSENTYX® Connect team can assist your office. Actual coverage and reimbursement decisions may be specific to each individual payer, and coverage information may be subject to change.
What is a medical exception?
A medical exception is a coverage request made to a patient’s health plan to remove a plan restriction placed on a treatment for medical reasons. If the IV formulation of COSENTYX is not covered by your patient’s health plan or is not affordable for your patient due to cost-sharing requirements, a medical exception request may be appropriate. When submitting a request, the prescriber must submit a statement of medical necessity to explain their rationale supporting the patient’s clinical need for COSENTYX. Be sure to include documentation of medical necessity for IV administration in your request.
Download our Prior Authorizations, Exceptions & Appeals Kit below for additional information, a submission checklist, and sample Letters of Medical Necessity when submitting an exception request.
We are here to help. If you have any questions, please contact your Access & Reimbursement Manager (ARM) or call the COSENTYX® Connect team at 1-844-COSENTYX (1-844-267-3689).
Prior Authorizations, Exceptions & Appeals Kit
How do I appeal to my patient’s health plan if the prior authorization
(PA) or exception request has been denied?
If an exception request or PA is denied, the patient’s health plan will provide a written explanation as to why it was denied and include information about how to request an appeal. Your office may file an appeal on the patient’s behalf.
An appeal is a request to the patient’s insurance company to reconsider their decision to deny coverage of COSENTYX. Appropriate documentation, such as an appeal letter, a letter of medical necessity, and relevant medical records can/should be submitted.
We are here to help. If you have questions, please contact your Access & Reimbursement Manager (ARM) or call the COSENTYX® Connect team at 1-844-COSENTYX (1-844-267-3689).
For additional information, a helpful appeal submission checklist, and sample appeal letters, download our Prior Authorizations, Exceptions & Appeals Kit:
STARTING COSENTYX
Where can I find a list of contacts that are available to support my office
and patients?
See our Important Contacts page for a list of resources and their available links, phone numbers, and fax numbers that may be useful when helping patients start and stay on COSENTYX.
How can I provide patients with more
information about COSENTYX?
Patients can use one of the patient brochures to learn more about how COSENTYX can treat their disease. For additional information about COSENTYX, patients can also visit www.COSENTYX.com.
How can I find dosing information for the IV formulation of COSENTYX?
Cosentyx-DosingCalculator.com provides step-by-step instructions to help HCPs determine appropriate IV dosing and an overview of the preparation and administration of the IV formulation of COSENTYX.
HCP, healthcare professional.
Where can I learn more about the results
of treatment with COSENTYX
in clinical trials?
The effectiveness and safety of COSENTYX IV formulation are based on the pharmacokinetic exposure and extrapolation of the established effectiveness and safety of SC COSENTYX in adult patients with active PsA, AS, or nr-axSpA.1
Please visit COSENTYXhcp.com to learn more about how SC COSENTYX performed in clinical trials.
AS, ankylosing spondylitis; nr-axSpA, non-radiographic axial spondyloarthritis; PsA, psoriatic arthritis; SC, subcutaneous.
Reference: 1. Cosentyx. Prescribing information. Novartis Pharmaceuticals Corp.
What testing do patients need to complete before starting COSENTYX?
Evaluate patients for tuberculosis (TB) infection prior to initiating treatment with COSENTYX. Please see the full Prescribing Information for more information about pretreatment evaluation for TB.
Does the IV formulation of COSENTYX
require premeds?
No premeds are required prior to infusing COSENTYX.1
Reference: 1. Cosentyx. Prescribing information. Novartis Pharmaceuticals Corp.
How can I help patients find a treatment center that can administer the IV formulation of COSENTYX since my office does not provide infusions?
The National Infusion Center Association (NICA) Infusion Center Locator conveniently locates the infusion centers near you and your patients. Novartis Pharmaceuticals Corporation does not endorse or recommend any specific infusion center.
For additional resources, please visit the
Important Contacts
page or contact your
Access & Reimbursement Manager.
3/24 304266
INDICATIONS
IMPORTANT SAFETY INFORMATION
CONTRAINDICATIONS
COSENTYX® (secukinumab) is indicated for the treatment of moderate to severe plaque psoriasis in adult patients who are candidates for systemic therapy or phototherapy.
WARNINGS AND PRECAUTIONS
Infections
INDICATIONS
COSENTYX® (secukinumab) is indicated for the treatment of moderate to severe plaque psoriasis (PsO) in patients 6 years and older who are candidates for systemic therapy or phototherapy.
COSENTYX is indicated for the treatment of active psoriatic arthritis (PsA) in patients 2 years of age and older.
COSENTYX is indicated for the treatment of adult patients with active ankylosing spondylitis (AS).
COSENTYX is indicated for the treatment of adult patients with active non-radiographic axial spondyloarthritis (nr-axSpA) with objective signs of inflammation.
COSENTYX is indicated for the treatment of active enthesitis-related arthritis (ERA) in patients 4 years of age and older.
COSENTYX is indicated for the treatment of adult patients with moderate to severe hidradenitis suppurativa (HS).
IMPORTANT SAFETY INFORMATION
CONTRAINDICATIONS
COSENTYX is contraindicated in patients with a previous serious hypersensitivity reaction to secukinumab or to any of the excipients in COSENTYX. Cases of anaphylaxis have been reported during treatment with COSENTYX.
WARNINGS AND PRECAUTIONS
Infections
COSENTYX may increase the risk of infections. In clinical trials, a higher rate of infections was observed in COSENTYX treated subjects compared to placebo-treated subjects. In placebo-controlled clinical trials in subjects with moderate to severe PsO, higher rates of common infections, such as nasopharyngitis (11.4% versus 8.6%), upper respiratory tract infection (2.5% versus 0.7%) and mucocutaneous infections with candida (1.2% versus 0.3%) were observed in subjects treated with COSENTYX compared to placebo-treated subjects. A similar increase in risk of infection in subjects treated with COSENTYX was seen in placebo‑controlled trials in subjects with PsA, AS and nr-axSpA. The incidence of some types of infections, including fungal infections, appeared to be dose‑dependent in clinical trials.
In the postmarketing setting, serious and some fatal infections have been reported in patients treated with COSENTYX.
Exercise caution when considering the use of COSENTYX in patients with a chronic infection or a history of recurrent infection. Instruct patients to seek medical advice if signs or symptoms suggestive of an infection occur. If a patient develops a serious infection, monitor the patient closely and discontinue COSENTYX until the infection resolves.
Pre-treatment Evaluation for Tuberculosis
Evaluate patients for tuberculosis (TB) infection prior to initiating treatment with COSENTYX. Avoid administration of COSENTYX to patients with active TB infection. Initiate treatment of latent TB prior to administering COSENTYX. Consider anti-TB therapy prior to initiation of COSENTYX in patients with a past history of latent or active TB in whom an adequate course of treatment cannot be confirmed. Monitor patients closely for signs and symptoms of active TB during and after treatment.
Inflammatory Bowel Disease
Inflammatory Bowel Disease Inflammatory Bowel Disease (IBD) exacerbations, in some cases serious and/or leading to discontinuation of COSENTYX, occurred in COSENTYX treated subjects during clinical trials in PsO, PsA, AS, nr-axSpA, and HS. In adult subjects with HS, the incidence of IBD was higher in subjects who received COSENTYX 300 mg every 2 weeks (Ulcerative Colitis [UC] 1 case, EAIR 0.2/100 subject-years; Crohn’s Disease [CD] 1 case, EAIR 0.2/100 subject-years) compared to subjects who received COSENTYX 300 mg every 4 weeks (IBD 1 case, EAIR 0.2/100 subject-years). In addition, new onset IBD cases occurred in subjects treated with COSENTYX in clinical trials. In an exploratory trial in 59 subjects with active Crohn’s disease [COSENTYX is not approved for the treatment of Crohn’s disease], there were trends toward greater disease activity and increased adverse reactions in subjects treated with COSENTYX as compared to placebo-treated subjects.
Exercise caution when prescribing COSENTYX to patients with IBD. Patients treated with COSENTYX should be monitored for signs and symptoms of IBD.
Eczematous Eruptions
In postmarketing reports, cases of severe eczematous eruptions, including atopic dermatitis‑like eruptions, dyshidrotic eczema, and erythroderma, were reported in patients receiving COSENTYX; some cases resulted in hospitalization. The onset of eczematous eruptions was variable, ranging from days to months after the first dose of COSENTYX.
Treatment may need to be discontinued to resolve the eczematous eruption. Some patients were successfully treated for eczematous eruptions while continuing COSENTYX.
Hypersensitivity Reactions
Anaphylaxis and cases of urticaria occurred in COSENTYX treated subjects in clinical trials. If an anaphylactic or other serious allergic reaction occurs, administration of COSENTYX should be discontinued immediately and appropriate therapy initiated.
The removable caps of the COSENTYX Sensoready® pen and the COSENTYX 1 mL and 0.5 mL prefilled syringes contain natural rubber latex, which may cause an allergic reaction in latex-sensitive individuals. The safe use of the COSENTYX Sensoready pen or prefilled syringe in latex-sensitive individuals has not been studied.
Immunizations
Prior to initiating therapy with COSENTYX, consider completion of all age-appropriate immunizations according to current immunization guidelines. COSENTYX may alter a patient’s immune response to live vaccines. Avoid use of live vaccines in patients treated with COSENTYX.
MOST COMMON ADVERSE REACTIONS
Most common adverse reactions (>1%) are nasopharyngitis, diarrhea, and upper respiratory tract infection.
Please see full Prescribing Information, including Medication Guide.