Click for information on Doptelet Connect services:
FORMULARY LOOK-UP TOOL Do you know your patients’ coverage?
Accessing Doptelet Resources
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Getting Started With Doptelet
Gives an overview of the Doptelet access process and the pathway options from prescription through continuing care.
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Coding Resource
Provides useful codes to identify appropriate patients and assists with the billing and reimbursement of Doptelet.
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Prior Authorization Resource Guide
Explains general steps in the prior authorization process to help HCP offices get patients started on Doptelet.
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Accessing Doptelet Through Specialty Pharmacies and Distributors
Lists contact information for specialty pharmacies and distributors that are authorized to dispense Doptelet.
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You've Prescribed Doptelet: Now What?
Outlines the process for patients in obtaining a Doptelet prescription with a specialty pharmacy.
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After a patient has been prescribed Doptelet, the patient can be enrolled in Doptelet Connect. To enroll a patient, complete the prescription and enrollment form below, including all healthcare provider and patient signatures, and fax to 855-686-8729.
Doptelet Connect offers access and reimbursement support to help patients access Doptelet. Doptelet Connect provides information regarding patient insurance coverage and financial assistance information that may be available to help patients with financial needs.
For more information, call 1-833-368-2663. Monday-Friday 8 AM-8 PM ET.
Doptelet Copay Assistance Program*
The Doptelet Copay Assistance Program* is for eligible patients who have commercial prescription insurance. Patients may pay as little as $0 per prescription, up to a maximum benefit of $15,000 per calendar year.
For more information, call 1-833-368-2663.
Monday-Friday 8 AM-8 PM ET.
Doptelet Copay Assistance Program
Outlines how the Doptelet Copay Assistance Program can help lower out-of-pocket costs for eligible patients receiving Doptelet.
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Doptelet Patient Assistance Program†
Provides patients with Doptelet at no cost to patients who meet the eligibility requirements.
Accessing Additional Doptelet Connect Forms and Resources
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Prescription and Enrollment Form
Authorization provides patient/caregiver access to the Doptelet Connect Patient Support Program.
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Patient Consent Form
To enroll a patient, complete the form, including all healthcare provider and patient signatures, and fax to 855-686-8729.
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Doptelet Connect Process Flow for Healthcare Professional Office
Explains relationship between the HCP offices and Doptelet Connect and steps each may take during the access and reimbursement process.
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Doptelet Connect Overview
Summary of the different access and reimbursement support options that help patients access Doptelet.
Coverage for Doptelet is better than ever
Doptelet is available for 97% of commercial and 75%
of Medicare-insured patients nationwide
See Formulary Status in Your Area
Formulary coverage of Doptelet on selected plans in:
Do you have questions on getting access to therapy for your patients related to COVERAGE, PRIOR AUTHORIZATION, or STEP EDITS?
Consult with your dedicated field reimbursement senior manager at Doptelet.escalation@sobi.com.
Please include the following information with each email inquiry:
1) Practice Name 2) Contact Name 3) Direct Phone Number 4) State and ZIP Code 5) Issue Needing Assistance
For Pharmacies and Distributors
Doptelet prescriptions are filled only through specialty pharmacies in the Doptelet network or by dispensing physician practices. Specialty pharmacies typically mail the patient prescriptions directly to the patient. There are also physician practices that elect to dispense Doptelet through their in-office dispensing pharmacies.
*In order to participate in the Doptelet Copay Assistance Program (“Program”), a patient must be aged ≥18 years and have commercial prescription insurance for Doptelet. This Program is not valid for patients whose prescription claims are reimbursed, in whole or in part, by any state or federal government program, including (but not limited to) Medicaid, Medicare, Medigap, Department of Defense (DoD), Veterans Affairs (VA), TRICARE, Puerto Rico Government Insurance, or any state patient or pharmaceutical assistance program. This offer is not valid for patients paying with cash. The Program is void where prohibited by law. Certain rules and restrictions apply. Sobi reserves the right to revoke, rescind, or amend this offer without notice. This Program is not insurance.
†Program subject to eligibility requirements and program terms and conditions.