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This information is intended for healthcare professionals in the United States.
Are you a healthcare professional?
Yes
NoDiscover the Copay Assistance Program
Terms and Conditions
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
Offers a collection of digital resources for HCP office staff to navigate Doptelet access and reimbursement process.
DOWNLOADEnrollment Guide
Information to Help Complete the Prescription and Enrollment Form
Provides information on how to complete the Prescription and Enrollment Form
Accessing Doptelet Documents
Doptelet Prior Authorization Resource Guide
Explains general steps in the PA process to help HCP offices get patients started on Doptelet
Accessing Doptelet: Specialty Pharmacies and Distributors
Lists the contact information for the specialty pharmacies and distributors that are authorized to dispense Doptelet
Provides useful codes to identify appropriate patients and assists with the billing and reimbursement of Doptelet
You’ve Prescribed Doptelet: Now What?
Outlines the process for patients in obtaining a Doptelet prescription with a Specialty Pharmacy
Doptelet Connect offers access and reimbursement support to help patients access Doptelet® (avatrombopag). Doptelet Connect provides information regarding patient healthcare coverage options 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.
Evaluate a patient’s prescription coverage, including benefits investigation, prior authorization, and appeal assistance support.
Provide field reimbursement support through a single point of contact.
Provide financial assistance information.
Identify potential financial assistance options that may be available to help eligible patients with financial needs.
Answer logistical questions and provide education and coordination around the specialty pharmacy fulfillment process.
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.
DOWNLOADDoptelet 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 of $15,000 per calendar year.
Doptelet Patient Assistance Program†
The Patient Assistance Program† provides Doptelet at no cost to patients who meet the eligibility requirements.
View form en español.
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.
Prescription and Enrollment Form
Prescribes Doptelet and enrolls a patient into Doptelet Connect
View form en español
Doptelet Connect Process Flow for Healthcare Professional (HCP) Offices
Explains relationship between the HCP offices and Doptelet Connect and the steps each may take during the access process
Authorization provides patient/caregiver access to the Doptelet Connect Patient Support Program
View form en español
Doptelet Copay Program
In order to participate in the Doptelet Copay Assistance Program (Program), a patient must be ≥18 years or older and have commercial prescription insurance for Doptelet. The Program is not valid for patients whose prescriptions 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 cash-paying patients. 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 requirement and program terms and conditions.
INDICATION
DOPTELET® (avatrombopag) is indicated for the treatment of thrombocytopenia in adult patients with chronic liver disease who are scheduled to undergo a procedure.
IMPORTANT SAFETY INFORMATION
WARNINGS AND PRECAUTIONS
Thrombotic/Thromboembolic Complications. DOPTELET is a thrombopoietin (TPO) receptor agonist and TPO receptor agonists have been associated with thrombotic complications in patients with chronic liver disease (0.4%; (1/274) in DOPTELET-treated patients) and thromboembolic complications in patients with chronic immune thrombocytopenia (7%; (9/128) in DOPTELET-treated patients). Portal vein thrombosis has been reported in patients with chronic liver disease, and thromboembolic events (arterial and venous) have been reported in patients with chronic immune thrombocytopenia treated with TPO receptor agonists.
Consider the potential increased thrombotic risk when administering DOPTELET to patients with known risk factors for thromboembolism, including genetic prothrombotic conditions.
DOPTELET should not be administered to patients with chronic liver disease or chronic immune thrombocytopenia in an attempt to normalize platelet counts. Monitor platelet counts and for signs and symptoms of thromboembolic events and institute treatment promptly.
Serious Adverse Reactions
The most common serious adverse reaction reported in DOPTELET-treated patients compared to placebo was hyponatremia (0.7% v. 0%).
Adverse Reactions
The most common adverse reactions (≥3%) in patients with chronic liver disease were: pyrexia, abdominal pain, nausea, headache, fatigue, and peripheral edema.
Postmarketing Experience
Following the approval of DOPTELET, hypersensitivity reactions involving the immune system, including, but not limited to, pruritus, rash, choking sensation, swollen face, and swollen tongue have been reported.
These are not all the possible risks associated with DOPTELET. Please see Full Prescribing Information for DOPTELET at www.doptelethcp.com
To report suspected adverse reactions, contact Sobi North America at 1-866-773-5274 or FDA at 1-800-FDA-1088.
For WAC pricing, visit doptelethcp.com/wac-pricing.
INDICATION
DOPTELET® (avatrombopag) is indicated for the treatment of thrombocytopenia in adult patients with chronic liver disease who are scheduled to undergo a procedure.
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