Chronic ITP Copay Assistance & Provider Resources

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INDICATION & IMPORTANT SAFETY INFORMATION

INDICATION

DOPTELET^® (avatrombopag) is indicated for the treatment of thrombocytopenia in adult patients with chronic immune thrombocytopenia who have had an insufficient response to a previous treatment.

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 and acquired risk factors.

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

Serious adverse reaction that occurred more frequently in patients treated with DOPTELET (9%; 12/128) compared to placebo (5%; 1/22) was headache, occurring in 1.6% (2/128).

Adverse Reactions

The most common adverse reactions (≥10%) in patients with chronic immune thrombocytopenia were headache, fatigue, contusion, epistaxis, upper respiratory tract infection, arthralgia, gingival bleeding, petechiae, and nasopharyngitis.

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 statutory pricing disclosures, visit doptelethcp.com/wac-pricing.

Discover the Doptelet Copay Program

Eligible commercially insured patients may qualify for the Doptelet Connect program

What's the program?

Eligible patients may pay as little as $0 for each Doptelet prescription
Annual maximum benefit up to $15,000

Eligible patients must:

Have commercial insurance that covers Doptelet
Not be enrolled in any state or federal healthcare program such as Medicare, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DOD), or TRICARE
Be 18 years of age or older
Be a resident in the United States or a US Territory

How to enroll:

Approved pharmacies, healthcare professionals, and Doptelet Connect can enroll patients
Patients can enroll themselves as well as their caregivers
Please call 1-833-368-2663 Monday–Friday 8am–8pm ET for more information

Terms and Conditions

Patients pay as little as $0 per prescription. Copay Program has an annual calendar cap of $15,000
The Copay Saving Program is void where prohibited by law, taxes, or restricted
This offer is non-transferable, no substitutions are permissible, and this offer cannot be combined with any other rebate/coupon, free trial, or similar offer for the specified prescription
Sobi, Inc. reserves the right to rescind, revoke, or amend this offer at any time without notice
The Patient Copay Program for Doptelet is not insurance and is not intended to substitute for insurance
Patients, pharmacists, and healthcare providers must not seek reimbursement from health insurance or any third party for any part of the benefit received by the patient through this Copay Program. Patients must not seek reimbursement from any health savings, flexible spending, or other healthcare reimbursement accounts for the amount of assistance received from the Copay Program
Certain information pertaining to your use of the Copay Program will be shared with Sobi, Inc., the sponsor of the Copay Program. The information disclosed will include the date the prescription is filled, the number of pills or product dispensed by the pharmacists, and the amount of your copay that will be paid for by using this Copay Program. For more information, please see the Sobi Privacy Policy at https://sobi-northamerica.com/privacy-policy
Acceptance in this Program is not conditioned on any past, present, or future purchase, including additional doses
Enrollment for the Copay Program is valid through the calendar year
Sobi reserves the right to change program terms at any time

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