Services and support created with patients in mind

1-877-4-BENLYSTA (1-877-423-6597)
Monday-Friday, 8 AM to 8 PM, ET
Select option 1 for BENLYSTA Gateway
www.benlystagatewayonline.com

BENLYSTA Gateway

  • Benefits Investigation: Better understand insurance coverage for your patients
  • Evaluate your patient for eligibility for Co-pay Program to lower out-of-pocket costs* for BENLYSTA
  • Arrange for access to product through appropriate Specialty Pharmacy or Specialty Distributor

Injection support & training

  • Initial and Refresher Training: Patients can call to receive one-on-one injection training to build their self-injection skills for their initial injections after they have received training from their healthcare provider
  • Ongoing Injection Support: Trained nurses are available by phone anytime to talk through injections
  • Step-by-step instruction video available online

Information & tools

Patients can call to request the following free items:

  • Personalized communications: Patients receive tips, ideas, and info about living with SLE and BENLYSTA
  • Carrying case
  • Sharps disposal container

*The BENLYSTA Co-pay Program is not insurance. Government program enrollees are not eligible for this program. The BENLYSTA Co-pay Program is for private commercially insured patients or uninsured patients who do not qualify for the BENLYSTA Patient Assistance Program. The program covers the patient’s out-of-pocket costs for BENLYSTA up to a total of $11,000 annually, but does not cover co-pays for doctor’s office visits or cost of administration. To be eligible, the patient must be a U.S. resident (including the District of Columbia, Puerto Rico, and the U.S. Virgin Islands).

Nurses from BENLYSTA Cares do not give medical advice and will direct patients to their healthcare provider for any disease-, treatment-, or referral-related questions.

Nurses from BENLYSTA Cares are available by phone Monday-Friday, 8 AM to 8 PM, ET. If calling after hours, patients may leave a message and a nurse will return their call within 30 minutes.

What is BENLYSTA Gateway?

BENLYSTA Gateway is available through BENLYSTA Cares. BENLYSTA Gateway helps patients and healthcare professionals understand authorization*, access, distribution, and reimbursement for BENLYSTA.

1-877-4-BENLYSTA (1-877-423-6597)
Monday-Friday, 8 AM to 8 PM, ET
Select option 1 for BENLYSTA Gateway
www.benlystagatewayonline.com

Additional in-office resources

Ordering Guide

BENLYSTA Gateway Overview

Ordering BENLYSTA

BENLYSTA is available through a variety of options

Ordering BENLYSTA
  1. Specialty Distributor. Clinics can contact one of the approved specialty distributors below.
    • ASD Specialty Healthcare (1-800-746-6273)
    • Besse Medical (1-877-728-3476)
    • Cardinal Health Specialty (1-866-476-1340)
    • CuraScript (1-877-599-7748)
    • McKesson Specialty (1-800-482-6700)
    • McKesson Plasma and Biologics (1-877-625-2566)
    • Metro Medical (1-800-768-2002)
    • Oncology Supply (1-800-633-7555)
  2. Wholesaler. All GSK-authorized wholesalers are eligible to access BENLYSTA provided they service eligible customer classes of trade.
  3. Specialty Pharmacy Provider. Patients may need to use a network of Specialty Pharmacies. Please see Acquisition through Specialty Pharmacies or contact the payer for the full list of Specialty Pharmacies. The BENLYSTA Gateway or Payer Relations Manager (PRM) may also be able to provide assistance.

BENLYSTA Gateway can evaluate what acquisition alternatives exist based on the patient's insurance.

Should the patient be referred to an alternate site of care, contact your PRM to discuss coordination of care considerations.

Acquisition through Specialty Pharmacies

In-network Specialty Pharmacies include

  • Acro Pharmaceutical Services (800) 906-7798
  • AcariaHealth (800) 511-5144
  • Accredo Health Group, Inc. (877) ACCREDO (222-7336)
  • Aetna SP Specialty Pharmacy (866) 782-2779
  • AllianceRx Walgreens-Prime (888) 347-3416
  • Amber Pharmacy (888) 370-1724
  • Avella (877) 546-5779
  • BriovaRx (affiliate of OptumRx) (855) 427-4682
  • Cardinal Health Specialty Pharmacy (888) 662-6779
  • Cigna Specialty Pharmacy (800) 351-3606
  • Commcare Specialty Pharmacy (888) 203-7973
  • CVS Specialty Pharmacy (800) 237-2767
  • Diplomat (877) 977-9118
  • Exactus Pharmacy Solutions (866) 458-9246
  • For Humana Pharmacy, Inc. (800) 486-2668
  • Hy-Vee Pharmacy Solutions (877) RxHyVee (794-9833)
  • Kroger Specialty Pharmacy LA, LLC (888) 355-4191
  • Magellan Rx Pharmacy (866) 554-2673 - Florida; (800) 350-8119 - New York
  • Meijer Specialty Pharmacy/RxBiotech (855) 263-4537
  • Navarro Health Services (855) 647-7979
  • Reliance Rx (Independent Health) (800) 809-4763
  • SenderraRx (888) 777-5547
  • US Bioservices (888) 518-7246

BENLYSTA Gateway can evaluate what acquisition alternatives exist based on the patient’s insurance. If BENLYSTA is acquired through the Specialty Pharmacy, BENLYSTA Gateway can work with the Specialty Pharmacy by

  • Triaging prescription to in-network Specialty Pharmacy in states allowed by law
  • Triaging co-pay information to the Specialty Pharmacy
  • Working with Specialty Pharmacies to uncover status of enrolled patients

In-network Specialty Pharmacy may initiate co-pay application by patient request with BENLYSTA Gateway.

BENEFITS INVESTIGATION AND PRIOR AUTHORIZATION (PA) RESEARCH AND SUPPORT

BENLYSTA Gateway can complete a patient-specific benefits investigation with the patient's payer and provide PA research and support

For benefits investigation, BENLYSTA Gateway can:

  • Work directly with insurance companies to obtain specific coverage information
  • Determine whether payer requires prior authorization
  • Determine estimated patient out-of-pocket responsibility

Once BENLYSTA Gateway completes a benefit verification, you and your patient will receive a Summary of Benefits that will review the patient's coverage.

Please note that investigations do not guarantee a result and it is the provider's responsibility to check with the payer. The patient's payer is the most accurate source of information about the patient's coverage.

For PA research and support, BENLYSTA Gateway can:

  • Research plan requirements
  • Outline steps required for obtaining a PA from the patient’s plan
  • Obtain unique and plan-specific PA forms (where applicable)

BENLYSTA Gateway can also follow up with the plan to help determine the status of the PA submission (if requested).

Remember, BENLYSTA Gateway cannot complete PA forms or submit related information to plans. Instead, it is the responsibility of the office and prescribing physician to provide the plan with patient-specific clinical documentation.

GSK CO-PAY ASSISTANCE EVALUATION

BENLYSTA Gateway can evaluate eligibility for the BENLYSTA Co-pay Program

$0 Co-pay§ for eligible patients (eligibility restrictions and maximum limits apply)

Who may be eligible?

Patients who:

  • Have commercial medical or prescription insurance plan
  • Are not insured
  • Do not qualify for the Patient Assistance Program

Who is not eligible?

Patients who have or are eligible for state- or federal government-funded medical or prescription insurance plan, such as:

  • Medicare, including patients who are 65 or older
  • Medicaid
  • VA
  • Tricare

BENLYSTA Gateway can also help eligible uninsured patients obtain access to BENLYSTA free of charge through GSK’s Patient Assistance Program and arrange for the shipment directly to the site of service.

Learn more about the Co-pay Program

Provider Co-pay Brochure

Patient Co-pay Brochure

*BENLYSTA Gateway CANNOT complete prior authorization forms or submit related information directly to Payers on behalf of physician.

The BENLYSTA Co-pay Program is not insurance. Government program enrollees are not eligible for this program. The BENLYSTA Co-pay Program is for private commercially insured patients or uninsured patients who do not qualify for the BENLYSTA Patient Assistance Program. The program covers the patient’s out-of-pocket costs for BENLYSTA up to a total of $11,000 annually, but does not cover co-pays for doctor’s office visits or cost of administration. To be eligible, the patient must be a U.S. resident (including the District of Columbia, Puerto Rico, and the U.S. Virgin Islands).

§Up to a total of $11,000 annually.

831196R0 February 2018

Chat