Resources for Moderate to Severe Plaque PsO | TREMFYA® (guselkumab) HCP
  1. Access & Support
  2. Resources

TREMFYA® RESOURCES

For Your Office to Help Patients

Prescription Information and Enrollment Form

This form is the first step to understanding your patient's insurance coverage and enrolling the patient in other resources.

Sample Letter of Exception

To document the request for a Payer to cover a nonformulary product or when step therapy through other treatments is required.

Sample Letter of Medical Necessity

To document rationale as to why a Payer’s formulary products may not be clinically appropriate for a patient. May also be used when a Payer does not have a known coverage policy in effect.

Sample Letter of Appeal

To document and request a Payer review of a denied coverage determination for TREMFYA®, such as prior authorization or exception request denials.

Business Associate Agreement

Complete this Business Associate Agreement (BAA) one time only to allow you to request verification of patients’ insurance benefits without requiring individual Patient Authorization.

Patient Authorization

If no BAA is on file, you must secure Patient Authorization for each patient. Use this form or complete patient authorization on the Prescription Information and Enrollment Form (PEF). TREMFYA withMe cannot accept any patient without an executed BAA or Patient Authorization on file.

Access & Affordability Resources

Tools & resources that help navigate payer processes and support getting your patients started on TREMFYA®.

For Your Patients

Patient Brochure

A patient-friendly overview of key product information for TREMFYA®.

TREMFYA withMe

TREMFYA withMe can help verify insurance coverage for your patients, provide reimbursement information, find financial assistance options for eligible patients, and provide ongoing support to help patients start and stay on TREMFYA®.

TREMFYA withMe Savings Program

The TREMFYA withMe Savings Program can help eligible patients save on their out-of-pocket medication costs for TREMFYA®. Depending on their health insurance plan, savings may apply toward their co-pay, co-insurance, or deductible.

Patient Affordability Options

Once TREMFYA® has been prescribed, TREMFYA withMe can help find resources for patients to get started on TREMFYA® and stay on track. There may be options that make treatment more affordable.

Digital Patient Resources

Help your patients navigate their treatment journey with the TREMFYA® Welcome Experience.

Full Prescribing Information and IFU in Spanish

For Spanish-speaking patients, this document includes the full Prescribing Information, Medication Guide, and Instructions for Use (IFU).