For Your Office to Help Patients
Choose TREMFYA®, Get TREMFYA® Brochure
An overview of coverage and support programs to help your patients start and stay on TREMFYA®.
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.
TREMFYA® Prior Authorization Checklist
Reminders and tips when completing prior authorizations for your patients.
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.
TREMFYA withMe Delay and Denial Support
A resource that provides a detailed guide on how to get support in the event of a coverage delay or denial for your commercially insured patients.
To document and request a payer review a denied coverage determination for TREMFYA®, such as prior authorization or exception request denials.
Complete this Business Associate Agreement (BAA) one time only to allow you to request verification of patients’ insurance benefits without requiring individual 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.
TREMFYA withMe Specialty Pharmacy List
Quick reference guide to Specialty Pharmacy partners within the TREMFYA withMe program.
For Your Patients
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 Patient Brochure
A resource to help explain the benefits of TREMFYA withMe to your patients.
TREMFYA withMe Savings Program
Eligible commercially insured patients pay $5 per injection. Maximum program benefit per calendar year shall apply. Terms expire at the end of each calendar year and may change.
Discover options that can help make TREMFYA® more affordable for your patients. Download this resource to help your patients learn about cost support options.