Triptodur Care Program
Obstacles may arise when starting a treatment; rest assured Triptodur cares.
3 Ways to Prescribe Triptodur with Confidence
Triptodur can be filled through network specialty pharmacy in 1 of 3 ways:
-
eRx
Submit a prescription for
Triptodur via eRx and select:PANTHERx Rare Pharmacy
24 Summit Park Drive
Pittsburgh, PA 15275
NPI: 1316213531 -
Phone
Contact Triptodur Care
Program to submit a
prescription over the phone.Call (833) 401-CARE (2273)
Monday to Friday,
8:00 a.m. – 8:00 p.m. ET -
Fax
Download the Patient
Enrollment Form
( English | Español ) and
fax to (855) 246-3986
Triptodur can also be purchased direct via Specialty Distributors. For more information, or claims support, call the
(833) 401-CARE (2273), 8:00 a.m. – 8:00 p.m. ET, Monday to Friday.
Comprehensive support through the Triptodur Care Program includes:
-
Benefits investigation
- The Triptodur Care Program will fax your office a confirmation that we’ve received your patient’s Triptodur prescription within 2 hours of receipt if received between 8:00 a.m. - 5:00 p.m. ET.
- The Triptodur Care Program will complete a full Benefits Investigation.
- The Triptodur Care Program will review the Benefits Investigation results and contact your office if a prior authorization is needed.
-
Prior authorization and appeal support
- Pharmacy Benefit: If the insurance requires a prior authorization (PA) or appeal, the Triptodur Care Program will assist with documentation and processing. The Triptodur Care Program will let you know if more information is needed from your practice.
- Pharmacy Benefit: If the prescription is denied through pharmacy benefits and/or needs to be processed through the medical benefit, the Triptodur Care Program will assist with medical benefits documentation and processing as well.
- Please keep the Triptodur Care Program informed of any direct communication that comes from the health plan, including approvals or denials.
-
Copay Assistance Program for eligible patients*
- Your patients can save up to $10,000 off their out-of-pocket cost each calendar year (after they pay the first $5 for each fill).
- *Please review full Terms and Conditions below.
-
Dedicated care team for streamlined support to both parents and healthcare providers
- The Triptodur Care Program will reach out to your practice and the parent to schedule shipment of the medication around the injection appointment. Triptodur must be administered by a healthcare provider.
-
Support team available from 8:00 a.m. – 8:00 p.m. ET, Monday to Friday, at (883) 401-CARE-(2273)
Download these resources to get started:
Patient Enrollment Form:
Other Resources:
Eligible Patients May Pay as Little as $5*
Your patients can save up to $10,000 off their out-of-pocket cost each calendar year (after they pay the first $5 for each fill).
- Eligible patients can receive up to $10,000 off the out-of-pocket cost on the 1st fill and the remaining balance off the 2nd fill.
- If Triptodur is acquired by a clinic or hospital pharmacy through one of the specialty distributors, eligible patients or healthcare providers can receive copay reimbursement by completing a form. Please call the Triptodur Care Program for assistance.
Eligible Patients May Pay as Little as $5*
Patient Savings
Pharmacy and
Medical Benefit:
Payer ID / BIN: XXXXXX
GROUP: XXXXXXXXX
ID: XXXXXXXXXXXX
Eligible patients
may pay
as little as$5*
Terms and Conditions
By using Triptodur Copay Assistance, you certify that you currently meet the eligibility criteria and will comply with the Terms and Conditions described below:
- Copay Assistance is not valid for prescriptions that are eligible to be reimbursed, in whole or in part, by Medicaid, Medicare, or other federal or state healthcare programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico [formerly known as “La Reforma De Salud”]).
- Copay Assistance is not valid for prescriptions that are eligible to be reimbursed by private insurance plans or other health or pharmacy benefit programs that reimburse you for the entire cost of your prescription drugs.
- Insured must be 18 years of age or older; patients must be 2 years of age or older.
- Each patient is limited to one active Copay Assistance Offer at a time during this offering period and the Copay Assistance offer is not transferable.
- Copay Assistance may be used once every 145 days. Maximum savings of $10,000 per year. Up to $10,000 off of your out-of-pocket cost on the 1st fill and the remaining balance off the out-of-pocket cost on the 2nd fill.
- Copay Assistance cannot be combined with any other rebate or coupon, free trial, or similar offer for the specified prescription.
- Copay Assistance will be accepted at participating pharmacies.
- Copay Assistance is not health insurance.
- Patients without insurance or for whom their insurance will not cover the medication are entitled to up to $10,000 off of their out-of-pocket cost on the 1st fill and the remaining balance off the out-of-pocket cost on the 2nd fill.
- This offer is good only in the United States and Puerto Rico as allowed by law.
- Azurity reserves the right to rescind, revoke, or amend the Copay Assistance without notice.
- Offer valid from 01/01/2023 to 12/31/2023. No membership fees apply.
For more information on Triptodur Copay Assistance or the Triptodur Care Program please contact 833-401-CARE (2273) or visit us at www.Triptodur.com/hcp.
Click for IMPORTANT SAFETY INFORMATION FOR TRIPTODUR
IMPORTANT SAFETY INFORMATION FOR TRIPTODUR
INDICATION
TRIPTODUR is indicated for the treatment of pediatric patients 2 years of age and older with central precocious puberty (CPP).
IMPORTANT SAFETY INFORMATION
Contraindications
TRIPTODUR is contraindicated in:
- Individuals with a known hypersensitivity to triptorelin or any other component of the product, or other GnRH agonists or GnRH.
- Women who are or may become pregnant. Expected hormonal changes that occur with TRIPTODUR treatment increase the risk for pregnancy loss and fetal harm when administered to a pregnant woman. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be advised of the potential risk to the fetus.
Warnings and Precautions
Initial Rise of Gonadotropins and Sex Steroid Levels – During the early phase of therapy, gonadotropins and sex steroids rise above baseline because of the initial stimulatory effect of the drug. Therefore, a transient increase in clinical signs and symptoms of puberty, including vaginal bleeding, may be observed during the first weeks of therapy or after subsequent doses.
Psychiatric Events – Psychiatric events have been reported in patients taking GnRH agonists. Postmarketing reports with this class of drugs include symptoms of emotional lability, such as crying, irritability, impatience, anger, and aggression. Monitor for development or worsening of psychiatric symptoms during treatment with TRIPTODUR.
Convulsions – Postmarketing reports of convulsions have been observed in patients receiving GnRH agonists, including triptorelin. These included patients with a history of seizures, epilepsy, cerebrovascular disorders, central nervous system anomalies or tumors, and patients on concomitant medications that have been associated with convulsions such as bupropion and SSRIs. Convulsions have also been reported in patients in the absence of any of the conditions mentioned above.
Pseudotumor Cerebri (idiopathic intracranial hypertension) – has been reported in pediatric patients receiving GnRH agonists, including triptorelin. Monitor patients for signs and symptoms of pseudotumor cerebri, including headache, papilledema, blurred vision, diplopia, loss of vision, pain behind the eye or pain with eye movement, tinnitus, dizziness, and nausea.
Adverse Reactions
In clinical trials for TRIPTODUR, the most common adverse reactions (≥4.5%) are injection site reactions, menstrual (vaginal) bleeding, hot flush, headache, cough, and infections (bronchitis, gastroenteritis, influenza, nasopharyngitis, otitis externa, pharyngitis, sinusitis, and upper respiratory tract infection).
To report SUSPECTED ADVERSE REACTIONS, contact Azurity Pharmaceuticals, Inc. at 1-800-461-7449, or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch
The Important Safety Information does not include all the information needed to use TRIPTODUR safely and effectively. For additional safety information, please consult the full Prescribing Information for PDF Document: TRIPTODUR (File Size: 153 KB).