ASSIST for TYVASO (treprostinil)

The Referral Process

When you prescribe a United Therapeutics treatment, please explain the following referral process to your patient.

  • Tyvaso and Remodulin (treprostinil) are only available through select Specialty Pharmacy (SP) providers
  • The chosen Specialty Pharmacy will contact your patient to collect any incomplete information, review their insurance coverage with estimated co-pays, and schedule their prescription shipment along with any applicable nursing support

Complete and submit the Tyvaso referral form

Send the completed referral form and a copy of each of the patient’s insurance cards to one of the Specialty Pharmacies below or your local Veteran Affairs Pharmacy.

Tyvaso Specialty Pharmacy Network:

Phone 1-866-344-4874

Website accredo.com

Referral Process

Refer to the following steps to better understand the process after you prescribe Tyvaso.

Referral is sent to SP

SP collects missing information, performs benefit investigation

SP calls qualifying patient with benefit summary, reviews financial assistance, refers to Hub if needed

Hub reviews financial assistance needs, notifies SP of outcome

SP calls patient, confirms coverage and assistance with patient and insurance, and schedules shipment and nursing services

Let your patient know that after your office submits the referral form, an ASSIST Associate will call them to verify insurance coverage or to obtain additional information.

It is very important that the patient answers or returns this call, or the approval process could be delayed. You may want to let your patient know that the call will come from Melbourne, Florida, showing an area code of 321.

Questions?

If you have any questions about completing the referral form, contact ASSIST at 1-877-UNITHER (1-877-864-8437), Monday - Friday, 8:30 am to 7:00 pm ET.

INDICATION

Tyvaso (treprostinil) is a prostacyclin vasodilator indicated for the treatment of pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability. Studies establishing effectiveness included predominately patients with NYHA Functional Class III symptoms and etiologies of idiopathic or heritable PAH (56%) or PAH associated with connective tissue diseases (33%).

The effects diminish over the minimum recommended dosing interval of 4 hours; treatment timing can be adjusted for planned activities.

While there are long-term data on use of treprostinil by other routes of administration, nearly all controlled clinical experience with inhaled treprostinil has been on a background of bosentan (an endothelin receptor antagonist) or sildenafil (a phosphodiesterase type 5 inhibitor). The controlled clinical experience was limited to 12 weeks in duration.

IMPORTANT SAFETY INFORMATION

WARNINGS AND PRECAUTIONS
  • The efficacy of Tyvaso has not been established in patients with significant underlying lung disease (such as asthma or chronic obstructive pulmonary disease). Patients with acute pulmonary infections should be carefully monitored to detect any worsening of lung disease and loss of drug effect
  • Tyvaso is a pulmonary and systemic vasodilator. In patients with low systemic arterial pressure, Tyvaso may cause symptomatic hypotension
  • Titrate slowly in patients with hepatic or renal insufficiency, as exposure to treprostinil may be increased in these patients
  • Tyvaso inhibits platelet aggregation and increases the risk of bleeding
  • Co-administration of the cytochrome P450 (CYP) 2C8 enzyme inhibitor gemfibrozil may increase exposure to treprostinil. Co-administration of the CYP2C8 enzyme inducer rifampin may decrease exposure to treprostinil. Increased exposure is likely to increase adverse events, whereas decreased exposure is likely to reduce clinical effectiveness
DRUG INTERACTIONS / SPECIFIC POPULATIONS
  • The concomitant use of Tyvaso with diuretics, antihypertensives, or other vasodilators may increase the risk of symptomatic hypotension
  • Co-administration of the CYP2C8 enzyme inhibitor gemfibrozil increases exposure to oral treprostinil. Co-administration of the CYP2C8 enzyme inducer rifampin decreases exposure to oral treprostinil. It is unclear if the safety and efficacy of treprostinil by the inhalation route are altered by inhibitors or inducers of CYP2C8
  • Limited case reports of treprostinil use in pregnant women are insufficient to inform a drug-associated risk of adverse developmental outcomes. However, pulmonary arterial hypertension is associated with an increased risk of maternal and fetal mortality. There are no data on the presence of treprostinil in human milk, the effects on the breastfed infant, or the effects on milk production
  • Safety and effectiveness in pediatric patients have not been established
ADVERSE REACTIONS
  • The most common adverse reactions seen with Tyvaso in ≥4% of PAH patients and more than 3% greater than placebo in the placebo-controlled clinical study were cough (54% vs 29%), headache (41% vs 23%), throat irritation/ pharyngolaryngeal pain (25% vs 14%), nausea (19% vs 11%), flushing (15% vs <1%), and syncope (6% vs <1%). In addition, adverse reactions occurring in ≥10% of patients were dizziness and diarrhea

For additional information please see Full Prescribing Information or call Customer Service at 1-877-UNITHER (1-877-864-8437)