NINLARO 1Point overview

NINLARO 1Point is designed to assist patients with coverage, access, and staying on therapy

NINLARO 1Point is a comprehensive support program that offers an array of access and coverage services for patients taking NINLARO® (ixazomib) and their healthcare providers.

Our dedicated case management team can deliver personalized services that help your patients taking NINLARO and providers navigate coverage requirements for NINLARO, streamline product access, and connect to helpful resources.

Services include:

  • Benefit verification and prior authorization assistance
  • Assistance with appealing a payer denial*
  • NINLARO Co-Pay Assistance Program enrollment for eligible, commercially insured patients
  • Specialty pharmacy referral and coordination
  • Referral to alternative funding sources and third-party foundations
  • Connection to support services, including referrals for transportation services, legal support, and national and local organizations for counseling
  • NINLARO RapidStart Program for patients with insurance-related coverage determination delays
  • Patient Assistance Program
  • *NINLARO 1Point does not file claims or appeal claims for callers. It cannot guarantee success in overturning payer denials.
Contact Ninlaro 1point

CONTACT NINLARO 1POINT

PHONE: 1-844-N1POINT
(1-844-617-6468)
MON-FRI, 8 AM-8 PM ET




Coverage

UTILIZING OUR COVERAGE SERVICES

Your dedicated NINLARO 1Point case manager will assist with the benefit verification process by:

  • Researching current, payer-specific coverage guidelines for NINLARO® (ixazomib) on behalf of your patient
  • Using information provided during the enrollment process to identify payer policies requiring verification
  • Notifying your office of verification outcome/status within 2 business days
  • Providing your office with a summary of benefits outlining patient's cost share, exclusions, prior authorization requirements, and other details
  • Referring your prescription to your preferred specialty pharmacy or determining specialty pharmacies in your patient's payer network

Prior authorization assistance with NINLARO 1Point by:

  • Supplying your office with a summary of payer's prior authorization process and submission requirements
  • Communicating prior authorization results to your office/patient
  • Recording prior authorization expiration date and sending a renewal reminder to your office and patient 30 days prior
  • Referring prescription to specialty pharmacy in the payer's network
  • Contacting specialty pharmacy to monitor and record prior authorization status
Contact Ninlaro 1point

CONTACT NINLARO 1POINT

PHONE: 1-844-N1POINT
(1-844-617-6468)
MON-FRI, 8 AM-8 PM ET




NINLARO 1Point enrollment

ENROLLING YOUR PATIENTS IS SIMPLE

Complete the Enrollment Form

  • You and your patient will complete the NINLARO 1Point Enrollment Form. Please ensure your patient also provides a copy of their insurance card, if they have one. Your office will then submit the patient's insurance information along with a copy of the insurance card and prescription to NINLARO 1Point
Contact Ninlaro 1point

CONTACT NINLARO 1POINT

PHONE: 1-844-N1POINT
(1-844-617-6468)
MON-FRI, 8 AM-8 PM ET




NINLARO 1Point assistance

ASSISTANCE PROGRAMS FOR PATIENTS

NINLARO 1Point offers your eligible patients a range of financial assistance programs.

PATIENT SITUATION
SUPPORT OFFERING

Needs co-pay assistance

NINLARO Co-Pay Assistance Program

The NINLARO Co-Pay Assistance Program is intended for eligible patients who are commercially insured, but may have trouble affording their out-of-pocket costs for NINLARO® (ixazomib).

Whom and what the program covers

  • For commercially insured patients only
  • Patients could pay as little as $25 per monthly prescription. Maximum $25,000 annually
  • No income limit

For more information on the NINLARO Co-Pay Assistance Program, please contact your NINLARO 1Point case manager. See eligibility requirements.*†

*Eligibility requirements: This offer cannot be used if you are a beneficiary of, or any part of your prescription is covered by: (1) any federal or state healthcare program (Medicare, Medicaid, TRICARE, etc), including a state pharmaceutical assistance program, (2) the Medicare Prescription Drug Program (Part D), or if you are currently in the coverage gap, or (3) insurance that is paying the entire cost of the prescription. Patients must be at least 18 years old.

Terms & Conditions: Patient must meet Eligibility Requirements. This savings program covers out-of-pocket expenses greater than $25 per monthly prescription. Maximum value $25,000 annually. Co-pay card can be renewed every 12 months. This offer is not valid with any other program, discount, or incentive involving NINLARO. This offer may be rescinded, revoked, or amended without notice. No reproductions. This offer is void where prohibited by law, taxed, or restricted.

Medicare Part D patients

NINLARO 1Point helps identify third-party nonprofit foundations that can grant financial assistance to patients with their out-of-pocket treatment-related expenses (eg, co-pays, coinsurance, and deductibles).

Has an insurance delay

NINLARO RapidStart Program

The RapidStart Program can provide a free 28-day (1-cycle) supply of NINLARO® (ixazomib) to patients who may experience a delay in insurance coverage determination of at least 7 business days. Terms and conditions apply.*†

*The RapidStart Program provides a 28-day (1-cycle) supply of treatment of NINLARO at no charge for eligible patients new to NINLARO experiencing a delay in insurance coverage determination of at least 7 business days. There is no purchase obligation by virtue of a patient's participation in the RapidStart Program. Patients must have an on-label prescription for NINLARO consistent with the FDA-approved label for NINLARO and be enrolled in the NINLARO 1Point Program to qualify. Free product for the RapidStart Program will only be available through the RapidStart Program non-commercial specialty pharmacy. A delay in coverage determination of at least 7 business days is required for patients to be eligible for the RapidStart Program. The program may not be combined with any other offer and is not available to patients whose insurers have made a final determination to deny the patient coverage for NINLARO. Takeda reserves the right to change or end the program at any time. Benefits provided under the program are not transferable.

Eligibility is determined by monitoring of prescription status and coordination with in-office dispensing providers.

How to enroll a new NINLARO patient in the RapidStart Program

  • In order to receive the RapidStart Program supply, your practice must submit a completed NINLARO 1Point Enrollment Form and an on-label prescription for NINLARO to NINLARO 1Point on behalf of your eligible patients
  • Eligibility criteria require that the:
    • Patient has a clinically appropriate diagnosis for NINLARO as per the FDA-approved label
    • Patient must be new to NINLARO therapy
    • Patient must have experienced a delay in insurance coverage determination of at least 7 business days
  • Patients who have Medicare Part D or commercial insurance coverage may be eligible

How the RapidStart Program manages coverage determination delays

  • NINLARO 1Point must have received a completed enrollment form signed by the physician and patient
  • The RapidStart Program will confirm with the office and the payer that all required information has been submitted to the payer
  • If after 7 business days the RapidStart Program confirms that the payer has not made a coverage determination, the RapidStart Program supply will be sent to the patient

No insurance or underinsured

Patient Assistance Program

The Patient Assistance Program provides assistance to patients who either do not have insurance or are functionally underinsured. The program offers free monthly supplies of NINLARO® (ixazomib) to patients who meet certain eligibility requirements.

How to apply

In order to apply, your patient must:

Complete the Patient Assistance Program Application. It is important to note that you and your patient must sign this application.
Have a valid prescription for NINLARO.
Have 1 of the documents listed in the Patient Assistance Program Application that is required for household income verification.

If your patient is approved for this program, both of you will be notified, and a 1-month supply of NINLARO will be mailed to your patient. Each month, you will need to confirm that your patient still needs NINLARO.

Qualifying patients may be enrolled for up to 1 year.

Download patient assitance program application

Needs additional resources

Resources and Foundation Support

Additional resources for patients

Our NINLARO 1Point case managers can help your patients find the information and day-to-day or long-term support they need, including:

  • Access to resources about living with cancer: support and information, local and national advocacy groups
  • Referral to travel assistance (eg, to appointments)
  • Information about organizations providing legal services
  • Referral to counseling and support programs
  • Referral to emotional support resources
Contact Ninlaro 1point

CONTACT NINLARO 1POINT

PHONE: 1-844-N1POINT
(1-844-617-6468)
MON-FRI, 8 AM-8 PM ET




NINLARO 1Point distribution network

NINLARO® (ixazomib) IS AVAILABLE THROUGH BOTH SPECIALTY PHARMACIES AND PRACTICES THAT DISPENSE

Specialty pharmacies

  • Payer's or provider's preferred specialty pharmacy
  • Any specialty pharmacy within the NINLARO network

In-office dispensing

  • To arrange in-office dispensing, please contact your distributor/wholesaler or NINLARO 1Point directly
    Phone: 1-844-N1POINT (1-844-617-6468); select option 5; Mon-Fri, 8 am-8 pm ET
Download a list of specialty PHARMACIES within the NINLARO network
Contact Ninlaro 1point

CONTACT NINLARO 1POINT

PHONE: 1-844-N1POINT
(1-844-617-6468)
MON-FRI, 8 AM-8 PM ET




NINLARO 1Point
additional resources

ADDITIONAL RESOURCES FOR Patients

Our NINLARO 1Point case managers can help your patients find the information and day-to-day or long-term support they need, including:

  • Access to resources about living with cancer: support and information, local and national advocacy groups
  • Referral to travel assistance (eg, to appointments)
  • Information about organizations providing legal services
  • Referral to counseling and support programs
  • Referral to emotional support resources

Additional tools for the office

For your convenience, NINLARO 1Point provides sample templates of certain forms your practice may need to submit to payers to request access and coverage for NINLARO® (ixazomib). These forms can be easily downloaded and customized.

Letter of appeal

In the event that a payer denies a claim for NINLARO® (ixazomib), you can appeal the decision. It is important to follow the payer's appeal guidelines and time frames. The following sample letter is intended as a general guide for requesting reconsideration for denied claims.

NINLARO 1Point does not file claims or appeal claims for callers. It cannot guarantee success in overturning payer denials.

Download sample letter of appeal

Letter of medical necessity

Some payers may require the healthcare provider to submit a letter or statement of medical necessity for NINLARO. The following sample letter is intended as a general guide for submitting information to payers to substantiate medical necessity. Be sure to use this letter with your letterhead.

Draft your letter based on the template below by replacing all bracketed information with the appropriate office and patient information. Make sure you photocopy and include the back of the Statement of Medical Necessity form with your letter, along with the NINLARO package insert, and any other supporting documentation.

Download sample letter of medical necessity

Formulary exception requests

You may need to submit an exception request to a health plan requesting a drug that is not yet on formulary. Examples of formulary exception requests include:

  • Formulary exception request—for accessing coverage of a drug, such as NINLARO, that is not on formulary
  • Utilization management exception request—to have a plan restriction (eg, quantity limit, step therapy, or prior authorization) waived to access a drug
  • Tiering exception request—for obtaining a drug, if nonpreferred on formulary, at the lower cost-sharing terms as per preferred tier drugs

TO LEARN MORE OR VIEW AN EXAMPLE OF A LETTER OF MEDICARE PART D EXCEPTION, VISIT THE CENTERS FOR MEDICARE & MEDICAID SERVICES WEBSITE.

Contact Ninlaro 1point

CONTACT NINLARO 1POINT

PHONE: 1-844-N1POINT
(1-844-617-6468)
MON-FRI, 8 AM-8 PM ET