Sunday, August 10, 2014

Obtaining Auvi-Q Epinephrine Auto-injectors - Problems and Solutions

THIS POST IS NOW OUTDATED. 
The Auvi-Q has returned in ownership to its original inventors and their company, kaléo. An updated post will be published.

Top: Auvi-Q 0.15mg - Box and Contents
2 Active Devices, 1 Trainer Device and accompanying printed materials
(Updated to add:) Bottom: Auvi-Q Vouchers

Here's a summary of the recent problems that parents and caregivers have been having, 
when trying to obtain their Auvi-Q EAIs, along with possible solutions:
(This information pertains to patients in the U.S.A. and is presented to the best of my knowledge. 
Offers and conditions can change at any time, so please check directly with the pertinent company if you have any specific questions.)

Problem: I am having trouble getting my Auvi-Q prescription covered by my insurance company.

Solution(s): Patients can have their doctors submit a Statement of Medical Necessity to request "Prior Authorization" for the Auvi-Q. For Express-Scripts, your doctor can visit this website to submit the request by phone, or online. The following is an except from that form, showing some of the reasons that may qualify someone for an exemption:

If you have another prescription provider, you should still be able to use this form. Sanofi's Patient Connection site has other forms that might also be useful for appeals, etc.

Want some even better news? As of 1/1/2015, the Auvi-Q will return to the Express-Scripts Formulary, as a "Tier 2" medication, meaning it should be covered by most insurance plans! They were finally able to overcome the exclusivity contract brokered by another epinephrine manufacturer, and now freedom of choice has been restored to families in search of epinephrine! This change has already taken place with Caremark, as of 7/1/2014. (Updated to add: As of 1/1/2015, the Auvi-Q will also return to Tier 2 status for those covered by Aetna Value and Aetna Premium insurance plans!) If you use another prescription provider, contact them to let them know that you want the freedom to choose the life-saving device that you feel best suits your family's needs.

The $100 Co-pay Card offer will also still be in effect for the foreseeable future, but you can always get the latest information at www.auvi-q.com/savings. It offers $100 off the insurance co-pay, or $100 off the retail price for those paying out-of-pocket. (Yes, it's still going on for 2015!)



Problem: I was able to obtain a prescription for my Auvi-Q, but the set(s) I received from the pharmacy expire(s) in less than 12 months!

Solution: Fear not! Sanofi, makers of Auvi-Q, are offering a generous resolution to this issue.
Oh Mah Deehness posted this tidy summary of the information that Connie Green and a few of us received from Sanofi on the issue: "Patients or caregivers who, within the last 31 days, purchased an Auvi-Q that expires in less than 12 months are eligible to receive a savings card with a maximum benefit of $400 off one two-pack of Auvi-Q for each Auvi-Q purchase that meets the terms and conditions. Savings cards are valid for use January 1 – June 30, 2015.  Patients or caregivers who purchased an Auvi-Q in the past 31 days with 6 months or less of dating may receive a replacement Auvi-Q or they can opt to receive a savings card.  For more information, including terms and conditions, patients or caregivers should call Sanofi Customer Service at 1-800-633-1610." (If that number doesn't work, you can also try 1-800-207-8049, Option #5 and then Option #1. Thanks for the tip, Julie Brown!) Note: "In the past 31 days" means that you need to submit your request within 31 days of your invoice date, not within 31 days of the blog post.

I called the number when my EAIs arrived with an expiration date of April 2014. I was asked to provide visual proof of the quantity purchased, expiration date, lot number and the invoice date. To do so, I took a photo of the bottoms of my Auvi-Q boxes and a snapshot of my invoice from Express-Scripts. I was given an "Inquiry Number" which was required for submission. They offered me the choice of submitting the information via email or fax. It was a 6-minute phone call, according to my phone, and it took me another few minutes to send the email, so I'd call it a 10-minute process, tops. This is a pretty amazing deal, considering that my devices are good for 9 months and when I request my sets using their vouchers in June 2015, they could be good for another 6-12 months, providing me with 15-21 months of epinephrine coverage for that single co-pay! (Updated to add: I received by $400 vouchers in the mail! It took 20 days for them to arrive, which is no problem, at all, given that they are not valid for use for another 4 months.)


Problem: I use Express-Scripts mail order and they will not accept my Auvi-Q $0 co-pay card!

Solution: Express-Scripts states that they have no way to accept co-pay cards for auto-injectors purchased via mail order. To get the co-pay back, you must submit a request to Sanofi for reimbursement.

(You can confirm these instructions by calling 1-855-226-3941.)

You will need to provide:

  • The 11-digit ID# and GRP# that is found on the Auvi-Q card or a photocopy of the card.
  • A proof of purchase (original pharmacy receipt with pharmacy name, product name, prescription number or Rx#, date filled, quantity, and the price.)
  • Patient name, mailing address, city, state, zip, phone number, DOB, and the out of pocket payment.
    • For minors, provide the return mailing address as "[Child Name] c/o [Parent Name]"
Mail the above information to:
Auvi-Q Claims Processing Dept.
P.O. Box 7017
Bedminster, NJ 07921-9918


Note: The process remains the same for 2015. Submissions for 2015 must be postmarked no later than 12/31/2015. 


Problem: I am unable to afford my (or my child(ren)'s) Auvi-Qs.

Solution: Epinephrine is a potentially life-saving medication and no family at risk for anaphylaxis should have to forego it, during times of financial hardship. The Sanofi Patient Connection site has information and a form for the Patient Assistance Program. Some may be surprised to learn that they qualify for assistance under this program. The form includes a complete list of requirements, but, for example, the income requirement for a family of four is that it be under $59,625. (This is 250% of the U.S. poverty level at the time of this writing.) It's worth looking into, if financial strain is an issue.



Those at risk for anaphylaxis, and those who care for them, must have epinephrine on hand, at all times and they should have at least 2 doses. Please do not let anything or anyone stand in your way of getting what you need to protect yourself or your loved ones.

Disclaimer: I am not a doctor, nor a medical professional. Always consult with a doctor before making any healthcare decisions. This is not a paid post. A year ago, I attended a summit at the Auvi-Q headquarters, along with other bloggers, as invited guests with expenses paid, to see the Auvi-Q before its launch. We were never, and are not currently, under any obligation to write about or promote the Auvi-Q.

10 comments:

  1. Thanks for the helpful summary. I haven't filled my script yet and was a bit stressed about it.

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    1. I can relate to that! I hope this will ease the process, some!

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  2. Great write-up, Selena - thank you for the clarification!

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    1. Thank you and you are very welcome! :)

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  3. We have Caremark but ours is still $390 :-( Luckily we can use the $100 coupon.

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    1. Do you have a prescription plan with a high deductible? The Sanofi rep I spoke to did mention that for some with high deductibles, prescriptions are paid at full price until the deductible is met. :/ I'm glad the coupon helps offset that, some, but I know it's not ideal, sorry!

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  4. Any suggestions what to do if your Allergist refuses to submit this prior authorization form because he says that they all get denied anyway.

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    1. Wow, my gut reaction is to get a new allergist! However, I know that's not always an option. Does your allergist's office have another staff member that handles the actual processing of those requests? If you can fill out the form for them, they might be inclined to simply press "Send" on their fax machines. I would tell them that it's worth a try, unless they have a spare $400 in their pocket that they'd like to give you. ;) Also, it is not true that "they all get denied", because many have already been approved.

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  5. Where did you find the income guidelines for the Patient Assistance Program? We are a family of 7. Thank you!

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    1. Oh, sorry, I guess I didn't mention that! I got it from this website: http://aspe.hhs.gov/poverty/14poverty.cfm

      The Sanofi form mentions "<= 250%" for non-oncology drugs, so I did the calculation for a family of 4. A family of 7 looks to be <= $90,075.

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