IDHIFA is only available through the list of contracted specialty pharmacies or through authorized distributors for in-office dispensing by community physicians, hospitals, institutions, Veterans Affairs, and Department of Defense.
SPECIALTY PHARMACIES AND AUTHORIZED DISTRIBUTORS
|National Drug Codes (NDCs)|
|10-digit NDC||11-digit NDCa||Dosage strength||Description|
|59572-705-30||59572-0705-30||50 mg/tablet||Bottle of 30 pale yellow-to-yellow oval-shaped tablets; each film-coated tablet is debossed “ENA” on one side and “50” on the other side.|
|59572-710-30||59572-0710-30||100 mg/tablet||Bottle of 30 pale yellow-to-yellow capsule-shaped tablets; each tablet is debossed “ENA” on one side and “100” on the other side.|
|NDC for IDHIFA|
|Dosage strength||50 mg/tablet||100 mg/tablet|
|Description||Bottle of 30 pale yellow-to-yellow oval-shaped tablets; each film-coated tablet is debossed “ENA” on one side and “50” on the other side.||Bottle of 30 pale yellow-to-yellow capsule-shaped tablets; each tablet is debossed “ENA” on one side and “100” on the other side.|
aThe red zero converts the 10-digit NDC to the 11-digit NDC. Some payers may require each NDC to be listed on the claim. Payer requirements regarding the use of NDCs may vary. Electronic data exchange generally requires use of the 11-digit NDC.
Commonly used ICD-10 Codes*
*When selecting diagnosis codes, providers should consult a current ICD-10-CM manual and always select the most appropriate diagnosis code(s) with the highest level of detail to describe a patient’s actual condition.
Celgene Patient Support® provides
Depending on the patient’s insurance situation, there are programs and organizations that may help pay for IDHIFA.
Celgene Commercial Co-pay Program for eligible patients with commercial or private insurance (including healthcare exchanges).
Independent third-party organizations for patients who are unable to afford their medication (including patients with Medicare, Medicaid, or other government-sponsored insurance).‡
Celgene Patient Support® can provide you with information about independent third-party organizations that may be able to help patients with the cost of:
Celgene Patient Support® can provide information about financial assistance for transportation costs to and from medical appointments.
Celgene Patient Assistance (PAP) for qualified patients who are uninsured or underinsured.§
*Other eligibility requirements and restrictions apply. Please see full Terms and Conditions.
†Patients may be subject to a random audit to verify income.
‡Financial and medical eligibility requirements vary by organization.
§Patients must meet specified financial and eligibility requirements to qualify for assistance.
On behalf of the patient, our Specialists are available to assist with each of the following steps in the insurance approval process for IDHIFA*:
Prior authorization assistance†
*Celgene cannot provide insurance advice or make insurance decisions.
†Celgene provides a facilitation service and will not provide any medical input into a prior authorization or an appeal.
There are 3 simple ways to enroll in Celgene Patient Support®. Choose the option that is easiest for you.
You can enroll in Celgene Patient Support®. Click here to get started
Patients can be enrolled over the phone at 1-800-931-8691, Monday–Thursday, 8 am–7 pm ET, and Friday, 8 am–6 pm ET (translation services available)
Download the English or Spanish form here and return it to us by email at firstname.lastname@example.org or fax it to us at 1-800-822-2496
HCP Testing Overview
Hospital Formulary Kit
Patients must meet the following criteria to enroll:
Additional Terms and Conditions of the Celgene Commercial Co-pay Programs
© 2017 Celgene Corporation 06/17 US-CELG170216