Celgene Patient Support Specialist

POMALYST®  is only available
through a restricted distribution program.
Please see full Prescribing Information, including
Boxed WARNINGS.

Tools and resources

Celgene Patient Support® offers tools and services for POMALYST® that healthcare professionals, office staff, pharmacists, and patients may find helpful. Choose from the list below to access these tools available to you and your patients.

For additional clinical information on POMALYST, please visit www.POMALYST.com.

Patient financial brochure

The POMALYST patient financial assistance brochure is available to download and may be shared with patients and caregivers. The brochure is available in English and Spanish.

POMALYST®

POMALYST® financial brochure

English | Spanish | Medication guide

Coding and reimbursement

Below is a quick reference to potentially applicable billing codes for POMALYST®

National Drug Code (NDC)

59572-501-21 1 mg bottles of 21
59572-501-00 1 mg bottles of 100
59572-502-21 2 mg bottles of 21
59572-502-00 2 mg bottles of 100
59572-503-21 3 mg bottles of 21
59572-503-00 3 mg bottles of 100
59572-504-21 4 mg bottles of 21
59572-504-00 4 mg bottles of 100

Fast Track for First Prescription®

Fast Track for First Prescription® is available to help eligible patients receive their first prescription faster.

To be eligible, patients must:

  • Have received their first prescription for a Celgene oral oncology product for an FDA-approved indication
  • Have documented proof of insurance
  • Be enrolled in a Celgene REMS program

To enroll patients in the Fast Track program, please provide Celgene Patient Support® with the following:

  • Patient’s insurance information
  • Prescription
  • Patient’s Celgene REMS authorization number

Complete the online application and select the “Fast Track” option. You may also fax a completed application and prescription to 1-800-822-2496 and note “Fast Track” on the fax.

Field Reimbursement Specialist

Your Field Reimbursement Specialist is a field-based extension of Celgene Patient Support® who can provide the following for prescribed Celgene medications:

  • Coding and reimbursement education
  • Assistance with understanding regional and local payer coverage policies
  • Information about financial assistance options for patients

Call your Celgene Patient Support® Specialist to learn more.

Find a network pharmacy

POMALYST is available exclusively through a select network of pharmacies due to restricted distribution programs. Your Celgene Patient Support® Specialist can provide information on which pharmacy is in network with each patient’s insurer.

You can access the REMS Pharmacy Network List online at www.celgene.com/patients/rems-pharmacy-network.

REMS programs

To avoid embryo-fetal exposure, Risk Evaluation and Mitigation Strategy (REMS) programs are mandatory for the Celgene products THALOMID® (thalidomide), REVLIMID® (lenalidomide), and POMALYST® (pomalidomide). The THALOMID REMS® program, REVLIMID REMS® program, and POMALYST REMS® program require prescribers and pharmacists to be certified and patients to enroll and comply with all of the requirements for each program.

To enroll yourself and your patients, to receive more information, or to download forms related to the REMS programs, please visit www.CelgeneRiskManagement.com or call 1-888-423-5436.

Celgene Patient Support® programs

You can connect with your Celgene Patient Support® Specialist in person or through a web conference. Call your Celgene Patient Support® Specialist to set up a meeting.

Insurance forms

Letter of medical necessity
A letter of medical necessity is a letter written by the patient’s treating physician to the patient’s insurance company requesting prior approval for medication or reconsideration of a denial. The letter should generally contain information on the patient’s medical history and current treatment plan. You can download guidelines for writing a letter of medical necessity here.

download-letter-medical-necessity

Appointment of representative release form
The appointment of representative release form is often required by insurance companies in the event of an appeal. This form allows Celgene Patient Support® to assist the patient with the appeals process. You can download the form here.

Appointment of Representative Release Form

Patient resources

There are many independent resources available that can help patients be more informed and involved during their treatment with POMALYST.

Celgene does not endorse any of these organizations or their communications.

These organizations can connect patients with other patients and support groups, and help them find out more information about their diagnosis and treatment options.

American Cancer Society (ACS) | 1-800-ACS-2345 (1-800-227-2345) | www.cancer.org

CancerCare® Get You There | 1-800-813-HOPE (1-800-813-4673) | www.cancercare.org

Cancer Hope Network | 1-877-HOPENET (1-877-467-3638) | www.cancerhopenetwork.org

Cancer Support Community | 1-888-793-9355 | www.cancersupportcommunity.org

International Myeloma Foundation | 1-800-452-2873 | www.myeloma.org

Leukemia & Lymphoma Society | 1-800-955-4572 | www.lls.org

Lymphoma Research Foundation | 1-800-500-9976 | www.lymphoma.org

Multiple Myeloma Research Foundation | 1-203-229-0464 | www.themmrf.org

National Cancer Institute | 1-800-4-CANCER (1-800-422-6237) | www.cancer.gov

Patient Access Network Foundation | 1-866-316-PANF (7263) | www.panfoundation.org

Patient Advocate Foundation | 1-800-532-5274 | www.patientadvocate.org

Other services patients may need include transportation services, having meals delivered to their home, and help with choosing an insurance plan or paying for coverage.

TRANSPORTATION

American Cancer Society (ACS) | 1-800-ACS-2345 (1-800-227-2345) | www.cancer.org

CancerCare® Get You There 1-800-813-HOPE (4673) www.cancercare.org

FOOD DELIVERY

Meals on Wheels Americawww.mealsonwheelsamerica.org

INSURANCE AND DISABILITY

Centers for Medicare & Medicaid Services | www.cms.gov

Disability.gov | www.disability.gov

Health Insurance Marketplace | 1-800-318-2596 | www.healthcare.gov

Patient Advocate Foundation | 1-866-512-3861; Option 1 | www.patientadvocate.org

Caregiver organizations are available to provide support groups, information, advice, and referrals to resources for local and long-distance caregiving.

Cancer Support Community | 1-888-793-9355 | www.cancersupportcommunity.org

Caregiver Action Network | 1-202-454-3970 | www.caregiveraction.org

Family Caregiver Alliance | 1-800-445-8106 | www.caregiver.org

National Alliance for Caregiving | 1-301-718-8444 | www.caregiving.org

Well Spouse® Association | 1-800-838-0879 | www.wellspouse.org