TORISEL Patient Assistance Program FAQs
Q. What types of patients qualify for the TORISEL Patient Assistance Program?
A. The TORISEL Reimbursement Support Program offers product for patients who lack adequate coverage for TORISEL and meet program guidelines.
Q. What are the financial guidelines for the TORISEL Patient Assistance Program?
A. The TORISEL Patient Assistance Program offers assistance for those patients who lack adequate coverage for TORISEL. Each patient is evaluated on a case-by-case basis. The guidelines for inclusion in the program are based on the patient’s annual household income and household size.
Q. How do I enroll in the TORISEL Patient Assistance Program?
A.
- To determine if a patient qualifies for assistance, a provider will need to submit several forms to the TORISEL Reimbursement Support Program.
- Each patient will need to complete a Patient Enrollment Form. (Adobe PDF) After all forms are received, a dedicated Regional Reimbursement Consultant (RRC) will review the patient’s eligibility and can usually provide a response within 2 business days of receiving the completed enrollment form.
- Eligible patients receive assistance in the form of free product, which is distributed on a monthly basis to the treating provider.
Q. Is the TORISEL Patient Assistance Program application available on-line?
A. Yes, the form a patient needs to complete for the TORISEL Patient Assistance Program is available here.
Q. How does the shipping/refill process work for patients who are approved for assistance through the TORISEL Patient Assistance Program?
A. A total of 4 vials (4-week supply) will be sent for use for the patient enrolled in the program. The program staff will contact the treating provider’s office 3 weeks after each shipment to confirm the need for more product.
Q. How do I enroll in an additional patient assistance program?
A: See Finding Financial Support for a list of resources that can help you.
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Important Safety Information
- Before you begin treatment with TORISEL, your doctor may give you an antihistamine. It is possible to have a serious allergic reaction even after you receive an antihistamine. Tell your doctor or nurse if you are allergic to antihistamines or are unable to take antihistamines for any other medical reasons. Tell your doctor or nurse if you have any swelling around your face or difficulty breathing during or after treatment.
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TORISEL can cause serious side effects. The most common side effects are
- Rash
- Weakness/fatigue
- Mouth sores
- Nausea
- Swelling/fluid retention
- Loss of appetite
- Patients are likely to experience increased blood sugar levels. This may require treatment with or an increase in the dose of a medicine that lowers blood sugar levels. Tell your doctor or nurse if you are thirstier than usual or urinate more often than usual.
- Patients are likely to experience an increase in cholesterol and/or triglycerides. This may require treatment with or an increase in the dose of a medicine that lowers cholesterol and/or triglycerides.
- If you experience side effects that are too severe to tolerate, your health care professional may choose to delay your treatment, give you a lower dose of TORISEL, or discontinue treatment.
- Before you begin treatment with TORISEL, tell your doctor or nurse about ALL MEDICINES you are taking, including
- Prescription medications, including but not limited to antibiotics, anticonvulsants, antidepressants, antifungals, antivirals, blood pressure medications, blood thinners, dexamethasone, vaccines
- Nonprescription (over the counter) medications
- Vitamins
- Herbal supplements, including but not limited to St. John’s Wort
- Avoid eating grapefruit or drinking grapefruit juice during the course of your treatment with TORISEL, including the time between treatments.
Please see Important Safety Information continued on the next page.
- Treatment with TORISEL may affect your immune system. You may be at greater risk of getting an infection while receiving TORISEL.
Please see Important Safety Information continued on the next page.
Please see accompanying full Prescribing Information.
- Patients may get chronic inflammation of the lungs during treatment with TORISEL. Rare fatal cases have been reported. Tell your doctor or nurse right away if you have any trouble breathing, get a cough, or develop a fever.
- TORISEL may cause bowel perforation. Rare fatal cases have been reported. Tell your doctor or nurse right away if you have any new or worsening stomach pain or blood in your stool.
- Treatment with TORISEL may be associated with a risk of kidney failure, sometimes fatal.
- During treatment with TORISEL, wounds may not heal properly. Tell your doctor or nurse if you are recovering or still have an unhealed wound from surgery. Tell your doctor or nurse if you plan to have surgery during treatment with TORISEL.
- TORISEL may increase the risk of bleeding in the brain, which has, in rare cases, been fatal. You are at increased risk if
- You have a central nervous system tumor, such as a brain tumor
- You are taking medicine to keep your blood from clotting
- Some vaccines may be less effective when given during the course of treatment with TORISEL. You should avoid the use of live vaccines and close contact with people who have recently received live vaccines. Ask your doctor or nurse if you are eligible to receive a flu shot.
- Both men and women should use a reliable form of birth control during treatment and for 3 months after the last dose of TORISEL. TORISEL can harm an unborn baby. Tell your doctor or nurse before beginning treatment if you are pregnant or thinking of becoming pregnant.
Please see the full Prescribing Information for TORISEL.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.