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.|
|National Drug Codes (NDCs)|
|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.
There are programs and organizations that may help pay for IDHIFA®, depending on a patient's insurance situation.
Co-pay responsibility for IDHIFA® is reduced to $25 (subject to annual benefit limits) for eligible patients with commercial or private insurance (including healthcare exchanges).*
IDHIFA® may be available at no cost for qualified patients who are uninsured or underinsured.†
Patients who are unable to afford their medication (including patients with Medicare, Medicaid, or other government-sponsored insurance) may be able to receive help from independent third-party organizations.‡
Celgene Patient Support® can provide information about financial assistance for transportation costs to and from medical appointments.
*Other eligibility requirements and restrictions apply. Please see full Terms and Conditions on the Celgene Patient Support® website.
†Patients must meet specified financial and eligibility requirements to qualify for assistance.
‡Financial and medical eligibility requirements vary by organization.
Our Specialists are available to assist with each of the following steps in the insurance approval process for IDHIFA®*:
If you need assistance with the prior authorization or precertification process or are following up on a prior
authorization or precertification, Celgene Patient Support® can help.
If the patient's insurance company denies a prior authorization, precertification, or claim for IDHIFA®, Celgene Patient Support® can:
*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.
We have 2 simple ways for you to enroll in Celgene Patient Support®. Choose the option that is easiest for you.
Visit us online at www.celgenepatientsupport.com
Email us at email@example.com or fax to 1-800-822-2496
Need additional information?
Call us at 1-800-931-8691
Monday–Friday, 8 am – 8 pm ET, (translation services available)
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