The Auvi-Q has been available again for a week now, but chances are you haven’t taken advantage of it yet. After all, we only need new auto-injectors after the old ones have expired, or after we use them. For us, we won’t be in the market for new auto-injectors until summer (assuming all goes well.)
So since you may not need them yet, you may still be wondering how this whole “$0 Out of Pocket for Nearly Everybody” system is supposed to work. Well, while I had kaléo’s ear, I asked a lot of questions so I can break it down for you.
First off, the Auvi-Q will NOT be available at retail pharmacies for a while. Kaléo has stocked it at a network of specialty pharmacies across the country, and are focusing on their Direct Delivery service in order to ensure best expiration dating, to make sure you get the auto-injector you were prescribed (not swapped with a generic), and also to remove a lot of barriers.
Getting one is simple:
- Go to the Auvi-Q AffordAbility page, download the appropriate pdf, fill it out, and bring it with you to your doctor. Have your doctor write the script and fax it all to the number on the form. (To see which form you need, keep reading.)
- Be on hand to answer the phone when a pharmacy rep calls to confirm your information.
- The clock starts ticking with that phone call. You’ll get your auto-injectors within 24-48 hours (Monday thru Saturday), shipped to you or your doc’s office, as indicated on the form. They are “packaged and shipped in accordance with label requirements,” meaning that they will be protected from temperature extremes.
IF YOU HAVE QUESTIONS, CALL 1-877-30-AUVIQ.
Call from your doctor’s office, call from the pharmacy, call from home. The reps there will talk anyone through finding out what they need to do to get an Auvi-Q.
How does it work?
- If you have insurance but the Auvi-Q isn’t covered, kaléo will cover your entire cost. Yes, that’s right! They’ll still want your insurance information though, to verify you have it and to demonstrate to your insurer that there is demand. Use the “Direct Deliver Service Enrollment form” pdf, and include a copy of your insurance card.**
- If you have insurance and the Auvi-Q is covered, but your insurance wants a copay, kaléo covers your copay. (This is part of why they’re doing it direct ship, so your local pharmacy won’t demand that copay from you, nor will you have to deal with coupons or reimbursements.) Use the “Direct Deliver Service Enrollment form” pdf and include a copy of your insurance card.**
- Even if you have insurance and the Auvi-Q is 100% covered, you will still fill out the “Direct Deliver Service Enrollment form” pdf (and include a copy of your insurance card) and have your Auvi-Q direct shipped.
- If you don’t have insurance and your household income is under $100,000, kaléo will cover your cost. Use the “Enrollment form PAP” pdf (Patient Assistance Program). This is a very easy form, and you will still receive a confirmation phone call. This process should not take any longer than if you have insurance.
- If you don’t have insurance and your household income is above $100,000, you’ll pay the cash price of $360. Still through drop-shipping. You’ll use the “Direct Deliver Service Enrollment form” pdf. They will call to verify that you do not have insurance and wish to pay the cash price. If one of their network pharmacies is in your area, you may be able to arrange to drop in and pay cash or check, but most of the time you will need to pay via credit/debit.
- If you have MediCAID,
it is unfortunately not covered at this time. Medicaid will not cover the brand if a generic is available. Kaléo informed me that they are exploring options to make it available to Medicaid patients.**UPDATE: Yes, you can get Auiv-Qs now if you are on Medicaid! As long as your income is under $100,000 (kind of a given for Medicaid, I think) you can fill out the Patient Assistance form “Enrollment form PAP” pdf and receive Auvi-Qs for free as well.
- If you have MediCARE or TriCare, availability will depend on your plan. Some will cover it, some will only cover generics. Call the number, and if it’s covered, you’ll fill out the “Direct Deliver Service Enrollment form” pdf and have it submitted by your doctor, as above.
**In neither of the above cases will the cost of the Auvi-Q count towards your deductible.**
The one main flaw in this system is that it is not available immediately, so for patients who are filling their first epinephrine prescription or who are replacing used auto-injectors, there would be the 24-48 hour delay in arrival of the meds. If you need something immediately, get what you can. But if Auvi-Q is what you’d like to carry, why not get a set of those, too! You could keep the other brand for backup 🙂
I was neither paid nor asked to write up this information. I have not received any compensation or free product, nor am I a representative of kaléo. I am just excited about the Auvi-Q, and you can read the evolution of my thoughts on it here. Plus I like to understand things, so I asked questions until I felt that I had a complete picture. I hope this helps answer your questions as well!