The Fortovia Direct Rx Access Program: Easy for you, affordable for your patients
Important
Remind patients that the specialty pharmacy must contact them via phone prior to shipping their prescription to verify insurance, address, and collect co-pay.
*Terms and Conditions: Certain patients in Federal programs may not qualify. Qualified patients will pay $0 per ZUPLENZ prescription. After a maximum reimbursement allowance, any remaining costs will be the responsibility of the patient. Co-pay assistance is not valid for prescriptions reimbursed, in whole or in part, under Medicaid, Medicare, including Medicare Advantage and Part D prescription drug plans, or any other federal or state program (including state pharmaceutical assistance programs) or where prohibited, taxed, or otherwise restricted. Fortovia Therapeutics Inc. reserves the right to rescind, revoke, or amend this offer without notice. Patients understand and agree to comply with the terms and conditions of this offer as set forth here.
Dosing for ZUPLENZ
CINV, chemotherapy-induced nausea and vomiting; HEC, highly emetogenic chemotherapy; MEC, moderately emetogenic chemotherapy; PONV, postoperative nausea and vomiting;
RINV, radiation-induced nausea and vomiting.
†When dosing more than one film, each ZUPLENZ film should be allowed to dissolve completely before administering the next film.
Reference
You are encouraged to report negative side effects of prescription medical products to the FDA.
Visit www.fda.gov/safety/medwatch, or call Fortovia at 1-855-273-0468 for medical inquiries.
You are encouraged to report negative side effects of prescription medical products to the FDA.
Visit www.fda.gov/safety/medwatch, or call Fortovia at 1-855-273-0468 for medical inquiries.