Get Your Patients Started on ZEPOSIA

Patient Start Form

Enroll your patients in
ZEPOSIA 360 SupportTM and help
them get started on treatment.

Get Started With
Cover My Meds Icon

To begin the process online,
click the button below to visit
covermymeds.com

ZEPOSIA 360 SupportTM Program helps support your patients every step of the way

Initiation Support
Initiation Support

Preinitiation Assessment Assistancea

Provided at the homes of eligible patients:

  • Blood work
  • ECG with cardiologist overread
  • Macular edema screening with licensed eye clinician overread
  • VZV antibody testing

ZEPOSIA Starter Kit

Eligible patients enrolled in ZEPOSIA 360 SupportTM, who have been cleared to begin treatment, and who have not received a sample from their provider, will be provided a
starter kit that includes a 7-day starter pack and a 30-day supply of ZEPOSIA.

Access Support
Access Support

Access Assistance

Help with Benefits Investigation, Prior Authorization (PA), and Appeals

ZEPOSIA Bridge Programb

Commercially insured patients may be eligible to receive up to 24 months of ZEPOSIA through the Bridge Program if there is a delay in determining coverage.

  • Up to 24 months for $0, as long as program eligibility rules are met
  • Dispensed in 30-day increments

For assistance, call 1-833-ZEPOSIA (833-937-6742)

Financial Support
Financial Support

Co-pay Assistance Programc

ZEPOSIA 360 SupportTM may be able to identify possible financial assistance options for eligible, commercially insured patients.

  • Prescription Benefits—Eligible patients pay as little as $0 in out-of-pocket costs for their ZEPOSIA prescription
  • Medical Benefits—Commercially insured patients can be fully reimbursed for any out-of-pocket costs associated with preinitiation testing
  • Third-Party Referrals—Suggestions for independent third-party foundations that may be able to assist with treatment costs

For financial assistance and support, call 1-833-ZEPOSIA (833-937-6742)
Fax: 833-727-7701
Monday thru Friday
8 AM until 8 PM ET
Or visit us online at: ZEPOSIAportal.com

Dedicated GI NURSE NAVIGATORS* are available to support patients
on every step of their treatment journey *Nurse Navigators do not provide medical advice.

  • aHome visits for initial routine medical tests are not available to patients enrolled in Medicare, Medicaid, or other federal or state healthcare programs, or to patients living in Rhode Island.
  • bThe Bridge Program is available at no cost for eligible, commercially insured, on-label diagnosed patients if there is a delay in determining whether commercial prescription coverage is available, and is not contingent on any purchase requirement, for up to 24 months (dispensed in 30-day increments). The Bridge Program is not available to patients who have prescription insurance coverage through Medicare, Medicaid, or any other federal or state program, or MI residents, and is available for no more than 12 months to patients in MA, MN, and RI. Appeal of any prior authorization denial must be made within 90 days or as per payer guidelines, to remain in the Program. Eligibility will be re-verified in January for patients continuing into the following year, and may be at other times during Program participation. Offer is not health insurance, and may be modified or discontinued at any time without notice. Once coverage is approved by the patient’s commercial insurance plan, the patient will no longer be eligible. Other limitations may apply.
  • cDepending on insurance coverage and where the full cost is not covered by patient’s insurance, eligible patients may receive a prescription benefit offer for out-of-pocket drug costs and pay as little as $0 per prescription, as well as a medical assessment benefit offer for out-of-pocket costs for the initial blood tests, ECG screening, and eye exam. Maximum savings limit applies; patient out-of-pocket expenses may vary. This program is not health insurance. Offer not valid for patients enrolled in Medicare, Medicaid, or other federal or state healthcare programs. Please click here for Program Terms, Conditions, and Eligibility Criteria.

ECG=electrocardiogram; VZV=varicella-zoster virus.

Additional support for your patients

Ongoing Support
Ongoing Support
  • Payer Policy Research
  • Ongoing Reverification
  • Shipment Coordination/Tracking
  • Access and Reimbursement Guide
Support Coordinators
Support Coordinators
  • Dedicated Point of Contact for
    HCPs
  • Insurance Information and Support
  • Regionally Assigned Points of
    Contact

For additional access resources, click here.

Watch as a doctor and his patient discuss the UC journey

Dr Wolf speaks with a long time UC patient, Tim. Together they discuss his diagnosis and treatment journey, as well as the challenges that Tim has faced

UC journey video thumbnail

Dr Wolf was compensated for his time. Tim is an actual patient. He was compensated for his time.
Individual results may vary. See clinical trial results at ZEPOSIAhcp.com/UCresults

Resources for you and your patients

Resources to help you learn more about ZEPOSIA for the treatment of ulcerative colitis and to help get your patients started.

Getting Started

ZEPOSIA Start Form Instructions & Support

A step-by-step guide that outlines how to enroll patients in the ZEPOSIA 360 Support Program and get them started on treatment

Dosing, Initiation, and Patient Support Guide

Provides information on how to initiate treatment with ZEPOSIA, and education on the patient support offered to assist with the process

BMS eSign

Available for your patients who forget to sign the ZEPOSIA Start Form. BMS eSign enables your patients to electronically sign

Baseline Testing Clearance Form

Used by ZEPOSIA 360 SupportTM clinical partners to verify that a patient’s baseline tests have been reviewed by their prescriber and that they are able to start therapy

Access

Access and Reimbursement Guide

Provides information on the process for accessing ZEPOSIA from initiation to delivery, coverage authorizations and appeals, and patient support offered by the ZEPOSIA 360 SupportTM Program

ZEPOSIA 360 SupportTM Guide

Helps providers and office staff get appropriate patients the support they need

Specialty Pharmacy Resource

Provides a quick overview of the benefits of using specialty pharmacies (SPs) and a list of SPs ready to handle ZEPOSIA prescriptions

Patient Access Letters

Template letters (Formulary Exception, Medical Necessity, Appeals) to assist in getting appropriate patients access for ZEPOSIA

Support

ZEPOSIA Portal Assist

Provides an outline of how to enroll and manage patients using the ZEPOSIA portal

CoverMyMeds Overview

Overview of support available through CoverMyMeds® to enroll patients in the ZEPOSIA 360 SupportTM Program and assist with access

For Your Patients

Patient Brochure

Provides your patients with an overview of clinical study results, safety, and support information for ZEPOSIA

Treatment Options Overview

A comprehensive guide to current select approved treatment options for patients with moderate-to-severe UC that includes all classes of treatment

Patient Getting Started Brochure

Provides a comprehensive guide to your patients about getting started on ZEPOSIA

Additional Clinical Resources

ZEPOSIA UC Patient Profile – Bio-exposed

Meet Jorge. At first, he found relief with biologic treatment, but his symptoms are worsening. Learn more.

Tyramine and ZEPOSIA Food and Drug Interaction Information

A helpful list of foods and beverages that are high in tyramine (150 mg or more)—a compound that should be avoided if your patients are taking ZEPOSIA

ZEPOSIA UC Patient Profile – Bio-naïve

Meet Leah. She was initially able to manage her disease with diet and 5-ASAs, but that is no longer providing relief. Learn more.

Tyramine and ZEPOSIA Food and Drug Interaction Information

A helpful list of foods and beverages that are high in tyramine (150 mg or more)—a compound that should be avoided if your patients are taking ZEPOSIA

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