Resources and support created with patients in mind

1-877-4-BENLYSTA (1-877-423-6597)
Monday-Friday, 8 AM to 8 PM, ET

BENLYSTA Gateway

  • Benefits Investigation: Support for understanding your patients' insurance coverage
  • BENLYSTA Co-Pay Program*: Evaluate your patients for eligibility and if approved, patients could pay as little as $0 for BENLYSTA
  • Access Support: Prior authorization research^ and triage to appropriate Specialty Pharmacy or Specialty Distributor

Injection support & training

  • Refresher Injection Support: Once you’ve been trained by your healthcare provider and you’re ready for your injections, we’re here to help you build your injection skills by phone.
  • Ongoing Injection Support: Nurses are available by phone anytime to talk you through your injections and taking BENLYSTA.
  • Step-by-step instruction video is available online

Information & tools

Patients can call to request the following free items:

  • Personalized communications: Patients receive tips, ideas and info about what to expect as they get started on BENLYSTA and support to stay motivated as they continue.
  • Carrying case
  • Sharps disposal container

*The BENLYSTA Co-pay Program helps eligible approved patients with their out-of-pocket costs for BENLYSTA up to $11,000 every 12 months. Medicare eligible patients, and patients enrolled in government-funded programs, are not eligible for the BENLYSTA Co-pay Program. Patients must submit a Service Request Form so their eligibility can be determined. For full Program Terms & Conditions please visit here.

^BENLYSTA Gateway CANNOT complete prior authorization forms or submit related information directly to payers on behalf of physician.

Nurses from BENLYSTA Cares do not give medical advice and will direct patients to their healthcare provider for any disease-, treatment-, or referral-related questions. Nurses from BENLYSTA Cares are available by phone Monday-Friday, 8 AM to 8 PM, ET. If calling after hours, patients may leave a message and a nurse will return their call within 30 minutes.

What is BENLYSTA Gateway?

BENLYSTA Gateway is available through BENLYSTA Cares. BENLYSTA Gateway helps patients and healthcare professionals understand authorization*, access, distribution, and reimbursement for BENLYSTA.

1-877-4-BENLYSTA (1-877-423-6597)
Monday-Friday, 8 AM to 8 PM, ET
Select option 1 for BENLYSTA Gateway
www.benlystagatewayonline.com

Additional in-office resources

Ordering Guide

BENLYSTA Gateway Overview

Ordering BENLYSTA

BENLYSTA is available through a variety of options

Ordering BENLYSTA
  1. Specialty Distributor. Clinics can contact one of the approved specialty distributors below.
    • ASD Specialty Healthcare (1-800-746-6273)
    • Besse Medical (1-877-728-3476)
    • Cardinal Health Specialty (1-866-476-1340)
    • CuraScript (1-877-599-7748)
    • McKesson Specialty (1-800-482-6700)
    • McKesson Plasma and Biologics (1-877-625-2566)
    • Metro Medical (1-800-768-2002)
    • Oncology Supply (1-800-633-7555)
  2. Wholesaler. All GSK-authorized wholesalers are eligible to access BENLYSTA provided they service eligible customer classes of trade.
  3. Specialty Pharmacy Provider. Patients may need to use a network of Specialty Pharmacies. Please see Acquisition through Specialty Pharmacies or contact the payer for the full list of Specialty Pharmacies. The BENLYSTA Gateway or Payer Relations Manager (PRM) may also be able to provide assistance.

BENLYSTA Gateway can evaluate what acquisition alternatives exist based on the patient's insurance.

Should the patient be referred to an alternate site of care, contact your PRM to discuss coordination of care considerations.

Acquisition through Specialty Pharmacies

In-network Specialty Pharmacies include

  • Acro Pharmaceutical Services (800) 906-7798
  • AcariaHealth (800) 511-5144
  • Accredo Health Group, Inc. (877) ACCREDO (222-7336)
  • Aetna SP Specialty Pharmacy (866) 782-2779
  • AllianceRx Walgreens-Prime (888) 347-3416
  • Amber Pharmacy (888) 370-1724
  • Avella (877) 546-5779
  • BriovaRx (affiliate of OptumRx) (855) 427-4682
  • Cardinal Health Specialty Pharmacy (888) 662-6779
  • Cigna Specialty Pharmacy (800) 351-3606
  • Commcare Specialty Pharmacy (888) 203-7973
  • CVS Specialty Pharmacy (800) 237-2767
  • Diplomat (877) 977-9118
  • Exactus Pharmacy Solutions (866) 458-9246
  • For Humana Pharmacy, Inc. (800) 486-2668
  • Hy-Vee Pharmacy Solutions (877) RxHyVee (794-9833)
  • Kroger Specialty Pharmacy LA, LLC (888) 355-4191
  • Magellan Rx Pharmacy (866) 554-2673 - Florida; (800) 350-8119 - New York
  • Meijer Specialty Pharmacy/RxBiotech (855) 263-4537
  • Navarro Health Services (855) 647-7979
  • Reliance Rx (Independent Health) (800) 809-4763
  • SenderraRx (888) 777-5547
  • US Bioservices (888) 518-7246

BENLYSTA Gateway can evaluate what acquisition alternatives exist based on the patient’s insurance. If BENLYSTA is acquired through the Specialty Pharmacy, BENLYSTA Gateway can work with the Specialty Pharmacy by

  • Triaging prescription to in-network Specialty Pharmacy in states allowed by law
  • Triaging co-pay information to the Specialty Pharmacy
  • Working with Specialty Pharmacies to uncover status of enrolled patients

In-network Specialty Pharmacy may initiate co-pay application by patient request with BENLYSTA Gateway.

BENEFITS INVESTIGATION AND PRIOR AUTHORIZATION (PA) RESEARCH AND SUPPORT

BENLYSTA Gateway can complete a patient-specific benefits investigation with the patient's payer and provide PA research and support

For benefits investigation, BENLYSTA Gateway can:

  • Work directly with insurance companies to obtain specific coverage information
  • Determine whether payer requires prior authorization
  • Determine estimated patient out-of-pocket responsibility

Once BENLYSTA Gateway completes a benefit verification, you and your patient will receive a Summary of Benefits that will review the patient's coverage.

Please note that investigations do not guarantee a result and it is the provider's responsibility to check with the payer. The patient's payer is the most accurate source of information about the patient's coverage.

For PA research and support, BENLYSTA Gateway can:

  • Research plan requirements
  • Outline steps required for obtaining a PA from the patient’s plan
  • Obtain unique and plan-specific PA forms (where applicable)

BENLYSTA Gateway can also follow up with the plan to help determine the status of the PA submission (if requested).

Remember, BENLYSTA Gateway cannot complete PA forms or submit related information to plans. Instead, it is the responsibility of the office and prescribing physician to provide the plan with patient-specific clinical documentation.

GSK CO-PAY ASSISTANCE EVALUATION

BENLYSTA Gateway can evaluate eligibility for the BENLYSTA Co-pay Program

If approved, patients could pay as little as $0 for BENLYSTA

Who may be eligible?

Your patients may be eligible for the Program if they:

  • Have a commercial medical or prescription insurance plan; or
  • Are uninsured
  • AND
  • Are a resident of the US (including the District of Columbia, Puerto Rico, and the US Virgin Islands)

Who is not eligible?

Your patients are not eligible for the Program if they are:

  • Eligible for Medicare or have a state- or federal government-funded medical or prescription insurance plan such as Medicare, Medicaid, VA, or Tricare.
  • Age 65 or older (patients are considered eligible for Medicare and therefore not eligible for the Co-pay program).
  • Enrolled in a commercial health plan that does not permit the use of Co-pay assistance programs.

BENLYSTA Gateway can also help eligible uninsured patients obtain access to BENLYSTA free of charge through the GSK Patient Assistance Program and arrange for the shipment directly to the site of service.

Learn more about the Co-pay Program

Provider Co-pay Brochure

Patient Co-pay Brochure

*BENLYSTA Gateway CANNOT complete prior authorization forms or submit related information directly to Payers on behalf of physician.

The BENLYSTA Co-pay Program helps eligible approved patients with their out-of-pocket costs for BENLYSTA up to $11,000 every 12 months. If approved, patients could pay as little as $0 for BENLYSTA. Medicare eligible patients, and patients enrolled in government-funded programs, are not eligible for the BENLYSTA Co-pay Program. Patients must submit a Service Request Form so their eligibility can be determined. Click here for full Program Terms & Conditions.

1007434R0 July 2018

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