HOW TO SUCCESSFULLY START PATIENTS ON THEIR TREATMENT JOURNEY
Follow these 4 simple steps to help your patient get started on TAKHZYRO as soon as possible.
Complete the TAKHZYRO Start Form
The TAKHZYRO Start Form acts as your patient's prescription for TAKHZYRO. It also allows your patient to authorize Takeda to provide OnePath support services (e.g., access to a dedicated support manager and at-home injection training).
TAKHZYRO Start Form
TAKHZYRO Start Form:
If you need further assistance completing the TAKHZYRO Start Form, refer to the Annotated Guide for step-by-step instructions.
The TAKHZYRO Start Form requires:
- Patient name and contact details: Include the patient's full contact information, including email address and phone number. Also include your patient’s full name at the top of each page where indicated
- Prescriber signature: Review and consent to the prescriber certifications
- Dosage check box: Select 1 starting dosage for new patients
- OnePath enrollment: Remind your patient to check this box to enroll in OnePath and receive product support services such as one-on-one support with a Patient Support Manager (PSM), free injection training, and financial assistance
- Patient signature: Your patient needs to review and consent to the patient authorization, which is critical for allowing OnePath to begin a benefits investigation without delay.
Complete the TAKHZYRO Quick Start Program Enrollment Form
The Quick Start Program allows patients with commercial insurance* to receive up to 2 months' supply of TAKHZYRO at no cost while full benefits are being verified.
TAKHZYRO Quick Start Form
Important guidance when completing the Quick Start Form:
- Ensure your patient's Starting Dosage corresponds to the dosage selected in Section 4 of the TAKHZYRO Start Form
- The prescriber's signature is required. Stamps are not acceptable
*Patients on Medicare or Medicaid are not eligible for the Quick Start Program; please have your patient contact their OnePath representative to discuss other options that may be available to them.
Fax the completed form(s) to OnePath®
Complete the prescription submission by faxing the TAKHZYRO Start Form and the TAKHZYRO Quick Start Program: Enrollment Form to OnePath at 1-855-ONEPATH (1-855-663-7284). OnePath will begin the benefits investigation process and let your office know of any next steps.
Getting Started with TAKHZYRO Brochure
Let your patient know what to expect next:
- If your patient consented to OnePath Product Support, let them know that a dedicated support specialist will call them within 2 to 4 days. Ask your patient to answer the call and save the OnePath number (1-866-888-0660) to their phone to avoid spam blockers
- Additional HAE resources are available for patients to download
- To help your patient understand next steps, provide them with the Getting Started with TAKHZYRO Brochure
Partner with OnePath to support your patient
Generally, a prior authorization (PA) will be required for treatment to begin, and OnePath may contact your office to share additional information that will help you complete this process. Refer to the Benefits Verification Checklist for a list of the necessary information your patient may need when submitting a PA.
Benefits Investigation Checklist
The TAKHZYRO Start Form requires:
If a PA is denied, you can use these templates to help during the appeals process. OnePath can also answer questions your office has about the denials and appeals process.
Formulary Exception Letter
Letter of Intent to Treat
Statement of Medical Necessity
Claim Denial Letter
Coverage Denial Letter
- Learn more about OnePath Product Support for patients
- Contact OnePath directly at 1-866-888-0660 for questions about PA requirements as well as the appeals process if a claim is denied.
HCP and patient
Find materials and forms to help get patients started on TAKHZYRO.
Starting off right
Help your patients prepare for treatment by establishing expectations and goals.
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