To activate your patients savings card, have them text "Taltz" to 55900.

To submit to Taltz Together, please fax the completed enrollment form to 1-844-344-8108. Taltz Together will connect patients with the appropriate contracted specialty pharmacy. Patients participating in Taltz Together will be able to choose the support services that best suit their individual needs.

Pediatric Dermatology Enrollment Form

Adult Rheumatology Enrollment Form

For more information about Lilly’s privacy practice, please view the Privacy Statement .

Governmental beneficiaries excluded, subject to terms and conditions .

Offerings include:

Insurance Investigation

Help with preliminary insurance investigation and specialty pharmacy identification

Injection Training

Free of charge to patients and their families
Patients can choose either in-person or telephone training
Injection training videos available here , or through the Lilly Together^™ app

Ongoing Support

A personal patient resource to help answer questions or concerns
Help is available Monday-Friday from 8 AM to 10 PM ET
Available for patients who use the Lilly Together^™ app

Field Reimbursement Support

The Field Reimbursement Manager is an experienced access professional who can help your patients navigate the complex access and reimbursement environment

The managers are

Knowledgeable: understand Taltz Together services, access challenges, and affordability options
Connected: integrated with the Taltz Together call center and understand the Taltz contracted specialty pharmacy network
Patient Focused: committed to providing information to support patient access to Taltz

Sharps Disposal Support

Allows patients to safely dispose of Taltz devices. Once the container is full, your patients can mail it back and contact Taltz Together to receive another one. Also available for patients within the Lilly Together^™ app

Letters

Coverage Authorization Request Letter

Coverage Authorization Appeals Letter

Letter of Medical Necessity

Coverage Authorization Request Letter (Editable)

Coverage Authorization Appeals Letter (Editable)

Letter of Medical Necessity (Editable)

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS:

Taltz is contraindicated in patients with a previous serious hypersensitivity reaction, such as anaphylaxis, to ixekizumab or to any of the excipients.

WARNINGS AND PRECAUTIONS:

Infections
Taltz may increase the risk of infection. In clinical trials of adult patients with plaque psoriasis, the Taltz group had a higher rate of infections than the placebo group (27% vs 23%). A similar increase in risk of infection was seen in placebo-controlled trials of adult patients with psoriatic arthritis, ankylosing spondylitis, non-radiographic axial spondyloarthritis, and pediatric patients with plaque psoriasis. Serious infections have occurred. Instruct patient s to seek medical advice if signs or symptoms of clinically important chronic or acute infection occur. If a serious infection develops, discontinue Taltz until the infect ion resolves.

Pre-Treatment Evaluation for Tuberculosis
Evaluate patients for tuberculosis (TB) infection prior to initiating treatment with Taltz. Do not administer to patients with active TB infection. Initiate treatment of latent TB prior to administering Taltz. Closely monitor patients receiving Taltz for signs and symptoms of active TB during and after treatment.

Hypersensitivity
Serious hypersensitivity reactions, including angioedema and urticaria (each ≤ 0.1%). occurred in the Taltz group in clinical trials. Anaphylaxis, including cases leading to hospitalization, has been reported in post marketing use with Taltz. If a serious hypersensitivity reaction occurs, discontinue Taltz immediately and initiate appropriate therapy.

Inflammatory Bowel Disease
Patients treated with Taltz may be at an increased risk of inflammatory bowel disease. In clinical trials, Crohn's disease and ulcerative colitis, including exacerbations, occurred at a greater frequency in the Taltz group than the placebo group. During Taltz treatment, monitor patients for onset or exacerbations of inflammatory bowel disease and if IBD occurs, discontinue Taltz and initiate appropriate medical management.

Immunizations
Prior to initiating therapy with Taltz, consider completion of all age appropriate immunizations according to current immunization guidelines. Avoid use of live vaccines in patients treated with Taltz.

ADVERSE REACTIONS

Most common adverse reactions (≥1%) associated with Taltz treatment are injection site reactions, upper respiratory tract infections, nausea, and tinea infections. Overall, the safety profiles observed in adult patients with psoriatic arthritis, ankylosing spondylitis, non-radiographic axial spondyloarthritis, and pediatric patients with plaque psoriasis were consistent with the safety profile in adult patients with plaque psoriasis, with the exception of influenza and conjunctivitis in psoriatic arthritis and conjunctivitis, influenza, and urticaria in pediatric psoriasis.

Please see Prescribing Information and Medication Guide. Please see Instructions for Use included with the device.

IX HCP ISI 07MAY2020

INDICATIONS

Taltz is indicated for adults with active psoriatic arthritis (PsA), for adults with active ankylosing spondylitis (AS), and for adults with active non-radiographic axial spondyloarthritis (nr-axSpA) with objective signs of inflammation. Taltz is also indicated for patients aged 6 years or older with moderate-to-severe plaque psoriasis (PsO) who are candidates for systemic therapy or phototherapy.