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FOR ELIGIBLE COMMERCIALLY INSURED PATIENTS

More support for your patients:
Starting Taltz has never been easier

More commercial insurance plans than ever are offering Taltz as the preferred IL-17A antagonist1

Taltz Together™ Savings Card

Access regardless of treatment history or formulary requirements for as little as $5 or $25 per month, for up to 36 months.* See below for Terms and Conditions. Government Beneficiaries Excluded.

For commercially insured patients, after the treatment decision is made:

TOOLS for patients to get started

CoverMyMeds®

Prior authorization (PA) assistance available through CoverMyMeds for patients where a PA request is required.

Text to start

Text "Taltz" to 85099 to access savings and support.

Lilly Together™ App

Patients can set up a dosing plan and reminders, track symptom progress over time, view helpful resources, and share tracked information with their doctor.

Lilly Patient Support Provider Portal

Office sites will be able to digitally enroll patients in Taltz Together and utilize services to help with access and coverage assistance.

www.lillypatientsupport.com

Complete a Taltz Together Enrollment Form or send the prescription directly to an Enhanced Network Specialty Pharmacy to start your patients on Taltz.

This information is not a guarantee of coverage or payment (partial or full) and is subject to change without notice by a health plan or state. Please contact the plan or state for the most current information. Actual benefits are determined by each plan administrator in accordance with its respective policy and procedures.
Employers and employer groups may also offer additional benefit designs, which may be different than described.

How to Enroll | Enrollment Form | Taltz Enhanced Specialty Pharmacy Network | Sample Letters

Contact your sales representative for local plan information and patient support resources.

*Terms and conditions: Offer good until 12/31/2025 or for up to 36 months from Patient qualification into the program, whichever comes first. Patients must have coverage for Taltz through their commercial drug insurance and a prescription consistent with FDA approved product labeling to pay as little as $5 for a 28-day supply of Taltz. Offer subject to a monthly cap of wholesale acquisition cost plus usual and customary pharmacy charges and a separate annual cap of $9,100. Patients must have commercial drug insurance and prescription consistent with FDA-approved product labeling to pay as little as $25 for a 28-day supply of Taltz. Participation in the $25 program requires submission of a prior authorization (PA). If coverage is denied, an appeal must be submitted prior to 5th month fill. A new PA and appeal or medical exception (ME) must be submitted every 12 months or as required by Lilly to verify coverage status and potential eligibility for the $5 program. Offer subject to a monthly cap and a separate annual cap. Monthly and annual caps are set at Lilly's absolute discretion and may be changed by Lilly with or without notice. Participation in the program requires a valid patient HIPAA authorization. Patient is responsible for any applicable taxes, fees, or amounts exceeding monthly or annual caps. This offer is invalid for Patients without commercial drug insurance or whose prescription claims for Taltz are eligible to be reimbursed, in whole or in part, by any governmental program, including, without limitation, Medicaid, Medicare, Medicare Part D, Medigap, DoD, VA, TRICARE®/CHAMPUS, or any State Patient or Pharmaceutical Assistance Program. Offer void where prohibited by law and subject to change or discontinue without notice. Card activation is required. Subject to additional terms and conditions, which can be found at taltz.com/patient-support .

TRICARE® is a registered trademark of the Department of Defense (DoD), DHA.

FOR ELIGIBLE COMMERCIALLY INSURED PATIENTS

Access Taltz through a specialty pharmacy that is convenient for patients.

Over 150 specialty pharmacies can dispense Taltz.

To enroll in the Taltz Clear Access Program, the prescription must be sent to Taltz Together or an Enhanced Specialty Pharmacy partner.

Taltz Together can accept a prescription for Taltz via the Taltz Together Enrollment Form.

Enhanced Specialty Pharmacy Partners can accept a prescription for Taltz in 1 of 3 ways:

  1. Electronic prescription
  2. Taltz Together Enrollment Form
  3. Specialty pharmacy enrollment form

If your preferred specialty pharmacy is not included in the Taltz Enhanced Specialty Pharmacy Network , you must submit a completed enrollment form to Taltz Together.

If you have questions, your Taltz sales representative will be able to assist you.

Government beneficiaries excluded. Terms and conditions apply. See full details above.

To access the list of contracted specialty pharmacies in Puerto Rico, please contact your local sales representative.

Support

What are the steps to start a patient on Taltz?

Start with a Taltz Together Enrollment Form, which serves as the Taltz prescription

1. Depending on your office workflow, decide where the Taltz prescription will be sent.

Your options include:

A. Send the prescription to Taltz Together directly.

B. Send the prescription to a specialty pharmacy of your choice. You can find the list of the enhanced specialty pharmacy network partners here.

Declare your selection on the Taltz Together Enrollment Form.

2. Complete the Taltz Together Enrollment Form and have your patient sign it.

If the patient leaves the office without signing the enrollment form, have them call Taltz Together or go online at taltz.com to get their Taltz Savings Card.

3. When discussing initiation of Taltz treatment with your patient, be sure to instruct them to answer the phone to schedule Taltz shipment. Remind your patient to call Taltz Together should they have any questions or concerns about access or treatment cost.

4. Fax the Taltz Together Enrollment Form to Taltz Together (1-844-344-8108).

If sending the prescription to a specialty pharmacy, fax the completed Taltz Together Enrollment Form to Taltz Together and the specialty pharmacy.

Other types of support available for your patients

Your patients can now enroll directly in Taltz Together™ with the Lilly Together™ app.

To get started, patients can search for “Lilly Together” in the App Store® or on Google Play™ to download the app. Once signed in, patients can:

  • Access their savings card information directly through the app so it's always with them.
  • Use symptom tracking to help them understand progress and stay motivated on treatment, and give you a more complete view of their symptom information all in one place the next time you meet.
  • Connect with a Companion in Care™ team member for ongoing support.
  • Browse helpful resources and hear from other patients on Taltz all inside the app.

Reference: 1. Data on file. Lilly USA, LLC. DOF-IX-US-0243.

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.