FOR ELIGIBLE COMMERCIALLY INSURED PATIENTS
Prescribe with Confidence.
Your Patients are Covered.
More commercial insurance plans than ever are offering Taltz as the preferred IL-17A antagonist1
The Taltz Together™ Program
Ensure the treatment choice stays between you and your commercially insured patient.
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). 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 12/31/2024 or for up to 36 months from patient qualification into the program, whichever comes first. Patients must first use their card by 12/31/2021. Patients must have coverage for Taltz through their commercial drug insurance 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 set at Lilly’s sole discretion. Patients must have commercial drug insurance and prescription consistent with FDA-approved product labeling to pay as little as $25 for 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 wholesale acquisition cost plus usual and customary pharmacy charges. 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. 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 here .
†Shipment can be authorized by submitting a prescription to either an Enhanced Network Specialty Pharmacy or Taltz Together™ and commercial insurance is verified; patient enrolls in the Taltz Savings Card program and schedules shipment.
‡Contingent upon a patient scheduling a delivery with a specialty pharmacy.
§Constitutes that a prior authorization has been submitted.
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:
- Electronic prescription
- Taltz Together Enrollment Form
- 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 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.
Reference: 1. Data on file. Lilly USA, LLC. DOF-IX-US-0243.