- For U.S. Healthcare Professionals Only
Access & Support
3 Ways to enroll in Takeda Patient Support
1
Choose one of the convenient options below to complete the LIVTENCITY Start Form.
Fax
Download and complete the Start Form. Then fax the completed form to Takeda Patient Support at 1-855-268-1826.
Online
Visit our easy-to-use online enrollment. In a few clicks, your patient can be enrolled in Takeda Patient Support
iAssist
Enroll your patients in Takeda Patient Support with this easy-to-use registration.
2
Takeda Patient Support will review the Start Form and confirm patient eligibility.
3
Once eligibility requirements have been confirmed, the specialty pharmacy will coordinate the shipment of LIVTENCITY with the patient.
Important information
Takeda Patient Support
Benefits investigation
We provide support during the process of determining a patient’s insurance benefits and eligibility for certain services.
Prior authorization information
We’ll coordinate with your patient’s insurance company to determine any prior authorization requirements.
Specialty pharmacy triage and coordination
Through the selected pharmacy options, we’ll work with your patient’s insurance provider to help them gain access to LIVTENCITY.
Financial assistance options
Our Patient Support Managers (PSMs) can help educate patients on financial assistance options, if eligible.
Product and disease state education
Trained nursing professionals are ready to provide your patient education on their condition and LIVTENCITY. They cannot provide medical advice.
LIVTENCITY may be purchased directly by qualified
entities* from the following distributor
*Qualified entities for direct purchase include inpatient hospitals properly licensed by regulatory
authorities to administer or dispense pharmaceutical products to appropriate patients, entities
eligible to purchase under the Federal Supply Schedule, and 340B covered entities.
Get Connected…
By providing your contact information, your Takeda Transplant Account Manager can keep you informed about important developments relevant to you and your institution. All fields are required unless marked as optional.
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