SAVINGS AND SUPPORT
VIGAFYDE™ is backed by our Promise of Support™ Program
The Upsher-Smith Promise of Support™ Program reflects our deep commitment to rare disease care—delivering industry-leading support and resources, removing barriers to access, and simplifying prescribing so you can focus on care.
You start the process, we’ll do the rest
Two Ways to Prescribe
E-prescribe through your EMR system to our specialty pharmacy partner:
PANTHERx Specialty Pharmacy 1120 Stevenson Mill Road, Suite 400 Coraopolis, PA 15108 NCPDP ID: 6008002
Download, print, complete, and fax the VIGAFYDE Prescription Form to:
l-877-788-4948(Monday-Friday 8 AM-8 PM ET)
If you are sending the prescription on a weekend or after hours, fax to
The PROMISE OF SUPPORT™ Program Takes It From Here
We confirm Step 1 is complete—that both physician and patient Vigabatrin REMS Program documents have been submitted.
We determine if the patient is:
- Covered
- Not covered or uninsured
- Eligible for the copay assistance program
- Requires a prior authorization
If the patient requires a prior authorization or letter of medical necessity, we contact their insurance provider. We then fax all necessary forms to your office for you to complete. While this is being done, a VIGAFYDE starter/bridge supply is sent to the patient. Prior authorization and appeal support is available.
Download a sample letter of medical necessity.
VIGAFYDE Is Delivered and Treatment Can Begin
Prescription ships to the patient from a specialty pharmacy partner as soon as enrollment and eligibility have been confirmed.
Support for you
It is important to us that you have resources and partners that can help make getting VIGAFYDE for your patients as easy as possible. When you prescribe VIGAFYDE, Upsher-Smith’s Promise of Support™ Program offers a spectrum of assistance.
Our access experts help guide you through the process. If a Prior Authorization, Medical Exception, and/or appeals processes are required, we will contact their insurance provider. We then fax all necessary forms to your office for you to complete. While this is being done, a VIGAFYDE starter/bridge supply is sent to the patient.
For patients who do not have insurance, or situations in which VIGAFYDE is not covered by their insurance plan, the Promise of Support™ Program will assess options and provide help in accessing appropriate assistance.
Support for caregivers
Caregivers can expect exceptional support including:
$0 copay
for eligible patients*
Patient Assistance Program (PAP)* for
patients who are uninsured or underinsured
Prior authorization and appeal support
to accelerate access and reduce administrative burden
Quick Start medication supply
enables patients to start therapy during the insurance approval process
Bridge medication supply provides access to medication while resolving coverage gaps or refill delays
24/7 access to a pharmacist
for personalized help, education, and answers every step of the way
Refill reminders
available
Free home delivery
of medication
Award-winning specialty pharmacy
VIGAFYDE is available through PANTHERx® Rare, an award-winning specialty pharmacy dedicated to rare disease patients and families.
PANTHERx® Rare is a URAC-certified Rare Disease Pharmacy Center of Excellence and has been awarded the MMIT Patient Choice Award.
Our shared goal is to ensure your patients receive the support needed to stay on medication throughout their treatment journey.
