ACCESS & SUPPORT

Patient Support

$0* Co-pay

Eligible patients with commercial insurance may pay as little as $0 for each BEOVU treatment, with a maximum of $12,000 annually. Subject to terms and conditions. Limitations may apply.*

TO ENROLL A PATIENT OR SUBMIT A CO-PAY CLAIM

Visit the BEOVU GO provider portal, call BEOVU GO at 1-888-61-BEOVU (23688)1-888-61-BEOVU (23688)

Monday – Friday, 8:00 AM to 8:00 PM ET, or download the forms and submission instructions.

Patient Enrollment Form

Provider and Specialty Pharmacy Claim Form

Patient Pharmacy Claim Form

BEOVU Your Way™ is a program designed to support wet AMD patients and their caregivers. The program provides personalized one-on-one support throughout the treatment journey with access to a dedicated Care Champion.

Care Champion†

Care Champions are committed to understanding the unique needs and preferences of each patient.

When enrolled in BEOVU Your Way™, each patient will be matched with a designated Care Champion who will be their single point of contact for personalized support tailored to the patient's needs, coordinating a range of services.

Here's how patients can enroll in BEOVU Your Way™:

Patients can enroll in BEOVU Your Way™ by calling 1-888-61-BEOVU (23688) 1-888-61-BEOVU (23688) Monday – Friday, 8:00 AM to 8:00 PM ET

Complete the Patient Enrollment Form

*Limitations apply. Valid only for those with private insurance. The Program may include the Co-pay Card, Payment Card (if applicable), and Rebate, with a combined annual limit of $12,000. For patients covered under the medical benefit, the rebate for the patient's out-of-pocket costs will be assigned directly to the provider, unless the patient requests direct reimbursement. Patient is responsible for any costs once limit is reached in a calendar year. Program not valid (i) under Medicare, Medicaid, TRICARE, VA, DoD, or any other federal or state health care program, (ii) where patient is not using insurance coverage at all, (iii) where the patient's insurance plan reimburses for the entire cost of the drug, or (iv) where product is not covered by patient's insurance. The value of this program is exclusively for the benefit of patients and is intended to be credited towards patient out-of-pocket obligations and maximums, including applicable co-payments, coinsurance, and deductibles. Program is not valid where prohibited by law. Patient may not seek reimbursement for the value received from this program from other parties, including any health insurance program or plan, flexible spending account, or health care savings account. Patient is responsible for complying with any applicable limitations and requirements of their health plan related to the use of the Program. Valid only in the United States and Puerto Rico. This Program is not health insurance. Program may not be combined with any third-party rebate, coupon, or offer. Proof of purchase may be required. Novartis reserves the right to rescind, revoke, or amend the Program and discontinue support at any time without notice.

†BEOVU Your WayTM is a patient support program and not intended to take the place of the care provided by doctors or their office staff. BEOVU Your WayTM does not provide medical advice or treatment.

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INDICATIONS AND USAGE

BEOVU® (brolucizumab-dbll) injection is indicated for the treatment of Neovascular (Wet) Age-related Macular Degeneration (AMD).

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

BEOVU is contraindicated in patients with ocular or periocular infections, active intraocular inflammation or known hypersensitivity to brolucizumab or any of the excipients in BEOVU. Hypersensitivity reactions may manifest as rash, pruritus, urticaria, erythema, or severe intraocular inflammation.

WARNINGS AND PRECAUTIONS

Endophthalmitis and Retinal Detachments

Intravitreal injections, including those with BEOVU, have been associated with endophthalmitis and retinal detachments. Proper aseptic injection techniques must always be used when administering BEOVU. Patients should be instructed to report any symptoms suggestive of endophthalmitis or retinal detachment without delay and should be managed appropriately.

Increase in Intraocular Pressure

Acute increases in intraocular pressure (IOP) have been seen within 30 minutes of intravitreal injection including with BEOVU. Sustained IOP increases have also been reported. Both IOP and perfusion of the optic nerve head must be monitored and managed appropriately.

Thromboembolic Events

Although there was a low rate of arterial thromboembolic events (ATEs) observed in the BEOVU clinical trials, there is a potential risk of ATEs following intravitreal use of VEGF inhibitors. Arterial thromboembolic events are defined as nonfatal stroke, nonfatal myocardial infarction, or vascular death (including deaths of unknown cause). The ATE rate in the two controlled 96-week neovascular AMD studies (HAWK and HARRIER) during the first 96-weeks was 4.5% (33 of 730) in the pooled brolucizumab arms compared with 4.7% (34 of 729) in the pooled aflibercept arms.

ADVERSE REACTIONS

Serious adverse reactions including endophthalmitis, retinal detachment, increases in intraocular pressure, and arterial thromboembolic events have occurred following intravitreal injections with BEOVU.

The most common adverse events (≥5% of patients) with BEOVU were vision blurred, cataract, conjunctival hemorrhage, vitreous floaters and eye pain.

As with all therapeutic proteins, there is a potential for an immune response in patients treated with BEOVU. Anti-brolucizumab antibodies were detected in the pre-treatment sample of 36% to 52% of treatment naive patients. After initiation of dosing, anti-brolucizumab antibodies were detected in at least one serum sample in 53% to 67% of patients treated with BEOVU. Intraocular inflammation was observed in 6% of patients with anti-brolucizumab antibodies detected during dosing with BEOVU. The significance of anti-brolucizumab antibodies on the clinical effectiveness and safety of BEOVU is not known.

Please see the Important Safety Information and full Prescribing Information for BEOVU.