GET YOUR PATIENT STARTED IN JUST 3 EASY STEPS:
With your patient, fill out the START Form and fax it to 1-800-621-5203.
A dedicated SareptAssist Case Manager will contact your patient to welcome them to the program and explain how they can help.
Ready to begin prescribing EXONDYS 51? Here’s what you need to know.
Here’s what you need to enroll your patient in SareptAssist, plus additional resources designed to assist you in getting your patient started on EXONDYS 51.
With your patient’s consent and signature, complete this form to enroll them in SareptAssist, our patient support program.
This form authorizes a Case Manager to start a benefits investigation to help with insurance benefits. Fax the completed form with the patient’s Genetic Mutation Worksheet to 1-800-621-5203.
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EXONDYS 51 (eteplirsen) is indicated for the treatment of Duchenne muscular dystrophy (DMD) in patients who have a confirmed mutation of the DMD gene that is amenable to exon 51 skipping. This indication is approved under accelerated approval based on an increase in dystrophin in skeletal muscle observed in some patients treated with EXONDYS 51. Continued approval for this indication may be contingent upon verification of a clinical benefit in confirmatory trials.
IMPORTANT SAFETY INFORMATION
Hypersensitivity reactions, including bronchospasm, chest pain, cough, tachycardia and urticaria, have occurred in patients who were treated with EXONDYS 51. If a hypersensitivity reaction occurs, institute appropriate medical treatment and consider slowing the infusion or interrupting the EXONDYS 51 therapy.