Helpful Resources for Your Practice

ENSPRYNG Access Solutions offers a range of access and reimbursement resources for your patients and practice after ENSPRYNG is prescribed, including help with benefits investigations (BIs), resources for prior authorizations (PAs), sample billing and coding information, resources for denials and appeals, information about distribution and referrals to potential financial assistance options.

Quick Links

Coverage

Get help understanding insurance benefits and coverage, such as with benefits investigations and prior authorization resources.

Benefits investigations

ENSPRYNG Access Solutions can conduct a benefits investigation (BI) which can determine:

  • If treatment is covered
  • If treatment is denied
  • If a prior authorization or pre-determination is required*
  • If your patient's insurance plan has a mandated or preferred SP

*If your patient’s request for a prior authorization is not granted, your ENSPRYNG Access Solutions Specialist can work with you to determine your next steps.

Get started with enrollment by following the steps below.

Option 1: Submit forms online

If your practice has a registered account for My Patient Solutions, you can get started by logging into your account.

Don't have an account?

Your patient is required to complete the patient consent section of the ENSPRYNG Start Form. You can either upload the patient consent section of the ENSPRYNG Start Form as part of your online application or have your patient submit the patient consent section of the ENSPRYNG Start Form via fax, text or e-submit.

  • An online tool to help you enroll patients in ENSPRYNG Access Solutions and manage your service requests at your convenience.

Option 2: Print form and fax or text

Step 1: Print ENSPRYNG Start Form below and have your patient complete the patient consent section of this form.

Step 2: Submit the completed form via fax or text.

Both sections of the form are required. We must have both sections of the completed ENSPRYNG Start Form before we can help you.

What to expect next:

  • The request will be processed within five business days upon receipt of both patient and prescriber consent.
  • Your office will be contacted to discuss the application outcome and any next steps.

Genentech reserves the right to modify or discontinue the program at any time and to verify the accuracy of information submitted.

The completion and submission of coverage- or reimbursement-related documentation are the responsibility of the patient and healthcare provider. Genentech makes no representation or guarantee concerning coverage or reimbursement for any service or item.

ENSPRYNG Patient Navigators

A Patient Navigator may assist during your patient's treatment with access, reimbursement and injection training support.

Learn more about ENSPRYNG Patient Navigators

ENSPRYNG Benefits Reverification

When a medical treatment is authorized by the patient’s insurance plan for a limited period of time, it will generally require reverification of coverage for continued treatment. ENSPRYNG Access Solutions can help you obtain reverification for your patients.

If the patient’s health insurance plan denies the request for reverification, your practice may file an appeal on behalf of your patient.

Reimbursement

Sample coding information and resources for denials and appeals

ENSPRYNG Sample Coding

This coding information may assist you as you complete the payer forms for ENSPRYNG. These tables are provided for informational purposes only. Please visit CMS.gov or other payers’ websites to obtain additional guidance on their processes related to billing and coding.

Download sample coding and the important safety information for ENSPRYNG below.

Correct coding is the responsibility of the provider submitting the claim for the item or service. Please check with the payer to verify codes and special billing requirements. Genentech does not make any representation or guarantee concerning reimbursement or coverage for any service or item.

Appeals

If your patient’s health insurance plan has issued a denial, your ENSPRYNG Access Solutions Specialist can provide resources as you prepare an appeal submission, as per your patient’s plan requirements. 

If a plan issues a denial: 

  1. The denial should be reviewed, along with the health insurance plan’s guidelines to determine what to include in your patient’s appeal submission.
  2. Your ENSPRYNG Access Solutions Specialist has local payer coverage expertise and can help you determine specific requirements for your patient.

A sample appeal letter and additional considerations are available on the Practice Forms and Documents page.

Appeals cannot be completed or submitted by Genentech on your behalf.

Online patient enrollment

My Patient Solutions is an online tool to help you enroll patients in ENSPRYNG Access Solutions and manage your service requests, all through one portal. It allows you the flexibility to work with ENSPRYNG Access Solutions when it’s convenient for you.

With My Patient Solutions, you can:

  • Enroll and re-enroll patients in financial assistance programs entirely online
  • Communicate with your ENSPRYNG Access Solutions Specialist
  • Easily identify next steps for service requests
  • View Benefits Investigation reports for all your enrolled patients
  • Follow up on prior authorizations or appeals
  • View co-pay assistance outcomes and referral information

How to register

Account registration can be completed by one person for the entire practice and for multiple practice locations. For help with registration or if you have questions, call us at 877-GENENTECH (877-436-3683) (6AM-5PM PST, Monday through Friday).

ENSPRYNG Distribution

ENSPRYNG Access Solutions works with specialty pharmacies (SPs) to help patients receive their prescribed Genentech medicines.

In addition to distributing medicines, an SP may provide the following services:

  • Reimbursement resources
  • Clinical services to support patients throughout their treatment
  • The ability to manage the specialty handling and shipping needs linked with many specialty therapies

You can work with your preferred SP or contact ENSPRYNG Access Solutions to learn which SP the patient’s health insurance plan mandates or prefers.

Genentech does not influence or advocate the use of any one specialty distributor or specialty pharmacy. We make no representation or guarantee of service or coverage of any item. For any product-specific distribution questions, call ENSPRYNG Access Solutions at 844-677-7964 (6AM-5PM PST, Monday through Friday).

Genentech has contracted with a network of authorized specialty distributors and specialty pharmacies (SPs) to service practices choosing to prescribe ENSPRYNG. 

These partners have made a commitment to product integrity and have agreed to distribute only products purchased directly from Genentech and not to distribute ENSPRYNG through secondary channels.

Authorized Distributors and Specialty Pharmacies

Distributor Telephone Fax Web Orders
AmerisourceBergen Specialty Group (ASD Healthcare) 800-746-6273 800-547-9413 www.asdhealthcare.com
Cardinal Specialty Distribution 866-677-4844 888-345-4916 orderexpress.cardinalhealth.com
Dakota Drug, Inc. 866-210-5887 763-421-0661 www.dakdrug.com
DMS Pharmaceuticals, Inc. 877-788-1100 847-518-1105 www.dmspharma.com
McKesson Plasma & Biologics (MPB) 877-625-2566 800-289-9285 www.mckesson.com
Distributor Telephone Fax Web Orders
AmerisourceBergen Specialty Group (ASD Healthcare) 800-746-6273 800-547-9413 www.asdhealthcare.com
Cardinal Specialty Distribution 866-677-4844 888-345-4916 orderexpress.cardinalhealth.com
CuraScript Specialty Distribution 877-599-7748 800-862-6208 www.curascriptsd.com
McKesson Plasma & Biologics (MPB) 877-625-2566 800-289-9285 www.mckesson.com
M&D Specialty Distribution 800-710-6100 318-524-3096 www.mdspecialtydist.com
Distributor Telephone Fax Web Orders
AmerisourceBergen Specialty Group
(Besse Medical, BioSolutions Direct, Oncology Supply)
800-543-8695
888-899-0063
800-248-8205
800-543-8695
888-899-0063
800-248-8205
www.besse.com
www.biosolutionsdirect.com 
www.oncologysupply.com
CuraScript Specialty Distribution 877-599-7748 800-862-6208 www.curascriptsd.com
McKesson Specialty Health 855-477-9800 888-752-7626 mscs.mckesson.com
Metro Medical (A Cardinal Health Company) 800-768-2002 615-256-4194 www.metromedicalorder.com
Distributor Telephone Fax Web Orders
Cardinal Health Puerto Rico 787-625-4200 787-625-4398 www.cardinalhealth.pr
Cesar Castillo Inc. 787-641-5082 787-999-1614 www.cesarcastillo.com
Specialty Pharmacy Telephone Fax Web
AcariaHealth
877-928-5120 877-928-5121 www.acariahealth.com
Accredo 800-803-2523 888-302-1028 www.accredo.com
Advanced Care Scripts 866-681-7131 866-679-7131 www.acs-rx.com
Aetna 866-782-2779
866-329-2779
www.aetna.com/individuals-families/pharmacy/specialty-pharmacy.html
Alivia Specialty Pharmacy (Puerto Rico only)
787-979-2023
N/A www.aliviahealth.com/specialty
AllianceRx Walgreens Prime
888-347-3416
877-231-8302
www.alliancerxwp.com
Amber Specialty Pharmacy 888-370-1724 877-645-7514 www.amberpharmacy.com
Axium Healthcare Puerto Rico/Kroger Specialty Pharmacy (Puerto Rico Only) 787-780-7200 800-546-2163 www.axiumpr.com
Biologics by McKesson 800-850-4306 800-823-4506
biologics.mckesson.com
BioMatrix 888-662-6779
877-800-4790
www.biomatrixsprx.com
CenterWell Specialty Pharmacy 800-486-2668 877-405-7940 www.centerwellpharmacy.com/specialty-medications.html
Cigna
800-351-3606
800-351-3616
www.cigna.com/specialty-pharmacy-services
CVS/Specialty 800-237-2767
800-323-2445
www.cvsspecialty.com
Diplomat Specialty Pharmacy 866-311-9966 866-208-4142 www.diplomatpharmacy.com
Option Care Health 844-624-4584
N/A
optioncarehealth.com/bioscrip
Optum Specialty Pharmacy 855-427-4682
877-342-4596
specialty.optumrx.com
Reliance Rx 800-809-4763
877-671-7189
www.reliancerxsp.com
Special Care Pharmacy Services
(Puerto Rico Only)
787-783-8579 787-783-2951 specialcarepr.com 
US Bioservices (ABSG) 866-916-0578
888-418-7246
www.usbioservices.com
Walgreens Specialty Pharmacy 888-782-8443 866-677-6685 www.walgreens.com/pharmacy/specialtypharmacy.jsp

About Specialty Pharmacies

ENSPRYNG Access Solutions works with specialty pharmacies (SPs) to help patients receive their prescribed Genentech medicines.

In addition to distributing medicines, an SP may provide the following services:

  • Reimbursement resources
  • Clinical services to support patients throughout their treatment
  • The ability to manage the specialty handling and shipping needs linked with many specialty therapies

You can work with your preferred SP or contact ENSPRYNG Access Solutions to learn which SP the patient’s health insurance plan mandates or prefers.

Genentech does not influence or advocate the use of any one specialty distributor or specialty pharmacy. We make no representation or guarantee of service or coverage of any item. For any product-specific distribution questions, call ENSPRYNG Access Solutions at 844-677-7964 (6AM-5PM PST, Monday through Friday).

Product issues

We are serious about patient safety. If your Genentech product is spoiled, expired or damaged, we may be able to help you replace it.

Please contact Genentech Customer Service at (800) 551-2231 for any order or return-related questions.

Contact Us

Questions? Contact ENSPRYNG Access Solutions

Call 844-677-7964 (Mon.–Fri., 6AM–5PM PST)

Indication

ENSPRYNG is indicated for the treatment of neuromyelitis optica spectrum disorder (NMOSD) in adult patients who are anti-aquaporin-4 (AQP4) antibody positive.

Contraindications

ENSPRYNG is contraindicated in patients with a known hypersensitivity to satralizumab or any of the inactive ingredients, an active hepatitis B infection, or active or untreated latent tuberculosis.

Warnings and Precautions

Infections
An increased risk of infections, including serious and potentially fatal infections, has been observed in patients treated with IL-6 receptor antagonists, including ENSPRYNG. The most common infections reported in a randomized clinical trial of patients treated with ENSPRYNG who were not on other chronic immunosuppressant therapies, and that occurred more often than in patients receiving placebo, were nasopharyngitis (12%) and cellulitis (10%). The most common infections in patients who were on an additional concurrent immunosuppressant, and that occurred more often than in patients receiving placebo, were nasopharyngitis (31%), upper respiratory infection (19%), and pharyngitis (12%). Delay ENSPRYNG administration in patients with an active infection, including localized infections, until the infection is resolved.

Hepatitis B Virus (HBV) Reactivation
Risk of HBV reactivation has been observed with other immunosuppressant therapies. Patients with chronic HBV infection were excluded from clinical trials. Perform HBV screening in all patients before initiation of treatment with ENSPRYNG. Do not administer ENSPRYNG to patients with active hepatitis. For patients who are chronic carriers of HBV [HBsAg+] or are negative for HBsAg and positive for HB core antibody [HBcAb+], consult liver disease experts before starting and during treatment with ENSPRYNG.

Tuberculosis
Tuberculosis has occurred in patients treated with other IL-6 receptor antagonists. Patients should be evaluated for tuberculosis risk factors and tested for latent infection prior to initiating ENSPRYNG. Consider anti-tuberculosis therapy prior to initiation of ENSPRYNG in patients with a history of latent or active tuberculosis in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent tuberculosis but having risk factors for tuberculosis infection. Consult infectious disease experts regarding whether initiating anti-tuberculosis therapy is appropriate before starting treatment. Patients should be monitored for the development of signs and symptoms of tuberculosis with ENSPRYNG, even if initial tuberculosis testing is negative.

Vaccinations
Live or live-attenuated vaccines should not be given concurrently with ENSPRYNG because clinical safety has not been established. Administer all immunizations according to immunization guidelines at least 4 weeks prior to initiation of ENSPRYNG for live or live-attenuated vaccines and, whenever possible, at least 2 weeks prior to initiation of ENSPRYNG for non-live vaccines.

Elevated Liver Enzymes
Mild and moderate elevations of liver enzymes have been observed in patients treated with ENSPRYNG at a higher incidence than in patients receiving placebo. ALT and AST levels should be monitored every 4 weeks for the first 3 months of treatment, followed by every 3 months for one year, and thereafter, as clinically indicated.

Decreased Neutrophil Counts
Decreases in neutrophil counts were observed in patients treated with ENSPRYNG at a higher incidence than placebo. Neutrophil counts should be monitored 4 to 8 weeks after initiation of therapy, and thereafter at regular clinically determined intervals.

Hypersensitivity Reactions
Hypersensitivity reactions, including rash, urticaria, and fatal anaphylaxis, have occurred with other IL-6 receptor antagonists.

Use in Specific Populations

Pregnancy

Pregnancy Exposure Registry

There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to ENSPRYNG during pregnancy. Healthcare providers are encouraged to register patients and pregnant women are encouraged to register themselves by calling 1-833-277-9338.

There are no adequate data on the developmental risk associated with the use of ENSPRYNG in pregnant women. In an animal reproduction study, no adverse effects on maternal animals or fetal development were observed in pregnant monkeys and their offspring, with administration of ENSPRYNG at doses up to 50 mg/kg/week. In the U.S. general population, the estimated background risk of major birth defect and miscarriage in clinically recognized pregnancies is 2 – 4% and 15 – 20%, respectively. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown.


Lactation
No information is available on the presence of ENSPRYNG in human milk, the effects of ENSPRYNG on the breastfed infant, or the effects of ENSPRYNG on milk production. ENSPRYNG was excreted in the milk of lactating monkeys administered ENSPRYNG throughout pregnancy. Human IgG is excreted in human milk and the potential for absorption in the infant is unknown. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for ENSPRYNG and any potential adverse effects on the breastfed infant from ENSPRYNG or from the underlying maternal condition.

Pediatric Use
Safety and effectiveness in pediatric patients have not been established.

Geriatric Use
Clinical studies of ENSPRYNG did not include sufficient numbers of patients aged 65 years and older to determine whether they respond differently from younger patients. However, population pharmacokinetic analyses in patients with NMOSD did not show that age affected the pharmacokinetics of ENSPRYNG. In general, caution should be used when dosing the elderly, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant diseases or other drug therapy.

Most Common Adverse Reactions

The most common adverse reactions (≥15% in either trial) were nasopharyngitis (31%), headache (27%), upper respiratory tract infection (19%), rash (17%), arthralgia (17%), extremity pain (15%), gastritis (15%), fatigue (15%), and nausea (15%).

You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835-2555.

For additional safety information, please see the full Prescribing Information and Medication Guide.

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      ENSPRYNG [prescribing information]. South San Francisco, CA: Genentech, Inc. 2022.

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    • Chihara N, Aranami T, Sato W, et al. Interleukin 6 signaling promotes anti-aquaporin 4 autoantibody production from plasmablasts in neuromyelitis optica. Proc Natl Acad Sci USA. 2011;108(9):3701-3706.

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      Knapp RK, Hardtstock F, Wilke T, et al. Evaluating the economic burden of relapses in neuromyelitis optica spectrum disorder: a real-world analysis using German claims data. Neurol Ther. 2022;11:247-263. https://doi.org/10.1007/s40120-021-00311-x

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