SUPPORT SERVICES

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COMMITTED TO YOU AND YOUR PATIENTS

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BENEFITS IDENTIFICATION

A full report, including insurance coverage, within 2 business days.

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CLAIMS ASSISTANCE

Helping address your questions up front. Receive coding and billing guidance before a claim is submitted.

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PRIOR AUTHORIZATION (PA) ASSISTANCE

If a PA is necessary, we provide access to helpful forms and assistance with payer requirements to facilitate approval. We track the status of PAs and clearly communicate results and next steps.

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APPEAL ASSISTANCE

Individualized guidance on appeal submission and assistance with documentation and forms. We track the status of appeals and clearly communicate results and next steps.

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PATIENT ASSISTANCE PROGRAM

Assistance for all qualifying patients. OcuCare will help determine patient eligibility and investigate options.

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COMMERCIAL ASSURANCE PROGRAM

Designed to assist eligible* patients, who have coverage for DEXTENZA (J1096) through a commercial insurance plan†.

DEXTENZA ASSISTANCE PROGRAMS

COMMERCIAL ASSURANCE PROGRAM (CAP)

Program Eligibility Criteria


PATIENT ASSISTANCE PROGRAM (PAP)

Eligible patients may receive DEXTENZA at no cost:

Program Eligibility Criteria


PRODUCT REPLACEMENT PROGRAM FOR DAMAGED OR UNUSABLE PRODUCT (UPRP)

Product replacement for DEXTENZA inserts rendered unusable:

Program Eligibility Criteria

  1. Product is deemed unusable if:
    • The product was mishandled, dropped, or broken;
    • The product was inappropriately stored, refrigerated, or frozen;
    • The product is deemed not appropriate for administration before, during, or after the procedure.
  2. Product replacement request must be submitted within 30 days from the date of incident.

MAKING SUPPORT CONVENIENT FOR YOU

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CLICK

MYOCUCARE.COM for 24/7 online access to interactive tools designed to help you throughout the access and reimbursement process.

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CALL OR FAX

877-286-2207 or fax 855-518-7564
Monday – Friday, 8:00AM – 6:00PM ET.

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CONNECT

Directly with your Field Reimbursement Manager or OcuCare Case Manager.

OcuCare provides comprehensive support for obtaining benefits identification and determining the appropriate codes preferred by the payer. For Medicare Advantage (Part C) or commercial patients, we recommend contacting your Ocular Therapeutix Field Reimbursement Manager or OcuCare beforehand.

REIMBURSEMENT RESOURCES

* The DEXTENZA Commercial Assurance Program patient benefit is not available for patients with any government insurance including but not limited to Medicare, Medicaid, Medicare Advantage (Medicare Replacement) plans.

† Up to the provider/facility acquisition cost (not to exceed $590). Program applies to the drug only. Commercial Assurance Program claims will apply towards Ocular’s Rebate Program tiers; however, a unit will not be eligible for a rebate under Ocular’s Rebate Program if the CAP reimbursement equals the acquisition cost.

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IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

DEXTENZA is contraindicated in patients with active corneal, conjunctival or canalicular infections, including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella; mycobacterial infections; fungal diseases of the eye, and dacryocystitis.

WARNINGS AND PRECAUTIONS

Intraocular Pressure Increase – Prolonged use of corticosteroids may result in glaucoma with damage to the optic nerve, defects in visual acuity and fields of vision. Steroids should be used with caution in the presence of glaucoma. Intraocular pressure should be monitored during treatment.

Bacterial Infections – Corticosteroids may suppress the host response and thus increase the hazard for secondary ocular infections. In acute purulent conditions, steroids may mask infection and enhance existing infection.

Viral Infections – Use of ocular steroids may prolong the course and may exacerbate the severity of many viral infections of the eye (including herpes simplex).

Fungal Infections – Fungus invasion must be considered in any persistent corneal ulceration where a steroid has been used or is in use. Fungal culture should be taken when appropriate.

Delayed Healing – Use of steroids after cataract surgery may delay healing and increase the incidence of bleb formation.

Other Potential Corticosteroid Complications – The initial prescription and renewal of medication order of DEXTENZA should be made by a physician only after examination of the patient with the aid of magnification, such as slit lamp biomicroscopy, and, where appropriate, fluorescein staining. If signs and symptoms fail to improve after 2 days, the patient should be re-evaluated.

ADVERSE REACTIONS

Ocular Inflammation and Pain Following Ophthalmic Surgery
The most common ocular adverse reactions that occurred in patients treated with DEXTENZA were: anterior chamber inflammation including iritis and iridocyclitis (10%), intraocular pressure increased (6%), visual acuity reduced (2%), cystoid macular edema (1%), corneal edema (1%), eye pain (1%), and conjunctival hyperemia (1%). The most common non-ocular adverse reaction was headache (1%).

Itching Associated with Allergic Conjunctivitis
The most common ocular adverse reactions that occurred in patients treated with DEXTENZA were: intraocular pressure increased (3%), lacrimation increased (1%), eye discharge (1%), and visual acuity reduced (1%). The most common non-ocular adverse reaction was headache (1%).

INDICATIONS

DEXTENZA is a corticosteroid indicated for:

  • The treatment of ocular inflammation and pain following ophthalmic surgery.
  • The treatment of ocular itching associated with allergic conjunctivitis.

Please see full Prescribing Information.