Prescribe Otezla 30 mg tablets for an appropriate patient
Request Starter Pack in section 4 of the START Form or from your Otezla Sales Representative
PA is required
SP coordinates co‑pay collection and direct mail shipment of medication to the patient
Submit PA form along with other required documentation to the insurer
PA is denied
SP coordinates co‑pay collection and direct mail shipment of medication to the patient
Appeal the denial by submitting the Letter of Medical Necessity and other required documentation to the insurer. Request this document on the Letter of Medical Necessity page, or contact OSP, 1-844-4OTEZLA (1-844-468-3952) 8 am - 8 pm ET, Monday - Friday
Should appeals be denied
SP coordinates co‑pay collection and direct mail shipment of medication to the patient
SP coordinates co‑pay collection and direct mail shipment of medication to the patient
Refer patient to the OSP to determine eligibility for the Patient Assistance Program
Indications & Important Safety Information
Please click here for Full Prescribing Information.
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