and Assistance Through
Patient Coverage and Reimbursement Support:
- Benefits Investigations
- Verify coverage, benefits (medical and pharmacy), and cost-sharing information for EYLEA (aflibercept) Injection under the patient's health plan
- For EYLEA support, please download and complete the Statement of Medical Necessity Form; patient signature is required
- Prior Authorization (PA) Assistance
- Research payer requirements and assist in obtaining prior authorization for EYLEA
- Claims Assistance
- Address questions on claims preparation
- Review the status of an EYLEA claim with your patient's insurance company to help address any issues
- Appeals Assistance
- Assist in resolving denied or underpaid claims and help navigate the appeals process
- There are several options available to help your patients with the cost of EYLEA
- Uninsured Patients may be eligible to receive EYLEA at no cost under the EYLEA4U® Patient Assistance Program
- Underinsured Patients Not Covered by a State or Federal Healthcare Program may qualify for assistance with their out-of-pocket co-pay costs through the EYLEA4U® Co-Pay Program
- Underinsured Patients Enrolled in a State or Federal Healthcare Programs may be referred to independent, non-profit organizations that help patients with their out-of-pocket treatment costs
- To confirm your patient's eligibility, call 1-855-EYLEA-4U (1-855-395-3248), Option 4, and speak with one of our Reimbursement Specialists or fax the completed Statement of Medical Necessity Form (patient signature required) to 1-888-335-3264
Reimbursement Specialists are available Monday through Friday from 9 am to 8 pm
Call: 1-855-EYLEA-4U (1-855-395-3248),
Option 4, or Fax: 1-888-335-3264.
IMPORTANT PRESCRIBING INFORMATION FOR EYLEA® (aflibercept) INJECTION
EYLEA® (aflibercept) Injection is indicated for the treatment of patients with
- Neovascular (Wet) Age-related Macular Degeneration (AMD): The recommended dose is 2 mg administered by intravitreal injection every 4 weeks (monthly) for the first 12 weeks (3 months), followed by 2 mg once every 8 weeks (2 months). Although EYLEA may be dosed as frequently as 2 mg every 4 weeks (monthly), additional efficacy was not demonstrated when EYLEA was dosed every 4 weeks compared to every 8 weeks.
- Macular Edema following Retinal Vein Occlusion (RVO): The recommended dose is 2 mg administered by intravitreal injection every 4 weeks (monthly).
- Diabetic Macular Edema (DME): The recommended dose is 2 mg administered by intravitreal injection every 4 weeks (monthly) for the first 5 injections, followed by 2 mg once every 8 weeks (2 months). Although EYLEA may be dosed as frequently as 2 mg every 4 weeks (monthly), additional efficacy was not demonstrated when EYLEA was dosed every 4 weeks compared to every 8 weeks.
IMPORTANT SAFETY INFORMATION FOR EYLEA® (aflibercept) INJECTION
- EYLEA® (aflibercept) Injection is contraindicated in patients with ocular or periocular infections, active intraocular inflammation, or known hypersensitivity to aflibercept or to any of the excipients in EYLEA.
- Intravitreal injections, including those with EYLEA, have been associated with endophthalmitis and retinal detachments. Proper aseptic injection technique must always be used when administering EYLEA. Patients should be instructed to report any symptoms suggestive of endophthalmitis or retinal detachment without delay and should be managed appropriately. Intraocular inflammation has been reported with the use of EYLEA.
- Acute increases in intraocular pressure have been seen within 60 minutes of intravitreal injection, including with EYLEA. Sustained increases in intraocular pressure have also been reported after repeated intravitreal dosing with VEGF inhibitors. Intraocular pressure and the perfusion of the optic nerve head should be monitored and managed appropriately.
- There is a potential risk of arterial thromboembolic events (ATEs) following use of intravitreal VEGF inhibitors, including EYLEA, defined as nonfatal stroke, nonfatal myocardial infarction, or vascular death (including deaths of unknown cause). The incidence of reported thromboembolic events in wet AMD studies during the first year was 1.8% (32 out of 1824) in the combined group of patients treated with EYLEA. The incidence in the DME studies during the first year was 3.3% (19 out of 578) in the combined group of patients treated with EYLEA compared with 2.8% (8 out of 287) in the control group. There were no reported thromboembolic events in the patients treated with EYLEA in the first six months of the RVO studies.
- Serious adverse reactions related to the injection procedure have occurred in <0.1% of intravitreal injections with EYLEA including endophthalmitis and retinal detachment.
- The most common adverse reactions (>5%) reported in patients receiving EYLEA were conjunctival hemorrhage, eye pain, cataract, vitreous floaters, intraocular pressure increased, and vitreous detachment.
Please see the full Prescribing Information for EYLEA.