Access | Reimbursement Support | Care

Stemline ARC™ Access

Help eligible patients receive the support they need with access to a variety of assistance programs

Stemline ARC provides access, reimbursement support, and care for eligible patients throughout treatment with ELZONRIS® (tagraxofusp-erzs) Injection for IV Use.

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Stemline Commercial Co-Pay Program*

  • Eligible patients may pay as little as $0 per month supply of ELZONRIS Injection for IV Use
  • Activation is simple: download and fax the completed enrollment form and Stemline ARC representatives will call you or the patient to get started. See full terms and conditions
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Stemline Patient Assistance Program

  • The Stemline Patient Assistance Program provides ELZONRIS Injection for IV Use to eligible patients who are under- or uninsured. Patients must meet certain criteria to qualify. Call 1-833-4-STEMLINE (1-833-478-3654) for more information
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Independent Third-Party Foundations

  • Stemline ARC can provide information about independent third-party foundations for eligible patients

*Patients must meet eligibility criteria. In order to be eligible for the Stemline Commercial Co-Pay Program, the patient must not have government-funded health insurance (eg, Medicare, Medicaid, or any other federal or state program), must be taking ELZONRIS Injection for IV Use for an FDA-approved indication, and must confirm that they meet all of the eligibility criteria and agree to the rules set forth in the terms and conditions for the program. Patients and healthcare providers are responsible for completing and submitting enrollment forms and coverage or reimbursement documentation. Stemline Therapeutics, Inc. makes no representation or guarantee concerning coverage or reimbursement of any service or item.

To be eligible for this program, insured patients must have exhausted all other forms of patient assistance and meet financial criteria. Insured and uninsured patients must also meet certain eligibility criteria.

Stemline Therapeutics, Inc. does not influence or control the operations or eligibility criteria of any independent charitable assistance foundation and cannot guarantee assistance after information has been provided by Stemline ARC. The information is provided as a resource to patients. The foundations that we discuss with patients are not exhaustive or indicative of Stemline Therapeutics, Inc.’s endorsement or financial support. There may be other foundations to support the patient’s disease state.

ELZONRIS Injection for IV Use is available through specialty distributors§

Distributor Phone & Fax Email Website

McKesson Plasma and Biologics

P: 1-877-625-2566
F: 1-888-752-7626

Contact

Visit

Cardinal Health

P: 1-877-453-3972
1-855-855-0708
F: 1-877-274-9897
1-614-553-6301

Contact

Visit

ASD Healthcare

P: 1-800-746-6273
F: 1-800-547-9413

Contact

Visit

§Stemline Therapeutics, Inc. does not influence or advocate for the use of any one distributor and makes no representation or guarantee of services or coverage of any product.

Stemline Commercial Co-Pay Program Terms and Conditions

By using the Stemline Commercial Co-Pay Program, the patient acknowledges and confirms that, at the time of usage, (s)he is currently eligible and meets the criteria set forth in the terms and conditions described. The Stemline Commercial Co-Pay Program is valid ONLY for patients with commercial (private or nongovernmental) insurance who are taking the medication for an FDA-approved indication. Patients using Medicare, Medicaid, or any other federal or state government-funded program to pay for their medications are not eligible. Patients who start utilizing their government coverage during their enrollment period will no longer be eligible for the program. Patients may pay as little as $0 per month and Stemline Therapeutics, Inc. will pay the remaining out-of-pocket cost up to a maximum of $25,000 per calendar year. Any costs exceeding the maximum of $25,000 are the responsibility of the patient. This Commercial Co-Pay Program is not health insurance or a benefit plan. Distribution or use of the Stemline Commercial Co-Pay Program does not obligate use or continuing use of any specific product or provider. Patient or guardian is responsible for reporting the receipt of all Commercial Co-Pay Program benefits or reimbursement received to any insurer, health plan, or other third party who pays for or reimburses any part of the prescription filled using the Commercial Co-Pay Program, as may be required. The Commercial Co-Pay Program is not valid for medications the patient receives for free or that are eligible to be reimbursed by private insurance plans or other healthcare or pharmaceutical assistance programs that reimburse the patient in part or for the entire cost of his/her Stemline medication. Patient, guardian, pharmacist, prescriber, and any other person using the Commercial Co-Pay Program agree not to seek reimbursement for all or any part of the benefit received by the recipient through the offer.

The Stemline Commercial Co-Pay Program will be accepted by participating pharmacies, physician offices, or hospitals. To qualify for the benefits of this Commercial Co-Pay Program, the patient may be required to pay out-of-pocket expenses for each treatment. This Commercial Co-Pay Program is only available with a valid prescription and cannot be combined with any other rebate/coupon, free trial, or similar offer for the specified prescription. Use of this Commercial Co-Pay Program must be consistent with all relevant health insurance requirements and payer agreements. Participating patients, pharmacies, physician offices, and hospitals are obligated to inform third-party payers about the use of the Commercial Co-Pay Program as provided for under the applicable insurance or as otherwise required by contract or law. The Commercial Co-Pay Program may not be sold, purchased, traded, or offered for sale, purchase, or trade. The Commercial Co-Pay Program is limited to 1 per person during this offer period and is not transferable. Program eligibility period is contingent upon the patient’s ability to meet and maintain all requirements as set forth by the program. Stemline Therapeutics, Inc. may periodically verify eligibility and will terminate patients without obligation to pay claims if change to status is detected. This program is not valid where prohibited by law and shall follow state restrictions in relation to AB-rated generic equivalents where applicable (i.e., MA, CA). The patient must be 18 years or older to receive Commercial Co-Pay Program assistance. This Commercial Co-Pay Program is (1) void if reproduced; (2) void where prohibited by law; (3) only valid in the United States and Puerto Rico; (4) only valid for FDA-approved on-label indications of Stemline products; and (5) expires on 12/31/2019. Healthcare providers may not advertise or otherwise use the program as a means of promoting their services or Stemline Therapeutics, Inc. products to patients. Stemline Therapeutics, Inc. reserves the right to rescind, revoke, amend, or terminate the program without notice at any time.

INDICATION

  • ELZONRIS is a CD123-directed cytotoxin for the treatment of blastic plasmacytoid dendritic cell neoplasm (BPDCN) in adults and in pediatric patients 2 years and older

IMPORTANT SAFETY INFORMATION

Boxed WARNING: CAPILLARY LEAK SYNDROME

  • Capillary Leak Syndrome (CLS), which may be life-threatening or fatal, can occur in patients receiving ELZONRIS. Monitor for signs and symptoms of CLS and take actions as recommended

WARNINGS AND PRECAUTIONS

Capillary Leak Syndrome

  • ELZONRIS can cause capillary leak syndrome (CLS), which may be life-threatening or fatal if not properly managed. The overall incidence of CLS in clinical trials was 55% in patients receiving ELZONRIS, including 46% in Grades 1 or 2, 6% in Grade 3, 1% in Grade 4, and 2 fatal events. Common signs and symptoms (incidence ≥ 20%) associated with CLS that were reported during treatment with ELZONRIS include hypoalbuminemia, edema, weight gain, and hypotension
  • Before initiating therapy with ELZONRIS, ensure that the patient has adequate cardiac function and serum albumin is ≥ 3.2 g/dL
  • During treatment with ELZONRIS, ensure that serum albumin levels are ≥ 3.5 g/dL and have not been reduced by ≥ 0.5 g/dL from the albumin value measured prior to dosing initiation of the current cycle. Monitor serum albumin levels prior to the initiation of each dose or more often as indicated clinically thereafter. Additionally, assess patients for other signs or symptoms of CLS, including weight gain, new onset or worsening edema including pulmonary edema, hypotension, or hemodynamic instability
  • Counsel patients to seek immediate medical attention should signs or symptoms of CLS occur at any time

Hypersensitivity Reactions

  • ELZONRIS can cause severe hypersensitivity reactions. Grade 3 or higher events were reported in 10% of patients in clinical trials. Monitor patients for hypersensitivity reactions during treatment with ELZONRIS. Interrupt ELZONRIS infusion and provide supportive care as needed if a hypersensitivity reaction should occur. If the reaction is severe, discontinue ELZONRIS permanently

Hepatotoxicity

  • Elevations in liver enzymes can occur with ELZONRIS. Grade 3 or higher elevations in liver enzymes occurred in approximately 40% of patients in clinical trials
  • Monitor alanine aminotransferase (ALT) and aspartate aminotransferase (AST) prior to each infusion with ELZONRIS. Temporarily withhold ELZONRIS if the transaminases rise to greater than 5 times the upper limit of normal (ULN) and resume treatment upon normalization or when resolved

ADVERSE REACTIONS:

The most common adverse reactions in the clinical trials (incidence ≥ 30%) are capillary leak syndrome, nausea, fatigue, peripheral edema, pyrexia, and weight increase. The most common laboratory abnormalities (incidence ≥ 50%) are decreases in albumin, platelets, hemoglobin, calcium, sodium, and increases in glucose, ALT, and AST.


Please see full Prescribing Information, including Boxed WARNING.


To report SUSPECTED ADVERSE REACTIONS, contact Stemline Therapeutics, Inc. at 1-877-332-7961 or contact the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

IMPORTANT SAFETY INFORMATION

INDICATION

  • ELZONRIS is a CD123-directed cytotoxin for the treatment of blastic plasmacytoid dendritic cell neoplasm (BPDCN) in adults and in pediatric patients 2 years and older

IMPORTANT SAFETY INFORMATION

Boxed WARNING: CAPILLARY LEAK SYNDROME

  • Capillary Leak Syndrome (CLS), which may be life-threatening or fatal, can occur in patients receiving ELZONRIS. Monitor for signs and symptoms of CLS and take actions as recommended

WARNINGS AND PRECAUTIONS

Capillary Leak Syndrome

  • ELZONRIS can cause capillary leak syndrome (CLS), which may be life-threatening or fatal if not properly managed. The overall incidence of CLS in clinical trials was 55% in patients receiving ELZONRIS, including 46% in Grades 1 or 2, 6% in Grade 3, 1% in Grade 4, and 2 fatal events. Common signs and symptoms (incidence ≥ 20%) associated with CLS that were reported during treatment with ELZONRIS include hypoalbuminemia, edema, weight gain, and hypotension
  • Before initiating therapy with ELZONRIS, ensure that the patient has adequate cardiac function and serum albumin is ≥ 3.2 g/dL
  • During treatment with ELZONRIS, ensure that serum albumin levels are ≥ 3.5 g/dL and have not been reduced by ≥ 0.5 g/dL from the albumin value measured prior to dosing initiation of the current cycle. Monitor serum albumin levels prior to the initiation of each dose or more often as indicated clinically thereafter. Additionally, assess patients for other signs or symptoms of CLS, including weight gain, new onset or worsening edema including pulmonary edema, hypotension, or hemodynamic instability
  • Counsel patients to seek immediate medical attention should signs or symptoms of CLS occur at any time

Hypersensitivity Reactions

  • ELZONRIS can cause severe hypersensitivity reactions. Grade 3 or higher events were reported in 10% of patients in clinical trials. Monitor patients for hypersensitivity reactions during treatment with ELZONRIS. Interrupt ELZONRIS infusion and provide supportive care as needed if a hypersensitivity reaction should occur. If the reaction is severe, discontinue ELZONRIS permanently

Hepatotoxicity

  • Elevations in liver enzymes can occur with ELZONRIS. Grade 3 or higher elevations in liver enzymes occurred in approximately 40% of patients in clinical trials
  • Monitor alanine aminotransferase (ALT) and aspartate aminotransferase (AST) prior to each infusion with ELZONRIS. Temporarily withhold ELZONRIS if the transaminases rise to greater than 5 times the upper limit of normal (ULN) and resume treatment upon normalization or when resolved

ADVERSE REACTIONS:

The most common adverse reactions in the clinical trials (incidence ≥ 30%) are capillary leak syndrome, nausea, fatigue, peripheral edema, pyrexia, and weight increase. The most common laboratory abnormalities (incidence ≥ 50%) are decreases in albumin, platelets, hemoglobin, calcium, sodium, and increases in glucose, ALT, and AST.


Please see full Prescribing Information, including Boxed WARNING.


To report SUSPECTED ADVERSE REACTIONS, contact Stemline Therapeutics, Inc. at 1-877-332-7961 or contact the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.