Click to find resources below for each of the following:
Help your patients determine which plans may cover TYMLOS:
The search tool below may help you and your patients figure out which insurance plans cover a TYMLOS prescription, and at what tier. To find out if your patient's plan is listed, select her state, region, and the name of her plan. Please note that this tool is provided and maintained by Managed Markets Insight & Technology, LLC and is not managed by Radius Health.
There are many different factors that determine the cost of a drug, how much an insurance company may pay toward the medication, and the amount a patient will be required to pay out-of-pocket. Please contact the patient's insurer or plan administrator directly if you have any questions, or if a plan is not listed.
If TYMLOS is not covered under your patient's insurance plan, you can advise her to call 1-866-896-5674 to learn about RadiusAssist, a patient assistance program that may be available to patients who cannot afford their medication.
For your office
Sample of Prior Authorization (PA) Cover Letter
Some health plans require a PA request form in order to satisfy their policy requirements to obtain TYMLOS coverage. Use this sample letter as a template to help you get started.
Sample Letter of Appeal
If a health plan denies TYMLOS coverage, they may require a letter of appeal along with a letter of medical necessity in order to reconsider the decision. This template can help you write your own letter of appeal.
Sample Letter of Medical Necessity (LMN)
Some health plans require a letter of medical necessity in addition to a letter of appeal that may help justify the clinical rationale for covering TYMLOS. Use this template to write a letter of medical necessity.
Radius Health, Inc. has partnered with CoverMyMeds to help you initiate electronic PA requests with ease in a paperless, secure, and HIPAA-compliant manner.
For interacting with a Specialty Pharmacy
5 Steps to TYMLOS Fulfillment
This brochure provides an overview of the 2 fulfillment pathways for patients to receive TYMLOS, as well as a simple 5-step process for how to fill the TYMLOS prescription.
For your patients
Eligible commercially insured patients may qualify for a program that offers savings. With the savings card, your patients may be eligible to pay out-of-pocket costs as low as $0 per month, with a maximum annual savings of $6,000. Please see eligibility, rules, and restrictions on the savings card.
This brochure will help your patients understand postmenopausal osteoporosis as a disease, its associated risk factors, and the role TYMLOS plays in treating PMO. Inside she can find information on the TYMLOS patient support program, directions on storage and use, and how to access a savings card.