Question 1

How can I lower the cost of my sirolimus

Accepted Answer

You can lower cost of your sirolimus using one of the 4 following drug savings programs: Rx Advantage Card for sirolimus, Canadian Prescription Savings for sirolimus, sirolimus Drug Coupons, sirolimus Patient Assistance Programs

Question 2

What dosages is sirolimus available in?

Accepted Answer

sirolimus is available as a 0.5 mg, 1 mg, and 2 mg oral tablet and a 1 mg/ml oral solution.

Question 3

What is sirolimus used for?

Accepted Answer

sirolimus is an immunosuppressant that is used to treat: Prevention of kidney transplant rejection Treatment of lymphangioleiomyomatosis (LAM)

Question 4

How does sirolimus work?

Accepted Answer

sirolimus is an immunosuppressant that lowers the activity of your immune system. You need a suppressed (lowered) immune system after receiving a transplant so your body doesn’t reject the new kidney.

Question 5

How do I take sirolimus?

Accepted Answer

sirolimus is typically taken as 6 mg or 15 mg by mouth on the day after your transplant, followed by 2 mg or 5 mg by mouth every day. For lymphangioleiomyomatosis, the typical starting dose is 2 mg by mouth every day. Your provider will likely measure the level of medication in your blood after a few weeks and will adjust your dose accordingly.

Question 6

Is it safe for me to take sirolimus?

Accepted Answer

sirolimus is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you.

Question 7

sirolimus Common Side Effects

Accepted Answer

Common side effects of sirolimus:  Swelling in arms and legs More cholesterol and fat in the blood High blood pressure Change in kidney labs Constipation Headache Pain Stomach pain Urinary tract infection

Question 8

sirolimus Serious Side Effects

Accepted Answer

Serious side effects are rare with sirolimus. Contact your healthcare provider immediately if you experience any of the following.  Infection: fever, chills, fatigue, muscle aches Serious lung problems (interstitial lung disease): breathing problems, chest pain, cough, tiredness Serious allergic reaction: trouble breathing, swelling of the face, tightening of the throat, rash, hives, welts, peeling or blistering skin

Question 9

Effects of other drugs, drug classes and over-the-counter products on sirolimus

Accepted Answer

The following medications may interact with sirolimus:  Avoid concomitant use with strong CYP3A4/P-gp inducers or strong CYP3A4/P-gp inhibitors that decrease or increase sirolimus concentrations See full prescribing information for complete list of clinically significant drug interactions

Question 10

Who makes sirolimus?

Accepted Answer

Various FDA-approved generic manufacturers

Question 11

Is sirolimus safe in pregnancy?

Accepted Answer

sirolimus should be used during pregnancy only if the potential benefit outweighs the potential risk to the embryo/fetus.

Question 12

What is the brand name for sirolimus?

Accepted Answer

RAPAMUNERAPAMUNE ORAL SOLUTION

Question 13

How can NowPatient help me to lower the cost of my sirolimus prescription?

Accepted Answer

After you create a FREE account with NowPatient, you will have access to 4 programs that can help lower the cost of your sirolimus prescription

Applicability to each program will be dependent on your insurance status.

Question 14

How do the NowPatient sirolimus savings programs work?

Accepted Answer

After you have created your FREE account with NowPatient, you can access the various programs from your account dashboard. Each program has clear instructions on how to check your eligibility. You can see how the process works by clicking on the feature link below and seeing the ‘How it works’ steps.

Drug Coupon and Patient Assistance Programs require an eligibility quiz to be completed.

Question 15

Are the NowPatient sirolimus savings programs suitable for everyone, regardless of insurance status?

Accepted Answer

No. Each program has its own eligibility and applicability requirements. The table below shows if a program is available to you, based on your insurance status.

	Rx Advantage Card* for sirolimus	Canadian Prescription Savings* for sirolimus	sirolimus Drug Coupon*	sirolimus Patient Assistance Program*
Insured (federal, state or government)	Available	Available	Not Available	Available If Offered by Pharmaceutical Company
Insured (Commercial or Private)	Available	Available	Available If Offered by Pharmaceutical Company	Available If Offered by Pharmaceutical Company
Uninsured	Available	Available	Not Available	Available If Offered by Pharmaceutical Company
Insured but without pharmacy benefit or drug coverage	Available	Available	Not Available	Available If Offered by Pharmaceutical Company

*This is not insurance.

Question 16

Are the NowPatient drug savings programs suitable for brand and generic versions of sirolimus?

Accepted Answer

No. Each program has applicability requirements. Please see below

	Rx Advantage Card* for sirolimus	Canadian Prescription Savings* for sirolimus	sirolimus Drug Coupon*	sirolimus Patient Assistance Program*
Brand	Yes	Yes	Yes, If Offered by Pharmaceutical Company	Yes, If Offered by Pharmaceutical Company
Generic	Yes	Yes	No	No

*This is not insurance.

Question 17

If you have Medicare Part D or Medicare Advantage and none of the sirolimus savings options are applicable or affordable for me, what can you do?

Accepted Answer

If you are insured with Medicare and the sirolimus drug savings options are not applicable to you and still remain unaffordable, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

The government site is easy to use and after you have selected your state, it will navigate you to the appropriate contact point to make the application. State Medicaid programs may cover the full cost of your medication.

People who qualify for both Medicare and Medicaid are called ‘dual eligibles’.

If you are denied Medicaid for sirolimus, and you are still unable to afford your copay or co-insurance element (for example if you are in the coverage gap or Donut Hole) then you may be eligible for a federal support program like Low Income Subsidy. To be eligible for Low Income Subsidy, you need to be a resident in one of the 50 States or the District of Columbia. You can check eligibility online at SSA Medicare D Extra Help. You can also call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).

Question 18

I am uninsured or underinsured and none of the sirolimus prescription saving options are applicable or affordable for me, what can I do?

Accepted Answer

If you are uninsured or underinsured (for example, sirolimus is not covered by your plan) and the drug savings options are not applicable or still unaffordable, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

The government site is easy to use and you can select your state and it will navigate you to the appropriate contact point to make the application. State Medicaid programs may cover the full cost of your medication.

If you are denied and all else fails, and if you have been prescribed sirolimus for an FDA-approved indication, you can call the pharmaceutical company to see if they have any other assistance programs.

Question 19

I am commercially or privately insured and none of the sirolimus prescription saving options are applicable or affordable for me, what can I do?

Accepted Answer

If your medication is not covered by your plan, you can appeal your insurance company’s decision. Sometimes, a formal appeal can result in the drug being covered if it is deemed medically necessary.

If you cannot afford your copay contribution, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

However, being privately insured might complicate your eligibility for Medicaid, as having private insurance may be considered in the financial eligibility assessment.

The government site is easy to use and you can select your state and it will navigate you to the appropriate contact point to make the application. If you qualify, state Medicaid may cover the full cost of your medication.

Question 20

If I have federal, state or commercial insurance and none of the sirolimus prescription saving options are applicable or affordable for me, are there any other support organisations that can help me with my co-insurance or copay contributions?

Accepted Answer

If you have already tried Medicaid and received a denial letter or if you are insured with Medicare and have been denied Low-Income Subsidy, then you can try one of the following organizational support programs:

1. Patient Access Network Foundation (PAN) assistance for sirolimus

If you are having trouble paying for your sirolimus medication due to unaffordable copays or deductibles, the Patient Access Network Foundation (PAN), may be able to assist you. To qualify for PAN assistance for sirolimus you will need to meet one or all of the following criteria:

Your income is below 400% of the federal poverty level
sirolimus is prescribed for an approved FDA indication
You live in and receive treatment in the United States or U.S. territories, even if you do not have U.S. citizenship
You have Medicare insurance coverage that covers sirolimus
If sirolimus is listed on PAN’s list of covered medications

You can check the Patient Access Network Foundation Website for more information.

2. HealthWell Foundation Copay Program for sirolimus

If you are having trouble paying for your sirolimus medication due to unaffordable copays or deductibles, the HealthWell Foundation Copay Program may be able to assist you. To qualify for assistance for sirolimus you will need to meet the following criteria:

You live in and are being treated in the United States
You are insured and your plan covers sirolimus
If sirolimus is listed on the HealthWell Foundation’s list of covered medications

You can check the HealthWell Foundation Website for more information.

3. Patient Advocate Foundation Co-Pay Relief Program for sirolimus

Patient Advocate Foundation’s Co-Pay Relief program exists to help reduce the financial distress you or your family may face when paying for your sirolimus treatment. If you qualify and can demonstrate the need, the foundation will provide you with direct payment covering co-pays, co-insurance, and deductibles. To qualify for assistance for sirolimus you will need to meet the following criteria:

You must be currently insured and have coverage for sirolimus
You must have a confirmed diagnosis and treatment plan
You must reside and receive treatment in the United States
Your Income must fall at or below 300% or 400% of the Federal Poverty Guideline (FPG) with consideration for the Cost of Living Index (COLI) and number in the household
Applications can also be completed by contacting the program sponsor, toll-free at 866-512-3861.

You can check the Patient Advocate Foundation Website for more information.