VELTASSA® (patiromer) for oral suspension

Indication and Usage

VELTASSA is indicated for the treatment of hyperkalemia.
Limitation of Use: VELTASSA should not be used as an emergency treatment for life-threatening hyperkalemia because of its delayed onset of action.

Important Safety Information

Contraindications: VELTASSA is contraindicated in patients with a history of a hypersensitivity reaction to VELTASSA or any of its components. Please see additional Important Safety InformationImportant Safety Information below and full Prescribing Information.

A single point of contact for patient support programs to help your patients quickly start on VELTASSA and stay on therapy

Below you can:

Start here to Get K+onnected

1-844-870-7597

Monday-Friday,
9 am to 8 pm ET

1-888-623-7092

Resources for download

Starter
Rx form

Access now

Letter of
medical necessity

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Letter of
appeal

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Formulary
exception letter

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Tiering exception
letter

Access now

Downloadable letters are editable templates. Please be sure to replace all content shown in brackets with appropriate information, check the letter for accuracy, and then print it on your letterhead. These templates are provided for informational purposes and should not be construed as a guarantee of coverage or reimbursement.

Enroll your patients in VELTASSA K+onnect today

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Patients
Started
Right
Away
 

Explore
Potential
Financial
Support
Programs
 

Arrange
Direct
Delivery
To The
Patient
 

What people are saying about VELTASSA K+onnect

VELTASSA K+onnect makes getting started easier

You may get patients started right away by submitting a completed Starter Rx form with prescription...then we will help coordinate the next steps

Enroll in VELTASSA K+onnect

Trial supply

Free trial supply (up to 20 days) available upon HCP request for patients prescribed VELTASSA for the treatment of hyperkalemia*

Financial assistance

Assess need and potential eligibility for financial support based on patient’s insurance coverage

Delivery

Specialty pharmacy provider ships prescription directly to patient

Ongoing support

Patient support programs

*VELTASSA Start Program not contingent on purchase. No guarantee VELTASSA will be approved by patient's health plan.

HCP=healthcare professional.

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VELTASSA K<sup class="plus">+</sup>onnect practice insights to avoid delays

BEFORE SUBMITTING THE STARTER Rx FORM

  • Complete the entire form, including the prescription information section
    • Enter the number of refills, as applicable
    • Specify the dosage
  • Sign and date the form*
  • Check the form for completeness and accuracy
  • Before sending your patients for lab tests, consider proactively obtaining
    a patient signature
    on the Starter Rx form; this can ensure access to
    patient services in the future, if necessary

You can also visit www.VELTASSAKonnect.com to enroll your patient electronically. Watch the video  to learn more.

BEFORE YOUR PATIENT LEAVES THE OFFICE

  • Inform the patient that VELTASSA will be shipped directly to their preferred location in refrigerated packaging
  • Tell your patient about the welcome call from VELTASSA K+onnect
  • Direct your patient to call VELTASSA K+onnect to schedule delivery of the welcome kit and free starting supply of VELTASSA
    • VELTASSA K+onnect will contact patients who do not call proactively
    • If they miss our call, patients must call back immediately so the starting supply of VELTASSA can be shipped

When possible, have the patient or patient's legal representative review and sign the Starter Rx form. If they are unable to sign the Starter Rx form, VELTASSA K+onnect will contact them directly. They may also visit www.VELTASSAeconsent.com to provide their authorization electronically.

VELTASSA K<sup class="plus">+</sup>onnect makes getting started easier

VELTASSA START PROGRAM

VELTASSA Start Program

Provides the patient with a FREE trial supply of up to 20 days of VELTASSA

  • Enroll a new patient with hyperkalemia, based on your judgment of medical necessity, by checking “yes” in the VELTASSA Start Program section of the Starter Rx form
  • VELTASSA Start can be delivered to the following locations:
    • The patient’s home
    • The HCP’s office
    • Another facility, such as a dialysis center
  • The VELTASSA Start Program is not contingent on purchase. There is no guarantee VELTASSA will be approved by the patient’s health plan. The free trial program is based on enrollment in VELTASSA K+onnect and is provided before insurance coverage is determined

When possible, patients should proactively call VELTASSA K+onnect at 1-844-870-7597 and dial 0 to schedule delivery of their welcome kit and free starter supply of VELTASSA. Just write “Phone Enrollment” at the top of the Starter Rx form.

If not, VELTASSA K+onnect will contact them directly. The starter supply of VELTASSA cannot be shipped until the patient returns the call to VELTASSA K+onnect.

ONE-STEP ENROLLMENT

  • The Starter Rx form is all you need to get started in one step
  • Components include insurance information, prescription, and patient authorization
  • VELTASSA K+onnect can provide support to patients in more than 200 languages; simply specify preferred language on the Starter Rx form
  • You submit the form; we will help coordinate next steps*

VELTASSA K+onnect will inform the HCP's office if the patient's health plan requires additional documentation, if applicable.

VELTASSA K<sup class="plus">+</sup>onnect services can help patients gain access to therapy

$25 CO-PAY PROGRAM

  • Eligible patients with commercial insurance may qualify for a coupon program that could reduce their co-pay to no more than $25 a month
    • No print coupon required
    • Savings are automatically applied
    • Patients enrolled in a government healthcare prescription drug program such as Medicare Part D or Medicaid are not eligible for the $25 Co-pay Program. This includes the period when patients are in the Medicare Part D coverage gap known as the "donut hole"
    • Services subject to terms and conditions. Please contact VELTASSA K+onnect for more information
  • Co-pay Program enrollment is available through VELTASSA K+onnect or certain pharmacies

PATIENT ASSISTANCE PROGRAM

  • Patients who are uninsured or underinsured with financial need may be eligible to receive free medication
  • Available to eligible patients who are enrolled in VELTASSA K+onnect
  • Financial documentation is required

INDEPENDENT THIRD-PARTY FOUNDATION REFERRALS

  • Some patients may be able to receive other financial assistance from other independent third parties
    • Relypsa does not determine the eligibility requirements of programs administered by independent third-party foundations
    • Financial disclosures may be required
  • Patients can call VELTASSA K+onnect to be warm transferred to an independent third-party foundation if appropriate
  • Referral to an independent third-party foundation is not a guarantee of co-pay assistance
  • Call VELTASSA K+onnect to learn more about the eligibility requirements for foundation support

VELTASSA K<sup class="plus">+</sup>onnect can offer support to patients when they need it

NURSE ADVOCATE SUPPORT

  • Patients will receive a welcome call from a Nurse Advocate
  • Nurse Advocates arrange for delivery of VELTASSA through the VELTASSA Start Program (if applicable)
  • Patients are provided a toll-free hotline to a Nurse Advocate to answer their general questions about the product and disease-state information, as well as provide ongoing informational support

CASE MANAGER SUPPORT

  • Case Managers specialize in helping patients understand their health plan coverage, including potential financial assistance options
  • A toll-free support hotline provides easy access to a Case Manager
  • Case Managers can also assist HCP offices with benefits investigations and information regarding the PA and appeals process

STAY-ON-TRACK PROGRAM

  • Stay-on-Track Program communications include:

Educational materials

 

Recipes to support a
low-potassium diet

Reminders about taking
their medications

All patients taking VELTASSA can call VELTASSA K+onnect directly to self-enroll in the Stay-on-Track Program

VELTASSA K+onnect does not provide medical advice. Patients should consult their HCP if they have any questions about their health or treatment.

VELTASSA is available through specialty and retail pharmacies

In-network specialty pharmacy

(through VELTASSA K+onnect)

  • Starter Rx form
  • Physician portal
  • Direct delivery to patient

Non-network specialty pharmacy

  • ePrescribe
  • Paper prescriptions
  • Direct delivery to patient

Retail pharmacy

  • ePrescribe
  • Paper prescriptions
  • Patient picks up at local pharmacy

Non-network and retail pharmacy patients who need additional assistance can contact your office or call VELTASSA K+onnect directly to enroll*

Patients who fill their prescriptions at a non-network specialty pharmacy or retail pharmacy are not eligible for the VELTASSA Start Program.

VELTASSA is available in both retail and specialty pharmacies.
Learn more

Discover the VELTASSA K+onnect Physician Portal

VELTASSA is FDA approved and available for prescription

Please contact your VELTASSA representative or VELTASSA K+onnect at 1-844-870-7597, Monday through Friday, 9 am to 8 pm ET for additional information about the program and how your patients can access VELTASSA.

Important Safety Information

Contraindications: VELTASSA is contraindicated in patients with a history of a hypersensitivity reaction to VELTASSA or any of its components.

Worsening of Gastrointestinal Motility: Avoid use of VELTASSA in patients with severe constipation, bowel obstruction or impaction, including abnormal post-operative bowel motility disorders, because VELTASSA may be ineffective and may worsen gastrointestinal conditions. Patients with a history of bowel obstruction or major gastrointestinal surgery, severe gastrointestinal disorders, or swallowing disorders were not included in clinical studies.

Hypomagnesemia: VELTASSA binds to magnesium in the colon, which can lead to hypomagnesemia. In clinical studies,
hypomagnesemia was reported as an adverse reaction in 5.3% of patients treated with VELTASSA. Approximately 9% of patients in clinical
trials developed hypomagnesemia with a serum magnesium value <1.4 mg/dL. Monitor serum magnesium. Consider magnesium
supplementation in patients who develop low serum magnesium levels.

Adverse Reactions: The most common adverse reactions (incidence ≥2%) are constipation, hypomagnesemia, diarrhea, nausea,
abdominal discomfort and flatulence. Mild to moderate hypersensitivity reactions were reported in 0.3% of patients treated with
VELTASSA and included edema of the lips.