RxAssist Home
RxAssist Home Home  |  About Us  |  Contact RxAssist          
      Patient Assistance Program Center

Program Details

Sanofi and Regeneron Pharmaceuticals, Inc.
Dupixent MyWay Program

Dupixent (dupilumab injection)
Phone: 1-844-387-4936 Provider Phone:
Fax: 1-844-387-3970 Website: Program Website
Eligibility Info:
  • Patient must be uninsured or underinsured.
  • Patients with Medicare Part D should contact the program.
  • Program also providers co-pay assistance.
  • Income at or below: Not Published
    Medical expenses can be deducted from reported income: Not Published
    Social security requested on form: No
    US citizenship/residency specified: Yes
    Attachments Required: Financial
    Physician License #
    Prescriber Signature
    Application may be
    Eligibility determination
    letter sent:
    Not Published
    Receives: Varies
    Shipped To: Patient
    Quantity in Shipment: Not Published
    Delivery Time: Not Published
    Re-application Policy: New application every 12 months
    Refill Policy: Not Published
    Other Information:

    Last Updated: 06/15/2022




    Application Forms
    & Instructions

    The following documents are provided in interactive PDF format, allowing you to type information directly into the form.

    Document Dupixent Enrollment Form - ENT/Pumonologist

    Document Dupixent Enrollment Form - Dermatologists

    Document Dupixent Enrollment Form - Allergists

    Document Dupixent Enrollment Form - Gastroenterologists


    Print-friendly version

    This information is for informational purposes only and is not meant to be a substitute for professional medical advice, diagnosis or treatment. Neither RxAssist nor RxVantage is offering advice, recommending or endorsing any specific prescription drug, pharmacy or other information on the site. Neither RxVantage nor RxAssist provide any warranty for any of the pricing data or other information. Please seek medical advice before starting, changing or terminating any medical treatment. Third party logos, trademarks, brand names and images contained on rxassist.org or rxvantage.com are for demonstration purposes only and are owned by their respective rights holders, who are not affiliated with this Site.

    Copyright © 2022, RxVantage, all rights reserved.