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Prior Authorization (PA)
Many health plans require a prior authorization (PA) for the use of LUCENTIS® (ranibizumab injection). This way they can be sure it is being given only to members meeting specific medical criteria. LUCENTIS® Access Solutions can help your practice identify whether a PA is needed and assist you in the process while you obtain it. All we need to begin are a completed and signed Statement of Medical Necessity form and requesting our assistance with the PA as well as a signed and dated Patient Authorization and Notice of Release of Information form.
LUCENTIS Access Solutions can help you compile the required forms so you can documentation so you can submit them to the health plan. If the plan approves the PA, LUCENTIS can be supplied through buy and bill or a specialty pharmacy (SP). If the PA is not granted, LUCENTIS Access Solutions can work with you to determine your next steps. Below is the process you need to follow.
NOTE: If your patient's request for a PA is denied, please see Appeals for more information.
Who is LUCENTIS for?
LUCENTIS® (ranibizumab injection) is a prescription medicine for the treatment of patients with Wet Age-Related Macular Degeneration (AMD) and Macular Edema Following Retinal Vein Occlusion (RVO).
What important safety information should I know about LUCENTIS?
LUCENTIS is a prescription medication given by injection into the eye, and it has side effects. Some LUCENTIS patients have had detached retinas and serious eye infections. LUCENTIS should not be used in patients who have an infection in or around the eye or are allergic to LUCENTIS or any of its ingredients. LUCENTIS patients have had increases in eye pressure within 1 hour of an injection. Serious side effects also include inflammation inside the eye, and rarely, problems related to the injection procedure, such as cataracts. Although not common, some LUCENTIS patients have had strokes or heart attacks. If your eye becomes red, sensitive to light, painful, or has a change in vision, you should call or visit your eye doctor right away. Ask your doctor if you have questions or want more information.
For additional safety information, please talk to your doctor and see the LUCENTIS full prescribing information.
LUCENTIS® is a registered trademark and the Access Solutions logo and the Access Solutions Treatment made possible logo are trademarks of Genentech USA, Inc.
