Support

Prescribing FILSUVEZ
Chiesi Total Care
FILSUVEZ Friends
Patient resources

Prescribing FILSUVEZ

Getting your patient started with FILSUVEZ is simple

Fill out the Prescription Form and Patient Enrollment Form

Once you have completed the forms:

1. Attach copies of patient insurance and prescription cards – front and back.

2. First prescription for the patient:

THE FIRST COPY OF THE FORM MUST BE FAXED FOR EACH PATIENT. Fax completed form to Chiesi Total Care^℠ at 1-877-914-0591. PLEASE COMPLETE ONE FORM PER PATIENT.

3. Subsequent prescriptions:

After the initial script is filled, future prescriptions can be made via telephone or e-script. If you wish to send additional forms via e-script please search for "PANTHERx" in your EMR/HMR’s e-prescribing software.

Prescription Form Patient Enrollment Form

Chiesi Total Care

For your patient to be eligible, you must first submit a prescription for FILSUVEZ to the specialty pharmacy

Chiesi Total Care^SM simplifies access and support so your focus can be on progress

Chiesi Total Care helps families start FILSUVEZ, streamlines access, and provides ongoing support throughout the FILSUVEZ treatment journey.

Learn more at 1-833-670-6464,
Monday through Friday, 8 AM to 8 PM ET.

Access patient support

The Chiesi Total Care Program assists with:

Insurance Consultation and Financial Support^*†

Treatment Support & Logistics Coordination

Nursing Support & Personalized Education

Dedicated Total Care Team

Eligible patients may pay
as little as a $0 copay

^*Patients participating in a government healthcare plan are not eligible for financial assistance programs.

^†Please refer to the full Terms and Conditions for eligibility requirements.

See what Chiesi Total Care has to offer

Get your patient started

FILSUVEZ Friends

One-on-one support from a FILSUVEZ Friends patient or caregiver^‡

Living with DEB or JEB can feel isolating for both patients and caregivers. FILSUVEZ Friends was created to support patients who are considering or have not yet started treatment, as well as their caregivers, by providing encouragement and helping them build meaningful connections as they navigate life with EB and FILSUVEZ treatment.

See how your patient can get involved in FILSUVEZ Friends

Learn more

^‡Participants must be at least 18 years of age or accompanied by a parent or guardian and reside in the United States. FILSUVEZ Friends patients and caregivers do not provide medical advice and only share their personal experiences. Conversations are not meant to take the place of discussions with healthcare providers.

Patient resources

Watch a wound care-certified nurse from the specialty pharmacy explain what you and your patients should know about treatment with FILSUVEZ