Qbrexza™ Affordability Assistance
Patients with a prescription for Qbrexza™ should be able to get that prescription filled at local pharmacies including CVS and Walgreens stores, at canadian pharmacies contained within larger retail outlets (like Walmart), or by mail order.
The company that makes Qbrexza™ is Dermira, Inc. based in Menlo Park, California. To help many axillary (underarm) hyperhidrosis patients* access Qbrexza™, Dermira has a savings and support program called DermiraConnect that includes a single, easy-to-use Qbrexza™ Copay Card that you* can receive three different ways:
- From your healthcare provider
- By downloading a card online
- By calling DermiraConnect at 1-877-DERMIRA (1-877-337-6472).
Once you have received your Qbrexza™ Copay Card, you can activate it by:
- Visiting Qbrexza.com's DermiraConnect page
- Calling DermiraConnect at 1-877-DERMIRA (1-877-337-6472)
- Showing your card, a photograph of your card on your phone, or a “digital wallet” version of your card to your pharmacist.
Depending on your healthcare coverage* (commercially insured, under-insured, or un-insured), the Qbrexza™ Copay Card:
- Helps to lower copay amounts for insured patients: Commercially insured patients should pay as little as $35 per prescription fill (for a 1-month supply of Qbrexza™) at the pharmacy. Some patients may pay less than $35, depending on their insurance. (With a maximum savings up to $200 per fill, $2500 maximum program limit until 12/31/19.)
- Helps make out-of-pocket costs more affordable for un/under-insured patients: Un/under-insured patients should pay no more than $70 per prescription fill (for a 1-month supply) at the pharmacy.
Ready to get started?
Hyperhidrosis sufferers should visit DermiraConnect to:
- Receive and activate a Qbrexza™ Copay Card (Remember, you can also activate your Qbrexza™ Copay Card by showing it, or a virtual image of it, to your pharmacist.)
- Perform an electronic benefits check, and find out if your insurance covers Qbrexza™ and about copay amounts.
- Web chat with a service representative for a benefits check and more (available 8am-8pm ET).
- Learn about Qbrexza™ mail-order options.
- Find a physician ready to prescribe Qbrexza™ to appropriate patients.
Having difficulty getting online or have more questions? You can also call DermiraConnect at 1-877-DERMIRA (1-877-337-6472) to accomplish all of the above. Or, if you prefer email, contact Support@DermiraConnect.com.
- Receive CoverMyMeds prior authorization support
- Perform electronic benefits checks for patients
- Access a prior authorization checklist
- Web chat with a service representative (available 8am-8pm ET)
- Download practical forms, including: a Sample Letter of Medical Necessity and a Sample Letter of Appeal.
Have a medical question related to Qbrexza™? We encourage you to reach out to your prescribing physician. Or, in the case of a medical emergency, call 911 or go to the nearest hospital emergency department.
For additional non-emergent medical questions or concerns, contact Dermira Medical Information at (877) 337-5553 or DermiraMedInfo@ashfieldhealthcare.com. The Dermira Medical Information lines should be used to report adverse events or side effects or to ask questions about safety, use, disposal, or dosing.
*Please note that according to the Qbrexza website, the Qbrexza™ Copay Card "is valid ONLY for patients with commercial (private or non-governmental) insurance or patients with no insurance. Patients enrolled in Medicare, Medicaid, Medigap, TRICARE, the Department of Veterans Affairs healthcare program, or any other federal or state government-funded healthcare program (“Government Programs”) are not eligible." Eligible patients must be residents of the United States, and the patient, or the patient's parent or guardian, must be 18 years or older to receive Qbrexza™ Savings Card assistance.
L74.5 - Focal Hyperhidrosis (L74.5 and L74.51 should not – however - be used for reimbursement purposes as there are multiple more specific codes)
L74.51 - Primary Focal Hyperhidrosis
L74.510 - Primary Focal Hyperhidrosis, Axilla
L74.511 - Primary Focal Hyperhidrosis, Face
L74.512 – Primary Focal Hyperhidrosis, Palms
L74.513 – Primary Focal Hyperhidrosis, Soles
L74.519 – Primary Focal Hyperhidrosis, Unspecified
L74.52 - Secondary Focal Hyperhidrosis
L74.8 - Other Eccrine Sweat Disorders
L74.9 - Eccrine Sweat Disorder Unspecified