Talk to your healthcare provider about enrolling in Kyowa Kirin Cares to receive assistance navigating access and reimbursement options for Poteligeo® (mogamulizumab-kpkc) injection. As soon as you both enroll, you will be assigned a dedicated oncology nurse who will help you understand your financial options based on your insurance coverage.
If you have commercial insurance, you may be eligible to receive co-pay assistance. Review the terms and conditions to learn if you qualify.a,b
If you have government or military insurance, an oncology nurse will be able to walk you through all available financial options.c
If you do not have insurance, you may be eligible for the Patient Assistance Program.c Review the terms and conditions to learn if you qualify.d
aPatients must be US residents with an active primary commercial plan; patients with federal or state government insurance such as Medicare, Medicaid, and Tricare are not eligible for co-pay assistance. Other terms and conditions may apply.
bCommercially insured patients do not need to participate in Kyowa Kirin Cares to be eligible for co-pay assistance.
cPatients that do not meet the Patient Assistance Program coverage criteria and have special circumstances of financial and/or medical hardship, as determined in accordance with Kyowa Kirin Cares criteria, can request that an exception may be made for them. The decision to grant an exception is based on an individual's unique circumstances and is made solely in the discretion of Kyowa Kirin.
dPatients must be US residents with no active medical or pharmacy benefit insurance and an annual gross income ≤400% of the federal poverty level, confirmed by electronic income verification response or documented proof of income.
Kyowa Kirin Cares is committed to supporting you throughout your journey with Poteligeo. Your dedicated oncology nurse can support you by:
Answering general questions about Poteligeo
Helping you stay on track with your treatments
Providing educational tools and resources
Calling routinely to check in and offer support
Work closely with your Kyowa Kirin Cares oncology nurse and healthcare provider to ensure you are receiving the support you need throughout your journey with POTELIGEO.
Access Kyowa Kirin Cares forms as well as useful Poteligeo information and resources.
To enroll in Kyowa Kirin Cares, download this form, print it out, and bring it with you to your next appointment. Fill it out with your healthcare provider who will then fax it to Kyowa Kirin Cares.DOWNLOAD
If you’re uninsured, you may qualify for the Patient Assistance Program. Download and fill out this form with your healthcare provider who will then fax it to Kyowa Kirin Cares to determine eligibility.DOWNLOAD
POTELIGEO is a prescription medicine used to treat mycosis fungoides (MF) or Sézary syndrome (SS) in adults who have tried at least one prior medicine (taken by mouth or injection) that did not work or in whom the disease has come back.
POTELIGEO may cause serious side effects that can be severe or life-threatening including skin problems, infusion reactions, infections, autoimmune problems, and complications from stem cell transplant.
Call or see your healthcare provider right away if you develop any symptoms of the following problems or if these symptoms get worse:
Skin problems: Signs and symptoms of skin reactions may include skin pain, itching, skin blistering or peeling, rash, painful sores or ulcers in your mouth, nose, throat or genital area.
Infusion reactions: Signs and symptoms of infusion reactions may include chills or shaking, redness on your face (flushing), itching or rash, shortness of breath, coughing or wheezing, dizziness, feeling like passing out, tiredness, fever.
Infections: Signs and symptoms of infection may include fever, sweats or chills, nausea, flu-like symptoms, sore throat or difficulty swallowing, shortness of breath, diarrhea or stomach pain, cough.
Autoimmune complications: Some people receiving POTELIGEO may develop autoimmune problems, and some people who already have an autoimmune disease may get worse during treatment with POTELIGEO.
Complications of stem cell transplant: Patients who receive a stem cell transplant using donor stem cells (allogeneic) after treatment with POTELIGEO may experience complications that can be severe and lead to death. Your healthcare provider will monitor you for signs of complications if you have an allogeneic stem cell transplant.
The most common side effects of POTELIGEO include rash, tiredness, diarrhea, muscle and bone pain, and upper respiratory tract infection.
have had a severe skin reaction after receiving POTELIGEO
have had an infusion reaction during or after receiving POTELIGEO
have or have had liver problems including hepatitis B (HBV) infection
have a history of autoimmune problems
have undergone or plan to have a stem cell transplant, using cells from a donor
have lung or breathing problems
are pregnant or plan to become pregnant
are breastfeeding or plan to breastfeed
Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
Please see Patient Information.
This website and the information contained herein is intended for use by US residents only. The information provided by the oncology nurse and on this website is for informational purposes only and does not constitute medical advice. It is not intended to replace a discussion between a patient and healthcare provider. The submission and completion of reimbursement- or coverage-related documentation is the responsibility of the patient and the healthcare professional.