You prescribe.
We deliver.
DYANAVEL Delivered in 2 easy steps:
GUARANTEED AVAILABILITY
- Perigon Pharmacy 360 will ensure that DYANAVEL XR tablets are always available for your patients–in all approved doses
FULL PATIENT SUPPORT
- Perigon Pharmacy 360 will manage all insurance paperwork for the program
- Patients get refill reminders, choice of delivery options, answers to program questions, and more!
LOW PRICE
- $25 per month with copay savings program* for commercially-insured patients with DYANAVEL coverage
- $100 per month for all eligible patients who choose to pay cash*
- Savings will be applied automatically for all eligible patients
FREE & FAST DELIVERY
- Quick turnaround with most deliveries scheduled in as little as a day
- Patients will have access to a free Quick Start program in case of delays*
- Perigon Pharmacy 360 will dispense DYANAVEL XR tablets as written
- Patients can have DYANAVEL XR tablets delivered directly to their door
- No delivery fee
Note: Not available for delivery to all areas. Program not for patients in California, Washington DC and Puerto Rico.
* Restrictions apply, please see details below.
Questions? We also deliver answers.
Perigon Pharmacy 360 will have a Care Delivery team available to answer questions about the DYANAVEL Delivered program on weekdays from 9 AM-6 PM ET.
Fax: 1.844.733.3779
All offer amounts are for a maximum of a 30-day supply of product.
*RESTRICTIONS:
All DYANAVEL XR tablet savings offers are valid only in the United States and Puerto Rico. By using these offers, the patient certifies that he or she will comply with any terms of his or her health insurance contract requiring notification to his or her payer of the existence and/or value of the offers. It is illegal to (or offer to) sell, purchase, or trade these offers. These offers are not transferable and is limited to one offer per person per prescription. Void where prohibited by law. Tris Pharma reserves the right to rescind, revoke, or amend these offers without notice at any time.
Patients with government insurance includes all patients who are a member, recipient or beneficiary of a government healthcare program such as Medicaid, a Medicare drug benefit plan, TRICARE, or other federal or state health programs (such as medical assistance programs).
Copay Savings Program: This offer is for patients with commercial or private insurance only and not for patients with government insurance. Copay for high deductible plans may vary. Cash Discount Cards and other non-insurance plans are not valid as primary under this offer. If the patient is eligible for drug benefits under any such program, the patient cannot use this offer.
Cash Offer: This offer is available to patients if they have no insurance or are underinsured such that the patient’s applicable insurance does not adequately cover the cost of DYANAVEL. Only valid through the DYANAVEL Delivered by Perigon program.
Not for patients with prescription insurance through State Medicaid or Managed Medicaid plans. For patients with other government insurance, the patient must agree in writing to not submit a claim for reimbursement to any government insurance program and commit to paying the cash price though the end of the defined plan year. Patients may not count the cash price paid via the Cash Offer as an expense incurred for purposes of determining out-of-pocket costs for any government insurance plan, including true out-of-pocket costs (TrOOP), for purposes of calculating the out-of-pocket spending threshold or triggering catastrophic coverage for Medicare Part D plans.
Quick Start Offer: This offer is available to patients who are new to DYANAVEL tablet therapy, have a valid prescription, have commercial or government insurance that does not exclude participation in the program, and have an ongoing (>24 hours) coverage-decision delay after submission of a completed prior authorization or other similar reimbursement request. This offer is limited to one use per patient per lifetime and is non-transferable. By redeeming this offer, patient certifies that they have not previously filled a prescription for DYANAVEL tablet. The Quick Start Program for the specified prescription cannot be combined with any other rebate/coupon, free trial, or similar offer. No substitutions are permitted. Patient is responsible for applicable taxes, if any. Only valid through the DYANAVEL Delivered by Perigon program.
Patients cannot seek reimbursement for DYANAVEL supplied to the patient via the Quick Start Program from health insurance or any third party, including state or federally funded programs. Patients may not count the DYANAVEL supplied to the patient via the Quick Start Program as an expense incurred for purposes of determining out-of-pocket costs for any government insurance plan, including true out-of-pocket costs (TrOOP), for purposes of calculating the out-of-pocket threshold or triggering catastrophic coverage for Medicare Part D plans.
Please see Full Prescribing Information, including Boxed Warning regarding Abuse, Misuse and Addiction.
IMPORTANT SAFETY INFORMATION
WARNING: ABUSE, MISUSE, AND ADDICTION
DYANAVEL XR has a high potential for abuse and misuse, which can lead to the development of a substance use disorder, including addiction. Misuse and abuse of CNS stimulants, including DYANAVEL XR, can result in overdose and death. Before prescribing DYANAVEL XR, assess each patient’s risk for abuse, misuse, and addiction. Educate patients and their families about these risks, proper storage of the drug, and proper disposal of any unused drug. Throughout treatment, reassess each patient’s risk and frequently monitor for signs and symptoms of abuse, misuse, and addiction.
INDICATION
DYANAVEL® XR (amphetamine) is indicated for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in patients 6 years and older.
IMPORTANT SAFETY INFORMATION
WARNING: ABUSE, MISUSE, AND ADDICTION
DYANAVEL XR has a high potential for abuse and misuse, which can lead to the development of a substance use disorder, including addiction. Misuse and abuse of CNS stimulants, including DYANAVEL XR, can result in overdose and death. Before prescribing DYANAVEL XR, assess each patient’s risk for abuse, misuse, and addiction. Educate patients and their families about these risks, proper storage of the drug, and proper disposal of any unused drug. Throughout treatment, reassess each patient’s risk and frequently monitor for signs and symptoms of abuse, misuse, and addiction..
- DYANAVEL XR is contraindicated:
-
- in patients known to be hypersensitive to amphetamine, or other components of DYANAVEL XR. Hypersensitivity reactions, such as angioedema and anaphylactic reactions, have been reported with other amphetamines.
- in patients taking monoamine oxidase inhibitors (MAOIs), or within 14 days of stopping MAOIs (including MAOIs such as linezolid or intravenous methylene blue), because of increased risk of hypertensive crisis.
- Sudden death has been reported in patients with structural cardiac abnormalities or other serious cardiac disease who were treated with CNS stimulants at the recommended ADHD doses. Serious cardiovascular effects with overdose may precipitate sudden cardiac death. Prior to treating patients with DYANAVEL XR, assess for the presence of cardiac disease. Avoid DYANAVEL XR use in patients with known structural cardiac abnormalities, cardiomyopathy, serious cardiac arrhythmia, coronary artery disease, or other serious cardiac disease. Further evaluate patients who develop exertional chest pain, unexplained syncope, or arrhythmias during DYANAVEL XR treatment.
- CNS stimulants cause increase in blood pressure (mean increase about 2 to 4 mm Hg) and heart rate (mean increase about 3 to 6 bpm). Monitor all patients for potential tachycardia and hypertension.
- Use of CNS stimulants may cause exacerbation of pre-existing psychosis and may induce a manic or mixed episode in patients with bipolar disorder. In patients without prior history of psychotic illness or mania, CNS stimulants may cause new psychotic or manic symptoms (e.g., hallucinations, delusional thinking, or mania) at the recommended dosage. Prior to initiating DYANAVEL XR treatment, screen patients for risk factors for developing a manic episode. If new psychotic or manic symptoms occur, consider discontinuing DYANAVEL XR.
- CNS stimulants have been associated with weight loss and slowing of growth rate in pediatric patients with ADHD; monitor weight and height during treatment with DYANAVEL XR. Treatment may need to be interrupted in children not growing as expected.
- CNS stimulants, including DYANAVEL XR, are associated with peripheral vasculopathy, including Raynaud’s phenomenon. Signs and symptoms are usually intermittent and mild; very rare sequelae include digital ulceration and/or soft tissue breakdown. Careful observation for digital changes is necessary during treatment with ADHD stimulants. Further clinical evaluation (e.g., rheumatology referral) may be appropriate for DYANAVEL XR-treated patients who develop signs or symptoms of peripheral vasculopathy.
- Serotonin syndrome risk is increased when co-administered with serotonergic agents (e.g., SSRIs, SNRIs, triptans), MAOIs, and during overdosage situations. If it occurs, discontinue DYANAVEL XR and any concomitant serotonergic agents immediately, and initiate supportive treatment.
- CNS stimulants, including amphetamine, have been associated with the onset or exacerbation of motor and verbal tics. Worsening of Tourette’s syndrome has also been reported. Before initiating DYANAVEL XR, assess the family history and clinically evaluate patients for tics or Tourette’s syndrome. Regularly monitor DYANAVEL XR-treated patients for the emergence or worsening of tics or Tourette’s syndrome and discontinue treatment if clinically appropriate.
- Most common adverse reactions observed with amphetamine products: dry mouth, anorexia, weight loss, abdominal pain, nausea, insomnia, restlessness, emotional lability, dizziness, and tachycardia. Based on limited experience with DYANAVEL XR in controlled trials, the adverse reaction profile of DYANAVEL XR appears similar to other amphetamine extended-release products. The most common (≥2% in the DYANAVEL XR group and greater than placebo) adverse reactions reported in the Phase 3 controlled study conducted in 108 patients with ADHD (aged 6 to 12 years) were: epistaxis (DYANAVEL XR 4%, placebo 0%), allergic rhinitis (4%, 0%) and upper abdominal pain (4%, 2%).
- DYANAVEL XR use during pregnancy may cause fetal harm. To monitor pregnancy outcomes in women exposed to DYANAVEL XR during pregnancy, healthcare providers are encouraged to register patients by calling the National Pregnancy Registry for Psychostimulants at 1-866-961-2388 or visiting online at https://womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/othermedications/.
- Because of the potential for serious adverse reactions in a breastfed infant, breastfeeding is not recommended during treatment with DYANAVEL XR.
- To report SUSPECTED ADVERSE REACTIONS, contact Tris Pharma, Inc. at (732) 940-0358 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Please see Full Prescribing Information for DYANAVEL XR including Boxed Warning regarding Abuse, Misuse, and Addiction.
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