Choosing where LEQVIO is administered determines how it will be acquired

How do you get your patients started on LEQVIO?

Watch Dr Rajkumar Sugumaran, Dr Suzanne Shugg, and Dr Prediman K. Shah discuss the flexible pathways available for acquisition and administration to patients.

Out-of-Office Administration

Administration takes place at a site other than your office* 

Practice locates and refers the patient to an Alternate Site of Care, which then handles the following:

• Benefits verification 
• Prior authorization support
• Acquisition of LEQVIO
• Administration of LEQVIO
• Submitting claims for reimbursement 

A system hospital outpatient department (HOPD) may act as an Alternate Site of Care. It's important to understand system requirements before sending the LEQVIO patient to that facility

*May include a clinic, hospital outpatient department, or another physician’s office.

LEQVIO via referral to an Alternate Injection Center (AIC)

If buy-and-bill is not your method of choice for acquiring LEQVIO, get details on how you can refer patients to an AIC or Alternate Site of Care (ASOC) to handle ordering, administration, and reimbursement for all services.

Buy-and-bill

Administration takes place in your office (Medical Benefit)

• Buy-and-bill is an option for acquiring drugs covered under the medical benefit that are administered by a health care provider
• Drugs covered under Medicare Part B (fee-for-service) must be acquired through this method

1. Verify benefits
   • HCP/office staff confirms the patient’s benefits with their insurance plan
2. Order LEQVIO through a distributor
   • HCP/office staff orders LEQVIO, assuming responsibility for storing and handling. A list of authorized LEQVIO distributors can be found below. If your practice is part of a system that uses a central purchasing model, then the buy-and-bill process steps may not apply
3. Administer LEQVIO
   • HCP administers LEQVIO in their office
4. Submit claim
   • HCP/office staff submits claim to payer for reimbursements
5. Manage reimbursement 
   • HCP/office staff receives reimbursement from payer and collects balance due (if any) from patient

Learn More

Download Buy-and-Bill 5-Step Guide

LEQVIO via buy-and-bill with in-office administration

Find out more about acquiring HCP-administered products like LEQVIO through buy-and-bill, the primary method of acquisition.

LEQVIO distributors

If you intend to buy-and-bill, LEQVIO can be ordered through our authorized distributors.

Novartis does not recommend the use of any particular distributor.

Group purchasing organizations

If you intend to work with a group purchasing organization (GPO), you can order through the following companies.

Novartis does not recommend the use of any particular group purchasing organization.

^†IPN Solutions, also known as Specialty Practice Network, includes International Rheumatology Network (IRN), International Gastroenterology Network (IGN), and International Cardiology Network (ICN).

Specialty Pharmacy (SP)

Administration takes place within your office via an SP

• A patient’s plan may restrict drug coverage under the pharmacy benefit using an SP
• LEQVIO ordered through an SP must be given to the specific patient for whom it was ordered (unlike through buy-and-bill, in which LEQVIO can be given to any patient for whom it’s prescribed)

THE SP PROCESS

Patient’s plan restricts coverage to the pharmacy benefit, or HCP prefers this pathway and the patient is eligible for the pharmacy benefit

1. Send RX - HCP sends prescription via e-prescribing platform to SP
2. Benefits verification (BV) - SP conducts BV, receives Statement of Benefits, and coordinates prior authorization of precertification as needed
3. Patient payment - Patient pays co-pay/coinsurance or deductible when SP dispenses LEQVIO
4. Send drug - SP sends LEQVIO to HCP practice or as dictated by insurance coverage
5. Store and schedule - HCP practice schedules patient injection visit and stores LEQVIO if needed
6. Administer - HCP administers LEQVIO to the patient
7. Collect for services - HCP practice collects patient co-pay for any services (administration fee)

Specialty Pharmacies

Novartis has made LEQVIO widely available through specialty pharmacies (SP), in the event white-bagging is required or preferred.

The following SPs have self-identified as supporting HCP-administered medical benefit products like LEQVIO. This means they currently support white-bagging for physicians and have familiarity and comfort with processing under both the medical and pharmacy benefits. This may be an option for private payers that offer Medicare Advantage and commercial health plans. Medicare Part B does not apply, as it is mandatory buy-and-bill.

This list of SPs is not comprehensive and other SPs may be available to you and your patients. Inclusion in this list is not an endorsement and Novartis cannot guarantee accuracy of this list or coverage of product. Novartis does not recommend or require the use of any particular pharmacy. Any SP in the LEQVIO distribution network that fits these criteria may be added to this list by contacting [email protected] ↗. This list is periodically updated.

Novartis does not recommend the use of any particular specialty pharmacy.

LEQVIO returns

For HCPs or facilities with technical complaints and replacement requests related to:

• Product administration or user error issues
• Temperature stability issues
• Damaged, dropped, or lost units

Contact the Customer Interaction Center at 1‑888‑NOW‑NOVA (1-888-669‑6682)

For HCPs or facilities choosing to return expired LEQVIO units:

Contact the Customer Interaction Center at 1‑888‑NOW‑NOVA (669‑6682)

For wholesalers or distributors choosing to replace damaged or expired LEQVIO units:

Contact Novartis Pharmaceuticals Corporation at 1‑800‑526‑0175 or email [email protected]