START ELIGIBLE PATIENTS ON THE QUICKSTART PROGRAM

Start TYSABRI without extended insurance delaysa

For eligible patients, TYSABRI is shipped to a TOUCH®-authorized infusion site within approximately 1 week of receipt of the Prescriber/Patient Enrollment Form and QuickStart Form

  • No drug cost to patients and no extended delays while awaiting insurance approval
  • Only patients with commercial insurance are eligible for this programa
  • Eligible patients may receive up to 3 QuickStart doses
  • Authorized infusion sites must accept free drug

Follow 3 steps:

  • Complete the Prescriber/Patient Enrollment Form as required by the TOUCH Prescribing Program, which can be found at TOUCHProgram.com
  • Complete and sign the QuickStart Form
  • Submit the forms together via fax to Biogen Patient Services

Biogen Support Coordinators will contact TYSABRI QuickStart patients

Once the forms are received, a Biogen Support Coordinator will contact your eligible patients to confirm details prior to shipping the first dose

aPatients insured through Medicaid, Medicare, VA, DoD, TRICARE®, or other governmental insurance are not eligible for this program.

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