Get her started on Vyleesi

The code for HSDD: F52.0

Vyleesi may have a prior authorization with some payors. If you have diagnosed your patient with HSDD, the proper diagnosis code in ICD-10-CM is F52.0.1*

2 ways to prescribe Vyleesi

ePrescribe

by choosing one of two
exclusive specialty pharmacies in
your EHR system:

Avella Specialty Pharmacy
Bio Plus Specialty Pharmacy

Download and fax

the Rx form, prescription, and patient insurance card to the specialty pharmacy listed on the form

Download Rx form

or
Save with Vyleesi
Copay and Refills

Each Vyleesi prescription includes no more than 4 autoinjectors2

Vyleesi can be prescribed PRN.2

Patients should not administer more than 1 dose in 24 hours, and no more than 8 doses per month.2

HSDD=hypoactive sexual desire disorder.

ICD-10-CM=International Classification of Diseases, Tenth Revision, Clinical Modification; EHR=electronic health record.

*Any decision regarding specific coding is at the discretion of the HCP. Provision of this information does not guarantee reimbursement.

Each patient’s eligibility is evaluated on an individual basis. In compliance with federal regulations, patients insured by a government-funded program (Medicaid, TRICARE, etc.) are not eligible. Patients must be 18 or older to qualify. These programs and any assistance provided may be discontinued or modified at any time based on eligibility, state and local laws, and program availability.

Financial assistance applies to the patient’s copay, coinsurance, or deductible for patients receiving Vyleesi. AMAG contributions against patient deductible and/or out-of-pocket maximums are subject to possible health plan restrictions. AMAG Pharmaceuticals will help lower the out-of-pocket cost to a $0 copay for the patient’s first prescription. AMAG will also provide copay assistance to lower the out of pocket cost for refills to a maximum copay of $99 per 4-pack. AMAG copay assistance will only apply to 2 fills every 30 days. Enrollment into the program cannot be retroactive.