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Getting EPIDIOLEX®
(cannabidiol)
to your patients

You can obtain EPIDIOLEX through two different pathways

Supported through JazzCares

Complete JazzCares Start Form

and submit to the JazzCares Team

JazzCares reaches out to your office

and provides a Benefits Investigation and specialty pharmacy options

  • If necessary, JazzCares will initiate the prior authorization process via CoverMyMeds® and will send the key code to your office

Complete PA process (if required)

  • Reach out to your ARM or the JazzCares Team if PA support is needed
  • Utilize covermymeds.com for electronic PA requests

Send the prescription

and patient face sheet or JazzCares Start Form to the specialty pharmacy provided by the JazzCares Team or the specialty pharmacy of your choice

EPIDIOLEX® (cannabidiol) is available through specialty pharmacies

Use the contact information below to reach any one of the national in-network pharmacies

AcariaHealth

Hours of operation
M-F, 9:00 AM to 9:00 PM ET

1311 West Sam Houston Parkway N #130
Houston, TX77043
United States

Accredo

Hours of operation
M-F, 8:00 AM to 8:00 PM ET

1640 Century Center Parkway
Memphis, TN38134
United States

Amber Pharmacy

Hours of operation
M-F, 8:00 AM to 8:00 PM ET; Sat, 9:00 AM to 3:00 PM ET

10004 South 152nd Street
Omaha, NE68138
United States

CVS Specialty

Hours of operation
M-F, 8:30 AM to 8:30 PM ET

800 Biermann Court
Mount Prospect, IL60056
United States

Kaiser Permanente National Specialty Pharmacy

Hours of operation
M-F, 8:00 am to 8:30 pm PT

4131 Geary Blvd. Floor 1, Room 112
San Francisco, CA94118
United States

Lumicera Health Services

Hours of operation
M-F, 8:00 am to 8:30 pm ET

310 Integrity Drive
Madison, WI53715
United States

Walgreens Specialty Pharmacy

Hours of operation
M-F, 8:00 AM to 7:00 PM ET

130 Enterprise Drive
Pittsburgh, PA15275
United States

Use the specialty pharmacy finder & benefits verification tool now

How to write a prescription

When writing a prescription, ensure you include the titration schedule, weight, and ICD-10 code. As certain health plans and institutions may have policies regarding cannabinoid products/use, prescriptions should include EPIDIOLEX by name to avoid rejection.

TITRATION

EPIDIOLEX Prescription | Image of a Prescription

Dosing/ titration schedule

Patient weight

ICD-10 diagnosis code

MAINTENANCE

EPIDIOLEX Prescription Example | Image of a Prescription

Dosing/ titration schedule

Patient weight

ICD-10 diagnosis code

If dose adjustment is required mid-prescription cycle, a new prescription will be needed.

ICD-10 diagnosis codes

The sample codes provided below are based on publicly available information and are informational only; they are not a guarantee or promise of coverage. Appropriate codes can vary by patient, setting of care, and payer. Correct coding is the responsibility of the provider submitting the claim for the item or service. Please check with the payer to verify codes and special billing requirements.

LGS

  • G40.811
  • G40.812
  • G40.813
  • G40.814

Dravet syndrome

  • G40.833
  • G40.834

TSC

  • Q85.1

This is provided for example purposes only. Not intended to supersede independent clinical judgment or institutional protocols. Please see full Prescribing Information for recommendations on liver monitoring.

Prior authorization (PA) support (if required)

Jazz Pharmaceuticals has partnered with CoverMyMeds® to help patients connect with their treatment by:

  • Helping to reduce time to therapy with online PA requests
  • Receiving faster PA determinations, and often in real time
  • Customized appeals support, which includes the appeals letter initiated by their HCP and payer follow-up
  • Automatically renewing previously submitted PA requests

To get started:

1

Sign up for a no-cost account, or log in to your existing account at covermymeds.com

2

Initiate or respond to an electronic PA request in the CoverMyMeds® system.

3

Complete requested clinical details and then electronically submit the request to the plan for determination.

Connect with CoverMyMeds® Support from:
Monday-Friday 8 AM–11 PM ET,
Saturday 8 AM–3 PM ET.
CoverMyMeds® Support: 1-866-452-5017
Live chat at covermymeds.com

Remember to complete the PA form in its entirety

1

Patient demographics and medical history

2

Physician name and NPI number

3

Patient diagnosis (ICD-10 code[s])

4

Product name and dosing

Required information varies by plan; it may help to include rationales, medical records, published data, any pertinent diagnostic or laboratory tests, and all previously tried and failed therapies.

See which plans in your area cover EPIDIOLEX