Access and support for treatment with ARCALYST (rilonacept)

INITIATING TREATMENT

Steps to initiate ARCALYST treatment.

Follow these steps to begin your patient’s ARCALYST treatment process. Please remember that each patient has unique needs and additional steps may be required.

 

Step 1

PRE-ENROLLMENT

Ensure your patient’s vaccination history is up to date, including the pneumonia and flu vaccines.

 

 

Step 2

ENROLLMENT FORM COMPLETION

The Enrollment Form will be provided by your Kiniksa Sales Specialist or is available for download below. 

Fax completed Enrollment Form to Kiniksa One Connect™ at (781) 609-7826.

 

 

 

Enrollment Form (English)
Enrollment
Enrollment Form (Spanish)
Enrollment

 

Fax completed Enrollment Form to Kiniksa One Connect at
(781) 609-7826.

Step 3

FULFILLMENT

Your patient will be contacted by Kiniksa One Connect to help arrange product delivery from select specialty pharmacies.

Kiniksa One Connect will work with your patients to set up one-on-one injection training sessions with either virtual support from an ARCALYST Nurse Educator or a combination of virtual/in-person training support that includes virtual support from an ARCALYST Nurse Educator and in-person support from a healthcare professional.

Kiniksa One Connect can help your patients with their treatment needs. 

Treatment resources

There may be several steps to obtaining approval for your patient’s treatment with ARCALYST. The downloadable resources below were developed to help simplify this process by providing information about gaining access to ARCALYST, understanding reimbursement claims, and working with a specialty pharmacy.

 

Access

The following downloadable resources can help guide you through the steps to product access.

 

 

 

 

Letter of Medical Necessity Guide
Letter of Medical Necessity
Letter of Medical Necessity Template
Letter of Medical Necessity Sample
Appeal Letter Guide
Appeal Letter
Appeal Letter Template
Appeal Letter
Tiering Exception Letter Guide
Tiering Guide
Tiering Exception Letter Template
Tiering Sample

Financial assistance

Resources for information about access to ARCALYST and navigating the reimbursement process.

 

 

 

 

Access & Reimbursement Guide
Access Guide

Kiniksa one connect white small
 
Kiniksa One Connect is a support program made up of a team of experienced individuals, known as Patient Access Leads, with knowledge of insurance plans and healthcare networks.

Patient Access Leads

Once enrolled in Kiniksa One Connect, you and your patient will be paired with a dedicated Patient Access Lead based on geographical location. They will work to provide personalized one-on-one support throughout your patient's treatment experience.

 

ARCALYST Nurse Educators

ARCALYST Nurse Educators can conduct sessions to help provide your patients with training on the injection process.

Starting treatment

 

Starting treatment

By helping to navigate your patients through their insurance coverage and partnering with your practice, we make getting your patient on treatment a seamless experience in a variety of ways: 

  • We coordinate, verify, and explain the benefits verification process
  • We assist with the prior authorization and appeals processes if required
  • When it's time for your patients to begin treatment, we help coordinate delivery of your patient’s therapy 

 

 

 

KOC-Finance

 

Financial assistance

Our programs help identify possible sources of financial support for eligible patients. 

  • The Kiniksa Copay Assistance Program can offer copays as low as $10 per month* 
  • The Quick Start Program supports qualified patients with delay in coverage for treatment initiation while awaiting prior authorization
  • The Patient Assistance Program supports qualified patients with no coverage for treatment

 

*To be eligible for the Kiniksa Copay Assistance Program, your patients must have commercial insurance, must not have Medicare, Medicaid, or other government insurance, and must meet other eligibility criteria. Your patient also must agree to the rules set forth in the terms and conditions for the program. Please visit kiniksapolicies.com/copay to review additional eligibility criteria.
Program offered for up to 60 days. To be eligible for the Kiniksa Quick Start Program, your patient must meet certain financial eligibility requirements. Please visit kiniksapolicies.com/qstart to review additional eligibility criteria.
Program offered for up to 12 months. To be eligible for the Kiniksa Patient Assistance Program, your patient must meet certain financial eligibility requirements. Please visit kiniksapolicies.com/pap to review additional eligibility criteria.

 

KOC-treatment-support
 

Treatment support

We provide access to Registered Nurses and Licensed Practical Nurses who are trained in both disease state and ARCALYST administration to maximize the patient experience. There are multiple injection training options including:

  • In-office training by you or your office staff
  • One-on-one injection training sessions with an ARCALYST Nurse Educator
KOC Brochure

Help your patients learn more about our services.

Call

 

Call 1-833-KINIKSA (1-833-546-4572)
Monday through Friday, 8 AM to 8 PM ET