How To Order

Getting Started With ADSTILADRIN

ADSTILADRIN IS FULLY AVAILABLE.

Ferring Pharmaceuticals is committed to ensuring a seamless ADSTILADRIN ordering experience

Step 1

Patient identification and submission of Patient Enrollment Form

Submit a completed Patient Enrollment Form: Once a patient has been identified, submit the form by fax to 1-888-322-5233 or online via ferringaccesssupport.com. You will receive a notification via email that your form has been successfully submitted
Ferring Access Support will conduct a benefits investigation.* Upon completion, Ferring Access Support will contact you via phone and/or fax with a benefits investigation summary, which will include details regarding the patient’s coverage:
- Support options may be available for the patient
- Results may include notifying your office of prior authorization requirements

ADSTILADRIN has confirmed 99% coverage for commercial and government-
insured patients¹

Download these helpful resources:

Patient Enrollment Form

Submit your enrollment form at ferringaccesssupport.com

Copay Program Leave Behind

Create an account, register and enroll patients,
and submit claims on hcp.ferringcopay.com

Eligible, commercially insured patients may pay as little as $100^†for each ADSTILADRIN prescription

Step 2

Account setup and ordering ADSTILADRIN

Please validate that your practice location has an active account set up with either Besse Medical or Optum Frontier Therapies
Account setup: If there is not an active account, please set up an account with Besse Medical by phone at 1-800-252-87591-800-252-8759 or by email at advancedtherapies@amerisourcebergen.com or with Optum Frontier Therapies by email at oft_specialtydistribution@optum.com
- Note: Account setup may take 3 to 5 business days provided that all information and documentation submitted are complete
Ordering ADSTILADRIN: Once benefits coverage is confirmed, you can proceed to order
- To order through the specialty distributor, contact Besse Medical at 1-800-252-87591-800-252-8759 or Optum Frontier Therapies at 1-833-754-64571-833-754-6457
- If ordering through the specialty pharmacy, Ferring Access Support will triage your prescription to Optum Frontier Therapies (1-855-768-97271-855-768-9727), and the patient and practice will be contacted by both Optum Frontier Therapies and Ferring Access Support

How to Order ADSTILADRIN Leave Behind Downloadable Guide

How to Order Leave Behind

Flexible payment terms:
Ferring offers 120-day payment terms^‡

Step 3

Instillation of ADSTILADRIN

Schedule the instillation appointment with your patient—intravesical administration
QUARTERLY: ONCE EVERY 3 MONTHS

Instructions for Use

For assistance, call 1-844-NADOnow1-844-NADOnow (1-844-623-66691-844-623-6669)
Monday to Friday, 9 _AM to 6 _PM ET

Watch video

ADSTILADRIN Ordering Walk-Through

Neal Shore, MD, FACS, a clinician from the ADSTILADRIN clinical trials, provides helpful details about how to order ADSTILADRIN.

Ferring Access Support is here for your patients and clinic

Ferring Access Support is a strong, integrated hub service to enhance the patient experience and drive reimbursement confidence and process within urology.

Benefits investigation support

Determine patient coverage for ADSTILADRIN, procedure, and site of care
Verify whether prior authorization/precertification is required and what is needed for submission
Provide support and guidance on applicable billing, coding, claims, and appeals

Patient support services

ADSTILADRIN Copay Program
- Eligible, commercially insured patients may pay as little as $100^† for ADSTILADRIN
Ferring Access Support Patient Assistance Program (PAP) for uninsured/underinsured patients who meet eligibility criteria^§
Referrals to third-party organizations including 501c3 charitable organizations, patient support and education groups, and state health exchange resources
Appointment scheduling assistance and adherence support

Fulfillment services

Support and streamlining of the ADSTILADRIN ordering and delivery process
Coordination of product shipment and patient instillation
ADSTILADRIN product replacement^¶

Dedicated reimbursement support

Dedicated team of specialists for all your coverage, access, and reimbursement needs
Case Managers and Field Reimbursement Managers

^*Only commercially insured patients will go through a benefits verification.
^†Available only for patients who meet eligibility requirements. Program does not cover the cost of administration, office visits, or any associated costs. Terms and conditions apply. Offer expires 12/31/24.

^‡Ferring offers approximately 120-day payment terms to its specialty distribution network. Payment terms offered from specialty distributor to HCP may vary.

^§The ADSTILADRIN Patient Assistance Program (PAP) is only available for qualified patients enrolled in Ferring Access Support Program. Participation in the PAP is free. Ferring does not collect any fees from people seeking assistance through PAP. Assistance is provided in the form of free product shipped to site of administration. ADSTILADRIN must be secured at the site of administration until the qualified PAP patient’s treatment date, and the medicine must be provided only to the eligible patient at no charge of any kind for the product. ADSTILADRIN PAP only covers the cost of the product and not administration or other services. Any medications supplied by Ferring as a result of enrollment in the PAP are for the use of the named patient only and will not be sold, traded, bartered, transferred, returned for credit, or submitted to any third party (such as Medicare, Medicaid, or other benefit provider) for reimbursement. If ADSTILADRIN is no longer medically necessary for a qualified patient’s treatment or if the patient’s insurance or financial status changes, this must be reported to Ferring Access Support Program. If patient authorization is signed, electronic verification of a patient’s financial status is available to help determine eligibility. PAP beneficiaries with government insurance are eligible to obtain medication through the end of the calendar year. PAP beneficiaries with commercial insurance are eligible to obtain medication for up to 12 months. Healthcare Providers may not submit claims or payment from this medication through an insurance plan of any kind. Patients may not seek true out-of-pocket (TrOOP) or other insurance credit for medication provided through the PAP. If applicable, PAP recipients will have their health plans receive written notification. Ferring may change or cancel the PAP at any time and Ferring reserves the right to terminate a patient’s enrollment in the PAP at any time.

^¶Terms and conditions may apply.

NEXT Resources

Sign Up to Receive Information and Updates on ADSTILADRIN (nadofaragene firadenovec-vncg)

Your Information

First Name*(Required)

Last Name*(Required)

Specialty*(Required)

Work Email Address*(Required)

NPI Number

Your Mailing Address

Mailing Address 1

Mailing Address 2

City

State

Zip Code*(Required)

*Required field.

Reference: 1. Ferring Access Support benefits investigations for commercial and government-insured patients through March 15, 2024.

Important Safety Information

INDICATION

ADSTILADRIN is a non-replicating adenoviral vector-based gene therapy indicated for the treatment of adult patients with high-risk Bacillus Calmette-Guérin (BCG)-unresponsive non-muscle invasive bladder cancer (NMIBC) with carcinoma in situ (CIS) with or without papillary tumors.

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS: ADSTILADRIN is contraindicated in patients with prior hypersensitivity reactions to interferon alfa or to any component of the product.

WARNINGS AND PRECAUTIONS:

Risk with delayed cystectomy: Delaying cystectomy in patients with BCG-unresponsive CIS could lead to development of muscle invasive or metastatic bladder cancer, which can be lethal. If patients with CIS do not have a complete response to treatment after 3 months or if CIS recurs, consider cystectomy.
Risk of disseminated adenovirus infection: Persons who are immunocompromised or immunodeficient may be at risk for disseminated infection from ADSTILADRIN due to low levels of replication-competent adenovirus. Avoid ADSTILADRIN exposure to immunocompromised or immunodeficient individuals.

DOSAGE AND ADMINISTRATION: Administer ADSTILADRIN by intravesical instillation only. ADSTILADRIN is not for intravenous use, topical use, or oral administration.

USE IN SPECIFIC POPULATIONS: Advise females of reproductive potential to use effective contraception during ADSTILADRIN treatment and for 6 months after the last dose. Advise male patients with female partners of reproductive potential to use effective contraception during ADSTILADRIN treatment and for 3 months after the last dose.

ADVERSE REACTIONS: The most common (>10%) adverse reactions, including laboratory abnormalities (>15%), were glucose increased, instillation site discharge, triglycerides increased, fatigue, bladder spasm, micturition (urination urgency), creatinine increased, hematuria (blood in urine), phosphate decreased, chills, pyrexia (fever), and dysuria (painful urination).

You are encouraged to report negative side effects of prescription drugs to FDA. Visit www.FDA.gov/medwatch or call 1-800-332-10881-800-332-1088. You may also contact Ferring Pharmaceuticals at 1-888-FERRING1-888-FERRING.

Please see full Prescribing Information for ADSTILADRIN.

How To Order

Getting Started With ADSTILADRIN

Download these helpful resources:

ADSTILADRIN Ordering Walk-Through