Prescriber certification
To prescribe JUXTAPID®, healthcare professionals must be certified in the JUXTAPID Risk Evaluation and Mitigation Strategy (REMS).
Prescriber certification is a 3-step process:
1.Review
the Prescribing Information and Fact Sheet
2.Complete
- the online Prescriber Training Module, including Knowledge Assessment
- the Prescriber Enrollment Form
- Send the Prescriber Enrollment Form to the JUXTAPID REMS Coordinating Center by fax: 1-855-898-2498 or email: REMS@chiesi.com
3.Agree
to counsel each new patient on the risk of hepatotoxicity and the need for baseline and periodic monitoring using the Patient Guide. Complete a Patient-Prescriber Acknowledgement Form with each patient
How do I obtain Juxtapid for my patient?
Am I certified in the Juxtapid REMS?
No
I SHOULD:
- Review the JUXTAPID Prescribing Information and the Fact Sheet
- Complete the online Prescriber Training Module including the Knowledge Assessment
- Upon completion, download the Training Completion document provided at the end of the training module
- Complete the Prescriber Enrollment Form.
- You may fill in the form online, then print it;
- or print it, then manually input the data into all fields;
- Sign the completed form and submit it with the Training Completion document
- by faxing both documents to 1-855-898-2498
- or emailing both documents to REMS@chiesi.com
- You will be notified by the REMS call center of your certification within one business day.
- Once certified, proceed as per the “yes” options.
Yes
IS THIS A NEW PATIENT?
I SHOULD:
- Counsel the new patient on the risk of hepatotoxicity and the need for baseline and periodic monitoring using the Patient Guide
- Complete and sign a Patient-Prescriber Acknowledgement Form with the patient to enroll them into the Juxtapid REMS
- Submit by faxing to 1-855-898-2498
- or emailing to REMS@chiesi.com
- Complete and sign a Prescription Authorization Form
- Submit to the Juxtapid REMS
- by faxing to 1-855-898-2498
IS THIS AN ESTABLISHED PATIENT WHO IS ALREADY ENROLLED IN THE JUXTAPID REMS?
I should:
- Complete and sign a Prescription Authorization Form each time and submit it to the Juxtapid REMS call center
- by faxing to 1-855-898-2498
