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For questions about financial assistance, call 1-844-DUPIXENT, option 1 or
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COPAY CARD ENROLLMENT

SEE IF YOU ARE ELIGIBLE TO SAVE ON DUPIXENT

Fill out this form with a valid email address and see if you’re eligible for the DUPIXENT MyWay® Copay Card. Plus, get the latest information about DUPIXENT, exclusive tools, and resources to help you understand and manage your condition.

Specify Prescription Information

All information is required unless otherwise indicated.

Verify Copay Eligibility

All information is required unless otherwise indicated.

You are eligible for a copay card!

We’ll need to collect some additional information, including a valid email address to send your card to once you’re registered. Please continue to the next step.

Based on the questions answered above, you are not eligible to register for a new copay card or to activate a copay card. You need to have a prescription for DUPIXENT as well as commercial insurance.

The DUPIXENT MyWay Patient Assistance Program may be able to help. Patients will need to meet the eligibility criteria, including household income, to qualify. The DUPIXENT MyWay team can research each patient’s situation and determine eligibility.

For more information or to enroll in the patient support program, contact us at:

1‑844‑DUPIXENT
(1-844-387-4936), option 1
Monday-Friday, 8 am-9 pm ET

Although you are not eligible, you can sign up
for DUPIXENT MyWay emails about
DUPIXENT below.

Based on the questions answered above, you are not eligible to register for a new copay card or to activate a copay card. You need to have a prescription for DUPIXENT as well as commercial insurance.

Although you are not eligible, you can sign up for DUPIXENT MyWay emails about DUPIXENT below.

COPAY CARD INFORMATION

All information is required unless otherwise indicated.

CONTACT INFORMATION

All information is required unless otherwise indicated.

Patient Information

Caregiver Information

COMMUNICATIONS PREFERENCES

All information is required unless otherwise indicated.

I acknowledge that by checking the checkbox, I consent to receive text messages from Sanofi regarding DUPIXENT at the mobile telephone number that I provide. Message and data rates may apply. I understand that I can opt out at any time by texting STOP and I can get help by texting HELP to 94742. Message frequency will vary. I understand that my consent is not required as a condition of purchasing any goods or services.

View Terms and Conditions and Privacy Policy.

Please read all of this copy before submitting.

I am enrolling in DUPIXENT MyWay® and authorize Regeneron Pharmaceuticals, Inc., Sanofi US, and their agents (together the "Alliance") to provide me services which may include medication and adherence communications and support, medication dispensing support, coverage and financial assistance support, disease and medication education, injection training and other support services.

I agree to my enrollment in the DUPIXENT MyWay® Copay Card program (“Program”) if confirmed as eligible, understand that copay card information will be sent to my designated specialty pharmacy along with my prescription, and any assistance with my applicable cost-sharing or co-payment for DUPIXENT (dupilumab) will be made in accordance with the Program terms and conditions.

There is a maximum annual patient benefit under the DUPIXENT MyWay® Copay Program. Copay amounts after applying copay assistance may depend on the patient’s insurance plan and may vary. The Program is intended to help patients access DUPIXENT. Patients may have insurance plans that attempt to dilute the impact of the assistance available under the Program. In those situations, the Program may change its terms in order to enable patients to realize the full benefits of the assistance available under the Program.

I authorize the Alliance to contact me by mail, telephone, or email, with information about DUPIXENT MyWay®, disease state and products, promotions, services and research studies, and to ask my opinion about such information and topics, including market research and disease-related surveys (together, the “Communications”). Sanofi US may also use my information for other communication, services, and marketing activities and may present personalized advertising to me on unaffiliated websites or applications.

I further authorize the Alliance to de-identify my health information and use it in performing research, education, business analytics, marketing studies or for other commercial purposes. I understand that members of the Alliance may share identifiable health information with one another in order to de-identify it for these purposes and as needed to perform individual support services or to send the Communications. I understand and agree that the Alliance may use my health information for these purposes and may share my health information with my doctors, specialty pharmacies, and insurers.

I understand that I do not have to enroll in DUPIXENT MyWay® or receive the Communications, and that I can still receive DUPIXENT injection, as prescribed by my physician. I may opt out of receiving Communications, individual support services, including the DUPIXENT MyWay® Copay Card, or opt out of DUPIXENT MyWay® entirely at any time by notifying a representative by telephone at 1-800-633-1610 or by sending a letter to Sanofi US Customer Service 100 Morris St, Morristown, NJ 07960.

I also understand that DUPIXENT MyWay® reserves the right to rescind, revoke, terminate, or amend this offer, eligibility, and terms and conditions at any time without notice. Commercially insured patients with questions or concerns about deductible, copay, or coinsurance amounts or the ability to obtain DUPIXENT can contact the Copay Card Program helpline at 1-855-520-3765.

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Thanks for ACTIVATING your DUPIXENT MyWay® Copay Card

Now that your card is activated, you can use it as proof of copay assistance. You can also use it to receive more information
about DUPIXENT from the DUPIXENT MyWay support program. Be on the lookout for an email from your support team. If you
need any additional copay support, call 1‑844‑DUPIXENT (1-844-387-4936), option 1

Now that you've signed up, you can use your card as proof of copay assistance.
You can also use it to receive more information about DUPIXENT from the DUPIXENT MyWay support program. Be on the lookout for an email from our support team with
your copay card. If you need your copay card immediately or require any additional
copay support, call 1‑844‑DUPIXENT (1-844-387-4936), option 1.

Learn how dupixent
is taken

DUPIXENT is a type of medicine called a biologic, and is taken as a subcutaneous injection under the skin. Explore more information on how DUPIXENT is taken.

View Instructions

Our support team
is here to help

In addition to the training from your doctor, a DUPIXENT MyWay Nurse Educator can provide supplemental injection training either online, over the phone, or in person with a training kit and training syringe or pen for practice.

For more information, dial
1-844-DUPIXENT
(1-844-387-4936), option 1 
Monday-Friday, 8 am-9 pm ET