NUWIQ® Free Trial for Patients with Hemophilia A
Octapharma Free Trial Program
With the Octapharma Free Trial Program, eligible Hemophilia A patients can receive treatment with NUWIQ (not to exceed 6 doses or not exceed approximately 20,000 IUs) at no cost, shipped directly to them and administered under your care and supervision.
If your patients are currently using another FVIII product, or not yet treating their hemophilia A with a factor therapy, you may want to consider NUWIQ.
3 Simple Steps to Enroll Your Patients
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Apply for the Free Trial Program on behalf of your patients by calling the Factor My Way Support Center at 1-855-498-4260 and initiating a request.
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A link to complete the Enrollment Form will be emailed to you to complete the request in the NUWIQ Provider Portal at the same time as a text message is sent to your patient to provide their consent.
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Upload a copy of the prescription with the completed Enrollment Form in the NUWIQ Provider Portal.
What Happens Next?
- A Factor My Way representative will review all the documents to ensure your patient meets program eligibility criteria.
- A Factor My Way representative will process the completed Enrollment and Patient Consent Forms, then send your patient’s prescription to a specialty pharmacy for fulfillment.
- A Factor My Way representative will confirm with the patient that their NUWIQ prescription has been shipped to them.
- Under your supervision and care you will administer NUWIQ to your patients.
