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Start Form

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Start Form -
Spanish

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Free Trial Offer Overview

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Free Trial Offer
Order Form

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Patient Consent
Form

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Injection Guide

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Service Center
Portal Overview

GET INSURANCE COVERAGE INFORMATION

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Prior Authorization
& Appeals Guide

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Letter of Medical Necessity Checklist

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Sample Letter of Medical Necessity

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Letter of Medical Exception Checklist

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Sample Letter of Medical Exception

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Letter of Appeal Checklist

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Sample Letter of Appeal

GET FINANCIAL SUPPORT

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Co-pay
Flashcard

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Co-pay Portal Overview

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Provider Commercial Co-pay Claim Form

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Specialty Pharmacy Commercial Co-pay Claim Form

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Patient Pharmacy Claim Form

GET PRODUCT

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Buy-and-Bill
5 Step Guide

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Buy-and-Bill Checklist

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Distribution & Acquisition
Flashcard

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Alternate Injection
Center Referral
Guide

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Alternate Injection
Center Referral/Order Form

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Alternate Injection
Center Clinical
Documentation
Referral Checklist

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LEQVIO Patient
Tracker

GET REIMBURSED

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Billing & Coding
Guide

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Permanent J-code
Flashcard

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Claim Filing
Checklist

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Annotated
CMS-1500
Form

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Annotated
CMS-1450 (UB-04)
Form

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IMPORTANT SAFETY INFORMATION

Adverse reactions in clinical trials (≥3% of patients treated with LEQVIO® and more frequently than placebo) were injection site reaction, arthralgia, urinary tract infection, diarrhea, bronchitis, pain in extremity and dyspnea.

Adverse reactions led to discontinuation in 2.5% and 1.9% of LEQVIO- and placebo-treated patients, respectively. Discontinuation due to injection site reactions, which included injection site pain, erythema and rash, were 0.2% and 0% of LEQVIO- and placebo-treated patients, respectively.

Please click here for LEQVIO full Prescribing Information.

INDICATION

LEQVIO (inclisiran) injection is indicated as an adjunct to diet and maximally tolerated statin therapy for the treatment of adults with clinical atherosclerotic cardiovascular disease (ASCVD) or heterozygous familial hypercholesterolemia (HeFH) who require additional lowering of low-density lipoprotein cholesterol (LDL-C). Limitations of Use: The effect of LEQVIO on cardiovascular morbidity and mortality has not been determined.

Please click here for LEQVIO full Prescribing Information.