Active

Psoriatic Arthritis

Active

Ankylosing Spondylitis

Moderate to Severe

Juvenile Idiopathic Arthritis

Non-Infectious

Intermediate, Posterior and Panuveitis

Active

Psoriatic Arthritis

Moderate to Severe

Hidradenitis Suppurativa

Gastroenterology

Moderate to Severe

Crohn's Disease

Moderate to Severe

Pediatric Crohn's Disease

Moderate to Severe

Ulcerative Colitis

Ophthalmology

Non-Infectious

Intermediate, Posterior and Panuveitis

For Healthcare
Professionals

Resources for PATIENT ACCESS AND SUPPORT

Download forms to help patients get the support
they need to start and stay on track with SKYRIZI AS PRESCRIBED

This information is for informational purposes only and is not intended to provide reimbursement or legal advice. The information presented here does not guarantee payment or coverage.

 

Practice forms and resources


SKYRIZI COMPLETE ACCESS AND ONBOARDING TOOLS

Once you and your patient complete the Skyrizi Complete Enrollment and Prescription Form, simply fax it to Skyrizi Complete and inform your patient that they will be receiving a call from their Nurse Ambassador. If you complete the Pharmacy Prescription, also fax it to your patient’s chosen specialty pharmacy.

ACCESS GUIDE

SKYRIZI Complete Enrollment and Prescription Form

Access and reimbursement forms

Skyrizi Complete is here to help your patients get timely access to SKYRIZI. Along with requesting information from a Skyrizi Complete Access Specialist, you can download the forms you need to get started.


TEMPLATES

Appeals Letter Sample Template

Letter of Medical Necessity Sample Template

HIPAA AUTHORIZATION TEMPLATE

Formulary Exception Letter Sample Template

Tiered Exception Letter Sample Template


Here you can download helpful guidelines and tips for completing these templates.

Billing and Coding

Billing and Coding Guide


SPECIALTY PHARMACY

Specialty Pharmacy Resources

Download forms to help patients get the support
they need to start and stay on track with SKYRIZI AS PRESCRIBED

This information is for informational purposes only and is not intended to provide reimbursement or legal advice. The information presented here does not guarantee payment or coverage.

 

PATIENT FORMS AND RESOURCES


SKYRIZI COMPLETE ENROLLMENT

Once you and your patient complete the Skyrizi Complete Enrollment and Prescription Form, simply fax it to Skyrizi Complete and inform your patient that they will be receiving a call from their Nurse Ambassador. If you complete the Pharmacy Prescription, also fax it to your patient’s chosen specialty pharmacy.

SKYRIZI Complete Enrollment and Prescription Form

ADDITIONAL RESOURCES

BENEFITS VERIFICATION CHART

PATIENT BROCHURE

INSURANCE COMPARISON

SKYRIZI COMPLETE BROCHURE

looking for more resources?Offer enrollment to patients and submit forms
electronically with CompletePro.com

By registering through CompletePro.com, you can choose the
capabilities that are most relevant to you and your patients' needs, such as:

Instant benefits verification:

  • Patient out-of-pocket costs
  • Any prior authorization requirements
  • Pharmacy options available to the patient
  • Patient eligibility for any drug discount from the pharmaceutical company

Online prescribing efficiencies:

  • Complete a Prior Authorization and send it directly to the insurer
  • Send a prescription directly to the patient's chosen pharmacy
  • Send Skyrizi Complete Savings Card to your patient's preferred specialty pharmacy (with or without a prescription)
  • Be notified via text, email, or website in advance of patient's prior authorization expiration
  • Easily access each patient's prescription fill status

Stay up to date on the latest SKYRIZI news and information


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Resources for your patients

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Only 4 doses per year

3-month dosing after 2 initiation doses at Weeks 0 and 4 (150 mg/dose)1

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IMPORTANT SAFETY INFORMATION AND INDICATION FOR SKYRIZI® (risankizumab-rzaa)1
Indication

SKYRIZI is indicated for the treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy.

Important Safety Information

Infection

SKYRIZI may increase the risk of infection. Do not initiate treatment with SKYRIZI in patients with a clinically important active infection until it resolves or is adequately treated.

In patients with a chronic infection or a history of recurrent infection, consider the risks and benefits prior to prescribing SKYRIZI. Instruct patients to seek medical advice if signs or symptoms of clinically important infection occur. If a patient develops such an infection or is not responding to standard therapy, closely monitor and discontinue SKYRIZI until the infection resolves.

Pre-Treatment Evaluation for Tuberculosis (TB)

Prior to initiating treatment with SKYRIZI, evaluate for TB infection and consider treatment in patients with latent or active TB for whom an adequate course of treatment cannot be confirmed. Monitor patients for signs and symptoms of active TB during and after SKYRIZI treatment. Do not administer SKYRIZI to patients with active TB.

Immunizations

Prior to initiating SKYRIZI, consider completion of all age appropriate immunizations according to current immunization guidelines. Avoid use of live vaccines in patients treated with SKYRIZI.

Adverse Reactions

Most common (≥1 %) adverse reactions associated with SKYRIZI include upper respiratory infections, headache, fatigue, injection site reactions, and tinea infections.

Please see Full Prescribing Information.

US-SKZD-190350

REFERENCE

  1. SKYRIZI [package insert]. North Chicago, IL: AbbVie Inc.
IMPORTANT SAFETY INFORMATION AND INDICATION FOR SKYRIZI® (risankizumab-rzaa)1
Infection SKYRIZI® may increase the risk of infection. Do not initiate treatment with SKYRIZI in patients with a clinically important active infection until it resolves or is adequately treated. Prior to initiating treatment with SKYRIZI, evaluate for TB infection and consider treatment in patients with latent or active TB for whom an adequate course of treatment cannot be confirmed. Monitor patients for signs and symptoms of active TB during and after SKYRIZI treatment. Do not administer SKYRIZI to patients with active TB.
IMPORTANT SAFETY INFORMATION AND INDICATION FOR SKYRIZI® (risankizumab-rzaa)1
Infection SKYRIZI® may increase the risk of infection. Do not initiate treatment with SKYRIZI in patients with a clinically important active infection until it resolves
IMPORTANT SAFETY INFORMATION AND INDICATION FOR SKYRIZI® (risankizumab-rzaa)1
Infection SKYRIZI® may increase the risk of infection. Do not initiate treatment with SKYRIZI in patients with a clinically important active infection until it resolves or is adequately treated. Prior to initiating treatment with SKYRIZI, evaluate for TB infection and consider treatment in patients with latent or active TB for whom an adequate course of treatment cannot be confirmed. Monitor patients for signs and symptoms of active TB during and after SKYRIZI treatment. Do not administer SKYRIZI to patients with active TB.
IMPORTANT SAFETY INFORMATION AND INDICATION FOR SKYRIZI® (risankizumab-rzaa)1
Infection SKYRIZI® may increase the risk of infection. Do not initiate treatment with SKYRIZI in patients with a clinically important active infection until it resolves
IMPORTANT SAFETY INFORMATION AND INDICATION FOR SKYRIZI® (risankizumab-rzaa)1
Indication

SKYRIZI is indicated for the treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy.

Important Safety Information

Infection

SKYRIZI may increase the risk of infection. Do not initiate treatment with SKYRIZI in patients with a clinically important active infection until it resolves or is adequately treated.

In patients with a chronic infection or a history of recurrent infection, consider the risks and benefits prior to prescribing SKYRIZI. Instruct patients to seek medical advice if signs or symptoms of clinically important infection occur. If a patient develops such an infection or is not responding to standard therapy, closely monitor and discontinue SKYRIZI until the infection resolves.

Pre-Treatment Evaluation for Tuberculosis (TB)

Prior to initiating treatment with SKYRIZI, evaluate for TB infection and consider treatment in patients with latent or active TB for whom an adequate course of treatment cannot be confirmed. Monitor patients for signs and symptoms of active TB during and after SKYRIZI treatment. Do not administer SKYRIZI to patients with active TB.

Immunizations

Prior to initiating SKYRIZI, consider completion of all age appropriate immunizations according to current immunization guidelines. Avoid use of live vaccines in patients treated with SKYRIZI.

Adverse Reactions

Most common (≥1 %) adverse reactions associated with SKYRIZI include upper respiratory infections, headache, fatigue, injection site reactions, and tinea infections.

Please see Full Prescribing Information.

US-SKZD-190350