How to start your patients on AVONEX

When you have a patient who is ready to start on AVONEX, you can prescribe online or download an AVONEX Start Form, complete it, and fax it to 1-855-474-3067.

To prescribe AVONEX, please follow these 3 steps:

1

After discussing AVONEX with your patient, have your patient read the Patient Consent Information and, if interested, sign the indicated areas on the accompanying AVONEX Start Form.

Biogen takes your patient’s confidentiality seriously. While patients are not required to sign the Start Form in order to receive AVONEX, signing both lines will expedite their enrollment in Biogen Support Services, which provides a variety of financial and insurance assistance options to help your patients get started on AVONEX (see eligibility guidelines). In addition, with both signatures Biogen can access your patient’s prescription status should you or your patient need assistance.

2

Complete the rest of the AVONEX Start Form.

Copy both sides of the patient’s medical insurance card and pharmacy benefit card, if available. In some cases, the medical and pharmacy cards may be the same.

3

Give your patient the Instructions for Patients and Patient Consent Information pages.

Then, fax the AVONEX Start Form to 1-855-474-3067. Prescriptions are only valid when received via fax. The Start Form can also be completed online.

Biogen is committed to getting your patients started on therapy as soon as possible. In addition to the AVONEX Start Form, there are a multitude of services available through Biogen Support Services to help ensure a successful start on treatment. Biogen Case Managers (Support Coordinators), who will reach out to your patients once they are prescribed AVONEX, are available Monday-Friday from 8:30 AM to 8 PM ET at 1-800-456-2255.

iAssista

Biogen and iAssist have partnered to support your prescribing preference. If your office prefers printed Start Forms, you may continue to fax them to 1-855-474-3067. If you would like to learn more about e-prescribing AVONEX through iAssist, please visit iAssist.com.

aiAssist is certified by Surescripts®.

If you have any questions or want to learn more about AVONEX, please call 1-800-456-2255.

Getting started

Get your patients started on therapy with the AVONEX Start Form

Download Start Form
Streamline the process and support patient adherence

myBiogen is an online resource for starting and keeping patients on therapy

Sign up at myBiogen.com

Support for your patients
is here
Biogen Case Managers
and Nurse Educators are here to help your patients start and continue on AVONEX

Get support today
Access and Reimbursement

Coverage and copay program for eligible patients

See Access and Reimbursement