Patient Access

The Fortovia Direct Rx Access Program: Easy for you, affordable for your patients.

The Fortovia Direct Rx Access Program:

Easy for you, affordable for your patients

SOLTAMOX is available at most retail pharmacies or through the Fortovia Direct Rx program described below.

For the prevention of breast cancer in high risk patients, SOLTAMOX may also be fully covered by most health insurances under their preventative services coverage, just like tamoxifen tablets.

Computer monitor, phone and a form

  • Prescribe via faxed form or Electronic Health Record (EHR) directly from a Fortovia Direct Rx specialty pharmacy
  • All commercially insured patients pay no more than $25 out-of-pocket costs*
  • A streamlined Patient Assistance Program is available for uninsured, underinsured, Medicare, Medicaid, and indigent patients
  • Free, 24-48 hour home delivery of product when ordered from a specialty pharmacy within the Fortovia Direct Rx network
Find a Direct Rx Specialty Pharmacy Rx form, which also contains Electronic Prescription information, here.

 

Fortovia patient assistance program table

Important:

  1. Confirm that you are entering the patient’s best contact information on the Rx form or EHR.
  2. Remind patients that the specialty pharmacy must contact them via phone prior to shipping their prescription to verify insurance, address and collect co-pay.

Fortovia is committed to ALL patients, with a streamlined Patient Assistance Program for patients ineligible for co-pay program

*Terms and Conditions:

Certain patients in Federal programs may not qualify. Qualified patients will pay $25 per Fortovia Therapeutics Inc. prescription products. After a maximum reimbursement allowance, any remaining costs will be the responsibility of the patient. Co-pay assistance is not valid for prescriptions reimbursed, in whole or in part, under Medicaid, Medicare, including Medicare Advantage and Part D prescription drug plans, or any other federal or state program (including state pharmaceutical assistance programs) or where prohibited, taxed, or otherwise restricted. Fortovia Therapeutics reserves the right to rescind, revoke, or amend this offer without notice. Patients understand and agree to comply with the terms and conditions of this offer as set forth here.

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SOLTAMOX® Important Safety Information - WARNING: UTERINE MALIGNANCIES and THROMBOEMBOLIC EVENTS

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WARNING: UTERINE MALIGNANCIES and THROMBOEMBOLIC EVENTS

  • Serious, life-threatening, and fatal events from use of tamoxifen include uterine malignancies, stroke, and pulmonary embolism. (5.1, 5.2)
  • Discuss risks and benefits of tamoxifen with women at high risk for breast cancer and women with ductal carcinoma in situ (DCIS) when considering tamoxifen use to reduce the risk of developing breast cancer. (5.1, 5.2)
  • For most patients already diagnosed with breast cancer, the benefits of tamoxifen outweigh its risks. (5.1, 5.2)

See full prescribing information for complete boxed warning.

SOLTAMOX® Important Safety Information

  • Tamoxifen citrate is contraindicated in patients who require concomitant warfarin therapy, or a history of deep vein thrombosis or pulmonary embolus, and in patients with known hypersensitivity to the drug or any of its ingredients.
  • Uterine malignancies: Promptly evaluate abnormal vaginal bleeding in a woman with current or past tamoxifen use.
  • Thromboembolic events: Risk increases with coadministered chemotherapy. For treatment of breast cancer, consider risks and benefits in patients with a history of thromboembolic events.
  • Embryo-fetal toxicity: Can cause fetal harm. Advise females of reproductive potential of the potential risk to a fetus and to use effective contraception.
  • Effects on the liver: Liver cancer and liver abnormalities, some fatal, have occurred. Perform periodic liver function testing.
  • The most common adverse reactions (≥20% incidence) associated with tamoxifen are hot flashes, mood disturbances, vaginal discharge, vaginal bleeding, nausea, and fluid retention.
  • Anastrozole and letrozole: Should not be used in combination with tamoxifen.
  • Warfarin: Do not use in patients taking tamoxifen for DCIS and for reduction in breast cancer incidence in women at high risk. Closely monitor coagulation indices for increased anticoagulant effect when used with tamoxifen for metastatic breast cancer or as adjuvant therapy.
  • Do not use tamoxifen in lactating women.
  • Verify pregnancy status of females prior to initiation of tamoxifen.
  • Advise females and males to use effective contraception.

Please see full Prescribing Information for SOLTAMOX®.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.