Use this information to better understand the steps to receiving your medication from a specialty pharmacy. It includes contact information for the in-network specialty pharmacies that may fulfill your prescription for RADICAVA ORS® (edaravone).
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Starting Treatment
What to Expect in Your RADICAVA ORS® Shipments
Learn what comes in your first shipment (Starter Kit) and all shipments after (Maintenance Kit), including dosing schedules, how to take RADICAVA ORS®, and fasting guidelines.
Steps on Your Way to Treatment Brochure
Use this brochure to help understand the steps you and your doctor may need to take for accessing treatment with RADICAVA ORS®.
Find Doctors Who Treat ALS
The ALS Care Locator search tool can help you locate neurologists and other doctors who provide treatment for ALS.
Patient Authorization Form
Patient authorization is required to complete a BIF. If you have not already signed a BIF and would like to enroll in the JourneyMate Support Program™, you may sign this form to enroll in JourneyMate Support Program™ services. You can provide this authorization online or via mail or fax.
While on Treatment
A Guide for RADICAVA ORS® Patients
This brochure will help you understand the importance of managing ALS and slowing the loss of physical function.
Insurance Coverage
Requesting an Exception From Your Health Plan
Use this instructional document to help you request an exception from your health plan if RADICAVA ORS® is not covered or you need to meet other requirements before obtaining access to the medication. It includes a checklist of steps to fill out for the exceptions and appeals process, and links to government resources.
Understanding Your Coverage and Costs for Treatment
This resource may help you understand your health insurance coverage and potential out-of-pocket costs for treatment with RADICAVA ORS®.
Understanding Government Health Plan Options Brochure
This brochure provides you with information about government health plan options that may be available.
RADICAVA ORS® VA Formulary Brochure
This resource helps patients understand that RADICAVA ORS® is on the VA National Formulary. It also provides information about treatment eligibility, benefit access, and other resources for veterans.
Open Enrollment Brochure
The 2027 Open Enrollment Information for Patients brochure is designed to help you understand coverage options. This brochure does not include a complete list of health plan options.
Financial Support
Out-of-Pocket Savings Program Brochure for RADICAVA ORS®
The Out-of-Pocket Savings Program for RADICAVA ORS® brochure provides information about the Out-of-Pocket Savings Program for eligible patients with commercial insurance.
Out-of-Pocket Savings Program Enrollment Form
You may also apply to the Out-of-Pocket Savings Program for RADICAVA ORS® by submitting the Out-of-Pocket Savings Program Enrollment Form.
Low-Income Subsidy (LIS) Program Informational Brochure
Learn about a program to help qualified Medicare Part D patients save on their prescription drugs. This brochure does not include a complete explanation of the LIS program.
Financial Support by Coverage
This resource provides the financial support programs available to help reduce patient out-of-pocket costs broken out by coverage type (commercial, government-funded (Medicare and Medicaid), uninsured, VA, and alternate support).
Patient Assistance Program Brochure
The Patient Assistance Program Brochure allows you to learn about the Patient Assistance Program for uninsured patients who are in financial need and may qualify for the program.
Learning about RADICAVA® and Talking to Your Doctor
RADICAVA ORS® Patient Brochure
This resource will help you learn about RADICAVA ORS® as part of the care provided by your healthcare team.
RADICAVA ORS® Care Partner Brochure
Provides support and resources to help you take care of your loved one while taking care of yourself. You'll also learn about treatment with RADICAVA ORS®
RADICAVA ORS® Clinical History and Real World Experience Resource
See how RADICAVA ORS® is built on a solid foundation of clinical research and the experiences of people living with ALS.
RADICAVA ORS® Talk to Your Doctor Discussion Guide
Get useful information about talking to your doctor about RADICAVA ORS®.
Starting Treatment
Benefit Investigation and Enrollment Form for RADICAVA ORS®
You or your doctor may download the Benefit Investigation and Enrollment Form (BIF) to prescribe RADICAVA ORS® (edaravone) and enroll you in the JourneyMate Support Program™.
Patient Authorization Form
Patient authorization is required to complete a BIF. If you have not already signed a BIF and would like to enroll in the JourneyMate Support Program™, you may sign this form to enroll in JourneyMate Support Program™ services. You can provide this authorization online or via mail or fax.
About RADICAVA ORS®
Para usted
Información del paciente
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RADICAVA ORS® (edaravone).
Folleto sobre RADICAVA ORS® para el paciente
Revise la información útil sobre este tratamiento oral.
