Beleodaq Patient assistance program
Complete a free online enrollment application to find out if you’re eligible to pay only $49 per month for your Beleodaq medication with our help.Get started today
- Secure: Your personal and medical information is safe with us
- Convenient: We manage the whole process and we’re here to assist you
- Ongoing refills: We request your medication refills on your behalf
NiceRx works with your healthcare provider to help you access affordable medications directly from U.S. pharmaceutical companies.
An introduction to NiceRx(01:52)
Next steps after qualifying(00:38)
Uploading documents and billing(00:50)
SSN & billing information(00:33)
Medication delivery time(00:41)
How it works
Get started by filling out the online enrollment application to find out if you are eligible.
NiceRx verifies your eligibility for medication assistance and notifies you if you are qualified. The pharmaceutical company provides your medication for free and you only pay our service fee.
You may be required to submit further information and documents required by the pharmaceutical company which can be securely uploaded online.
Your application is created and sent to your doctor for signature. At this stage, you will be billed $49 and will not be billed again until you receive your first medication delivery.
Your application is sent to the pharmaceutical company. You will be billed again once you receive your medication. We handle the entire ordering process including requesting ongoing refills.
Your monthly Beleodaq cost savings if eligible
If you are eligible to receive your Beleodaq prescription through the patient assistance program, your medication will be free. We charge a flat monthly service fee of $49 per medication to cover the cost of our services.
Am I eligible for Beleodaq patient assistance?
To be eligible for the Beleodaq patient assistance program, you will need to meet specific eligibility criteria set by the pharmaceutical company. At NiceRx, we review each Beleodaq enrollment application individually. The main factors considered are:
- I am a permanent, legal resident of the United States or Puerto Rico
- I am uninsured or my insurance doesn’t cover my medication
- I meet certain income eligibility requirements
How do I apply for the Beleodaq patient assistance program?
Applying for the Beleodaq patient assistance program through NiceRx is simple. Begin by completing the enrollment application on our website. We will ask for details about your healthcare provider, your insurance plan, and your household income. This information is required by the pharmaceutical manufacturers that supply your medication. We may be able to help you access patient assistance for other medications as well as Beleodaq, so please tell us about any medications that you have been prescribed.
If we determine that you may be eligible for Beleodaq assistance, we will handle the full enrollment process on your behalf. We will work with your healthcare provider to prepare and submit all the documents required for you to enroll. If you are successfully enrolled in the Beleodaq patient assistance program, we will also request your Beleodaq medication refills on your behalf for up to 1 year. At the end of your enrollment period, we will contact you for updated details and seek to re-enroll you in the program.
Is NiceRx a Beleodaq coupon provider?
NiceRx does not provide Beleodaq coupons, discount cards or copay cards. We do not offer printable Beleodaq manufacturer coupons, Beleodaq discounts, rebates, Beleodaq savings cards, trial offers, or free samples. We are a service provider that helps eligible individuals access patient assistance programs. Our service cost is $49 a month per medication, so you will likely save more on your Beleodaq medication with NiceRx.
Can NiceRx help me get Beleodaq cheaper if I have insurance?
NiceRx may be able to help you access Beleodaq patient assistance if:
- You have a high copay or coinsurance responsibility for Beleodaq
- Your insurance company will not pay for your Beleodaq prescription
- You do not have insurance
Complete your enrollment application online to find out more.
How much does Beleodaq cost without insurance?
Beleodaq prices without insurance will vary by retailer. As a guide, Beleodaq intravenous powder for injection 500 mg will typically cost around $2,100 for 1 powder for injection.
How much does Beleodaq cost with insurance?
Your individual healthcare plan will determine the copay of Beleodaq with insurance. To find out what you will need to pay, contact your pharmacist or insurance provider. They will be able to calculate your copay with your current insurance.
What is Beleodaq?
Beleodaq is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Aurobindo/Acrotech Biopharma. Beleodaq is a histone deacetylase inhibitor, effective in stopping cancer cells from growing in relapsed or refractory peripheral T-cell lymphoma (refractory PTCL).
FDA accelerated approval is based on tumor response rate and the duration of response. Future approval for this indication may depend upon proof of clinical benefit in the confirmatory trial.
What doses of Beleodaq are available?
Beleodaq is available in injection form, in the following doses: 500 mg, lyophilized powder in a single-use vial for reconstitution.
The recommended dosage of Beleodaq is 1,000 mg/m2 given over 30 minutes by intravenous infusion once daily on days 1-5 of a 21-day cycle. Cycles of treatment are repeated until disease progression or unacceptable toxicity.
Adverse reactions may need to be managed with treatment discontinuation or interruption with or without dosage reductions by 25%. Please read the prescribing information and always speak with a healthcare professional for medical advice about any changes to your dose so they can monitor and evaluate your condition.
Beleodaq active ingredients
Beleodaq contains belinostat, a histone deacetylase (HDAC) inhibitor, as the active ingredient.
Beleodaq side effects
The most common side effects of Beleodaq in clinical trials include:
- Nausea, pyrexia, and vomiting
- Tiredness, headache, dizziness
- Constipation, decreased appetite
In rare instances, Beleodaq can cause more serious adverse effects. These can include:
- Thrombocytopenia (reduced platelet count), leukopenia (neutropenia and lymphopenia), and anemia (severe tiredness, pale skin, shortness of breath). Modify dosage for hematologic toxicities
- Serious and fatal infections such as pneumonia and sepsis
- Liver problems – liver function test abnormalities, loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes)
- Tumor lysis syndrome (tumor cell breakdown)
- Embryo-fetal toxicity
- Easy bleeding and/or bruising, swollen hands, feet, or ankles
Your doctor will assess the benefits of using Beleodaq against your risk of side effects. Patients are encouraged to report negative side effects or adverse reactions of Beleodaq to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Beleodaq drug interactions
Beleodaq can interact with other medications. These include:
- Strong UGT1A1 Inhibitors
This list is not exhaustive and other prescription drugs may interact with Beleodaq. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
You should not use Beleodaq if you:
- Are allergic to the active ingredient belinostat
- Are allergic to any of the other ingredients in Beleodaq
- Are pregnant or are planning to become pregnant – females of reproductive potential are advised to use effective contraception during treatment and for 6 months after the last dose
Talk to your doctor before using Beleodaq if you:
- Are taking any of the medications that could interact with Beleodaq
- Have an infection
- Are receiving high-dose or intensive chemotherapy
- Have liver or kidney disease
- Are breastfeeding or are planning to breastfeed
Beleodaq is the trademark brand name for belinostat manufactured by Aurobindo/Acrotech Biopharma. A generic version of belinostat is not available. Generic drugs are generally cheaper than brand-name drugs, but you can still find Beleodaq savings through NiceRx.
*Qualifying persons may obtain medications directly from patient assistance programs without any out-of-pocket cost (or for less than $49 per medication). However, our monthly flat rate of just $49 per medication spares you the hassle of tracking down the different programs and filling out all the required paperwork for each program.
Enrollees enjoy a full-service solution, as NiceRx assists them and their physicians with the entire process. We prepare all required documents for the physician to sign, help enrollees manage all prescription refills, monitor eligibility criteria, and maintain enrollment.
**If you do not receive medications because you were determined to be ineligible for the prescription assistance by the applicable pharmaceutical companies and you have a letter of denial, we will refund any fees you paid toward medications for which you did not qualify to receive prescription assistance (“Refund”).
To receive a refund, you must send the letter of denial to us by fax to 888-517-7444, or by e-mail to [email protected] within 30 days of your receipt of such letter. The Refund is your sole and exclusive remedy for any fees you may wish to dispute.
The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.