How to Prescribe Rare Disease Therapies | Optum Frontier Therapies

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class="columns-container__full-width-background" style="background: url('/content/dam/optum3/optum/en/images/4599097-new-prescribe-pediatrician-02090-1200x628.jpg') 50% 50% no-repeat; background-size: cover;"> <span class="assistText" role="img" aria-label="/content/dam/optum3/optum/en/images/4599097-new-prescribe-pediatrician-02090-1200x628.jpg"></span> <div class="columns-container__background-image--content"> <div class="column-half section"> <div class="row--padding"> <div class="row "> <div class="col-half col-half--tablet"><div class="columns-container-full-width-img section"> <div class="show-in-edit-mode faux-edit-bar">Full Width Image Background</div> <div class="columns-container__full-width-background" style="background: url('/content/dam/optum3/optum/en/images/background-colors/white-box-90.png') 50% 50% no-repeat; background-size: cover;"> <span class="assistText" role="img" aria-label="/content/dam/optum3/optum/en/images/background-colors/white-box-90.png"></span> <div class="columns-container__background-image--content"> <div class="text silverplatter parbase section"><div class="show-in-edit-mode faux-edit-bar">Text</div> <div promo-lpos="" promo-name=""> <div class="text-component text-inner"><h1 style=" padding-top: 20.0px; "><span class="subhead banner__block">How to prescribe</span></h1> <h2 class="dash" style=" text-align: left; "><span class="beta">There are three ways to send us a prescription</span></h2> <p>Download, complete and sign the necessary therapy enrollment form. Be sure to note Optum Frontier Therapies as your preferred pharmacy.</p> <p><a href="#forms"><span class="button">Find forms</span></a></p> </div> </div> </div> </div> </div> </div> </div> <div class="col-half col-half--tablet"> </div> </div> </div> </div> </div> </div> </div> <div class="column-third section"> <div class="row--padding bg-color-off-white"> <div class="row none"> <div class="col-third col-third--tablet"><div class="columns-container-full-width-img section"> <div class="show-in-edit-mode faux-edit-bar">Full Width Image Background</div> <div class="columns-container__full-width-background" style="background: url('/content/dam/optum/Images/white-box-100.png') 50% 50% no-repeat; background-size: cover;"> <span class="assistText" role="img" aria-label="/content/dam/optum/Images/white-box-100.png"></span> <div class="columns-container__background-image--content"> <div class="text silverplatter parbase section"><div class="show-in-edit-mode faux-edit-bar">Text</div> <div promo-lpos="" promo-name=""> <div class="text-component text-inner"><h2><span class="delta">Option 1: e-prescribe</span></h2> <p>Frontier Therapies II - Optum<br /> 6425 Santa Margarita St. #110<br /> Las Vegas, NV 89118</p> <p>NABP: 788638<br /> NPI: 1720364532<br /> NCPDP: 2992750</p> </div> </div> </div> </div> </div> </div> </div> <div class="col-third col-third--tablet"><div class="columns-container-full-width-img section"> <div class="show-in-edit-mode faux-edit-bar">Full Width Image Background</div> <div class="columns-container__full-width-background" style="background: url('/content/dam/optum/Images/white-box-100.png') 50% 50% no-repeat; background-size: cover;"> <span class="assistText" role="img" aria-label="/content/dam/optum/Images/white-box-100.png"></span> <div class="columns-container__background-image--content"> <div class="text silverplatter parbase section"><div class="show-in-edit-mode faux-edit-bar">Text</div> <div promo-lpos="" promo-name=""> <div class="text-component text-inner"><h2><span class="delta">Option 2: fax</span></h2> <p>Send the appropriate therapy forms and documentation to 1-866-991-9929.<br /> </p> <p><br /> <br /> </p> </div> </div> </div> </div> </div> </div> </div> <div class="col-third col-third--tablet"><div class="columns-container-full-width-img section"> <div class="show-in-edit-mode faux-edit-bar">Full Width Image Background</div> <div class="columns-container__full-width-background" style="background: url('/content/dam/optum/Images/white-box-100.png') 50% 50% no-repeat; background-size: cover;"> <span class="assistText" role="img" aria-label="/content/dam/optum/Images/white-box-100.png"></span> <div class="columns-container__background-image--content"> <div class="text silverplatter parbase section"><div class="show-in-edit-mode faux-edit-bar">Text</div> <div promo-lpos="" promo-name=""> <div class="text-component text-inner"><h2><span class="delta">Option 3: call</span></h2> <p>Discuss the process, understand how to submit documentation, or place an order by calling us at <a href="tel:1-855-768-9727" style=" white-space: nowrap; ">1-855-768-9727.</a></p> <p><br /> <br /> </p> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <div class="column-full section"> <div class="row--padding"> <div class="row "> <div class="col-full"><div class="text silverplatter parbase section"><div class="show-in-edit-mode faux-edit-bar">Text</div> <div promo-lpos="" promo-name=""> <div class="text-component text-inner"><p><a id="forms"></a> </p> </div> </div> </div> </div> </div> </div> </div> <div class="column-full section"> <div class="row--padding"> <div class="row "> <div class="col-full"><div class="text silverplatter parbase section"><div class="show-in-edit-mode faux-edit-bar">Text</div> <div promo-lpos="" promo-name=""> <div class="text-component text-inner"><h2 style=" text-align: center; "><span class="dash align--center">Therapies and forms</span></h2> <p style=" text-align: center; "> </p> <p style=" text-align: center; ">Find out more about the therapies we dispense below. Select Find forms to access the appropriate therapy enrollment forms and documentation.</p> </div> </div> </div> <div class="alphalisting parsys section"><div class="row"> <ul class="unstyled horizontal-list alphalist-index zeta" id="top-of-list"> <li class="alphalist-index__item"> <a class="alphalist-index__link" href="#dtA"> A</a> </li> <li class="alphalist-index__item"> <a class="alphalist-index__link" href="#dtB"> B</a> </li> <li class="alphalist-index__item"> <div class="alphalist-index__letter"> C</div> </li> <li class="alphalist-index__item"> <div class="alphalist-index__letter"> D</div> </li> <li class="alphalist-index__item"> <a class="alphalist-index__link" href="#dtE"> E</a> </li> <li class="alphalist-index__item"> <a class="alphalist-index__link" href="#dtF"> F</a> </li> <li class="alphalist-index__item"> <div class="alphalist-index__letter"> G</div> </li> <li class="alphalist-index__item"> <div class="alphalist-index__letter"> H</div> </li> <li class="alphalist-index__item"> <div class="alphalist-index__letter"> I</div> </li> <li class="alphalist-index__item"> <div class="alphalist-index__letter"> J</div> </li> <li class="alphalist-index__item"> <a class="alphalist-index__link" href="#dtK"> K</a> </li> <li class="alphalist-index__item"> <a class="alphalist-index__link" href="#dtL"> L</a> </li> <li class="alphalist-index__item"> <div class="alphalist-index__letter"> M</div> </li> <li class="alphalist-index__item"> <a class="alphalist-index__link" href="#dtN"> N</a> </li> <li class="alphalist-index__item"> <div class="alphalist-index__letter"> O</div> </li> <li class="alphalist-index__item"> <a class="alphalist-index__link" href="#dtP"> P</a> </li> <li class="alphalist-index__item"> <a class="alphalist-index__link" href="#dtQ"> Q</a> </li> <li class="alphalist-index__item"> <a class="alphalist-index__link" href="#dtR"> R</a> </li> <li class="alphalist-index__item"> <a class="alphalist-index__link" href="#dtS"> S</a> </li> <li class="alphalist-index__item"> <div class="alphalist-index__letter"> T</div> </li> <li class="alphalist-index__item"> <div class="alphalist-index__letter"> U</div> </li> <li class="alphalist-index__item"> <a class="alphalist-index__link" href="#dtV"> V</a> </li> <li class="alphalist-index__item"> <div class="alphalist-index__letter"> W</div> </li> <li class="alphalist-index__item"> <div class="alphalist-index__letter"> X</div> </li> <li class="alphalist-index__item"> <div class="alphalist-index__letter"> Y</div> </li> <li class="alphalist-index__item"> <div class="alphalist-index__letter"> Z</div> </li> </ul> <div class="alphalist__row"> <h2 class="alphalist__header epsilon" id="dtA">A</h2> <div class="contactus_child"> <article class="contact-address row"> <h2 class="contact-address__title delta col-5"> ADSTILADRIN® </h2> <div class="contact-address__details col-7"> <div class="contact-address__desc"> <p>ADSTILADRIN® is a non-replicating adenoviral vector-based gene therapy indicated for the treatment of adult patients with high-risk Bacillus Calmette-Guérin (BCG)-unresponsive non-muscle invasive bladder cancer (NMIBC) with carcinoma in situ (CIS) with or without papillary tumors.</p> </div> </div> </article> <script type="text/javascript"> //$(document).ready(function () { // var cuMapSearchStr = ""; // if(cuMapSearchStr.length < 1){ cuMapSearchStr = ""; } // if(cuMapSearchStr.length > 0){ // contactUsChildMap(cuMapSearchStr, "js-contactusMap_Xoo1mND4DA"); // } //}); </script> </div> </div> <span id="end-list"></span> <div class="alphalist__row"> <h2 class="alphalist__header epsilon" id="dtB">B</h2> <div class="contactus_child"> <article class="contact-address row"> <h2 class="contact-address__title delta col-5"> BEQVEZ<sup>TM</sup> </h2> <div class="contact-address__details col-7"> <div class="contact-address__desc"> <p>BEQVEZ (fidanacogene elaparvovec) is an adeno-associated virus (AAV) vector-based gene therapy indicated for the treatment of adults with moderately-severe to severe hemophilia B (congenital factor IX deficiency) with factor IX activity less than or equal to 2 IU/dL (International units per deciliter) without antibodies to AAV serotype Rh74 (AAVRh74).</p> </div> </div> </article> <script type="text/javascript"> //$(document).ready(function () { // var cuMapSearchStr = ""; // if(cuMapSearchStr.length < 1){ cuMapSearchStr = ""; } // if(cuMapSearchStr.length > 0){ // contactUsChildMap(cuMapSearchStr, "js-contactusMap_p0Dvoao0GV"); // } //}); </script> </div> <div class="contactus_child"> <article class="contact-address row"> <h2 class="contact-address__title delta col-5"> Bylvay® </h2> <div class="contact-address__details col-7"> <div class="contact-address__desc"> <p>Bylvay® is an ileal bile acid transporter (IBAT) inhibitor indicated for: Progressive Familial Intrahepatic Cholestasis (PFIC) • the treatment of pruritus in patients 3 months of age and older with progressive familial intrahepatic cholestasis (PFIC).  Alagille Syndrome (ALGS) • the treatment of cholestatic pruritus in patients 12 months of age and older with Alagille syndrome (ALGS). </p> <p><a href="/how-to-prescribe/bylvay.html">Find forms</a></p> </div> </div> </article> <script type="text/javascript"> //$(document).ready(function () { // var cuMapSearchStr = ""; // if(cuMapSearchStr.length < 1){ cuMapSearchStr = ""; } // if(cuMapSearchStr.length > 0){ // contactUsChildMap(cuMapSearchStr, "js-contactusMap_tZUDjabtK5"); // } //}); </script> </div> </div> <span id="end-list"></span> <div class="alphalist__row"> <h2 class="alphalist__header epsilon" id="dtE">E</h2> <div class="contactus_child"> <article class="contact-address row"> <h2 class="contact-address__title delta col-5"> ELEVIDYS™ </h2> <div class="contact-address__details col-7"> <div class="contact-address__desc"> <p>ELEVIDYS is an adeno-associated virus vector-based gene therapy indicated in individuals at least 4 years of age: • For the treatment of Duchenne muscular dystrophy (DMD) in patients who are ambulatory and have a confirmed mutation in the DMD gene. • For the treatment of DMD in patients who are non-ambulatory and have a confirmed mutation in the DMD gene The DMD indication in non-ambulatory patients is approved under accelerated approval based on expression of ELEVIDYS micro[1]dystrophin (noted hereafter as “micro-dystrophin”). Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial(s). </p> <p><a href="/how-to-prescribe/elevidys-enrollment-form.html">Find forms</a></p> </div> </div> </article> <script type="text/javascript"> //$(document).ready(function () { // var cuMapSearchStr = ""; // if(cuMapSearchStr.length < 1){ cuMapSearchStr = ""; } // if(cuMapSearchStr.length > 0){ // contactUsChildMap(cuMapSearchStr, "js-contactusMap_zovDndfoVR"); // } //}); </script> </div> </div> <span id="end-list"></span> <div class="alphalist__row"> <h2 class="alphalist__header epsilon" id="dtF">F</h2> <div class="contactus_child"> <article class="contact-address row"> <h2 class="contact-address__title delta col-5"> FILSPARI® </h2> <div class="contact-address__details col-7"> <div class="contact-address__desc"> <p>FILSPARI (sparsentan) is an endothelin and angiotensin II receptor antagonist indicated to reduce proteinuria in adults with primary immunoglobulin A nephropathy (IgAN) at risk of rapid disease progression, generally a urine protein-to-creatinine ration (UPCR) ≥1.5 g/g.</p> <p><a href="/how-to-prescribe/filspari-enrollment-form.html">Find forms</a></p> </div> </div> </article> <script type="text/javascript"> //$(document).ready(function () { // var cuMapSearchStr = ""; // if(cuMapSearchStr.length < 1){ cuMapSearchStr = ""; } // if(cuMapSearchStr.length > 0){ // contactUsChildMap(cuMapSearchStr, "js-contactusMap_EkUlhvoj2L"); // } //}); </script> </div> </div> <span id="end-list"></span> <div class="alphalist__row"> <h2 class="alphalist__header epsilon" id="dtK">K</h2> <div class="contactus_child"> <article class="contact-address row"> <h2 class="contact-address__title delta col-5"> KUVAN® </h2> <div class="contact-address__details col-7"> <div class="contact-address__desc"> <p>KUVAN® is a phenylalanine hydroxylase activator indicated to reduce blood phenylalanine (Phe) levels in adult and pediatric patients one month of age and older with hyperphenylalaninemia (HPA) due to tetrahydrobiopterin- (BH4-) responsive Phenylketonuria (PKU). KUVAN® is to be used in conjunction with a Phe-restricted diet.</p> <p><a href="/how-to-prescribe/kuvan-enrollment-form.html">Find forms</a></p> </div> </div> </article> <script type="text/javascript"> //$(document).ready(function () { // var cuMapSearchStr = ""; // if(cuMapSearchStr.length < 1){ cuMapSearchStr = ""; } // if(cuMapSearchStr.length > 0){ // contactUsChildMap(cuMapSearchStr, "js-contactusMap_vGSjvUWZp6"); // } //}); </script> </div> </div> <span id="end-list"></span> <div class="alphalist__row"> <h2 class="alphalist__header epsilon" id="dtL">L</h2> <div class="contactus_child"> <article class="contact-address row"> <h2 class="contact-address__title delta col-5"> LUMRYZ™ </h2> <div class="contact-address__details col-7"> <div class="contact-address__desc"> <p>LUMRYZ is a central nervous system depressant indicated for the treatment of cataplexy or excessive daytime sleepiness (EDS) in adults with narcolepsy.</p> <p><a href="/how-to-prescribe/lumryz.html">Find forms</a></p> </div> </div> </article> <script type="text/javascript"> //$(document).ready(function () { // var cuMapSearchStr = ""; // if(cuMapSearchStr.length < 1){ cuMapSearchStr = ""; } // if(cuMapSearchStr.length > 0){ // contactUsChildMap(cuMapSearchStr, "js-contactusMap_kDaJXveIM8"); // } //}); </script> </div> </div> <span id="end-list"></span> <div class="alphalist__row"> <h2 class="alphalist__header epsilon" id="dtN">N</h2> <div class="contactus_child"> <article class="contact-address row"> <h2 class="contact-address__title delta col-5"> NITYR<sup style="font-size: 12.0px; line-height: 12.0px;">®</sup> </h2> <div class="contact-address__details col-7"> <div class="contact-address__desc"> <p>NITYR<sup style="font-size: 9.0px;line-height: 9.0px;">®</sup> is a hydroxyphenyl-pyruvate dioxygenase inhibitor used to treat adults and children with hereditary tyrosinemia type 1 (HT-1). NITYR works by preventing the body from breaking down an amino acid called tyrosine and by keeping other toxic substances from building up and causing harm to liver or kidneys. </p> <p><a href="/how-to-prescribe/nityr-enrollment-forms.html">Find forms</a></p> </div> </div> </article> <script type="text/javascript"> //$(document).ready(function () { // var cuMapSearchStr = ""; // if(cuMapSearchStr.length < 1){ cuMapSearchStr = ""; } // if(cuMapSearchStr.length > 0){ // contactUsChildMap(cuMapSearchStr, "js-contactusMap_WleHOieZ9H"); // } //}); </script> </div> </div> <span id="end-list"></span> <div class="alphalist__row"> <h2 class="alphalist__header epsilon" id="dtP">P</h2> <div class="contactus_child"> <article class="contact-address row"> <h2 class="contact-address__title delta col-5"> PALYNZIQ® </h2> <div class="contact-address__details col-7"> <div class="contact-address__desc"> <p>PALYNZIQ® is a phenylalanine (Phe)-metabolizing enzyme indicated to reduce blood Phe concentrations in adult patients with phenylketonuria who have uncontrolled blood Phe concentrations greater than 600 micromol/L on existing management.</p> <p><a href="/how-to-prescribe/palynziq.html">Find forms</a></p> </div> </div> </article> <script type="text/javascript"> //$(document).ready(function () { // var cuMapSearchStr = ""; // if(cuMapSearchStr.length < 1){ cuMapSearchStr = ""; } // if(cuMapSearchStr.length > 0){ // contactUsChildMap(cuMapSearchStr, "js-contactusMap_ISQE9XnXS3"); // } //}); </script> </div> </div> <span id="end-list"></span> <div class="alphalist__row"> <h2 class="alphalist__header epsilon" id="dtQ">Q</h2> <div class="contactus_child"> <article class="contact-address row"> <h2 class="contact-address__title delta col-5"> Qalsody<sup style="font-size: 12.0px; line-height: 12.0px;">TM</sup> </h2> <div class="contact-address__details col-7"> <div class="contact-address__desc"> <p>QALSODY<sup>TM</sup> (tofersen) is indicated for the treatment of amyotrophic lateral sclerosis (ALS) in adults who have a mutation in the superoxide dismutase 1 (SOD1) gene. This indication is approved under accelerated approval based on reduction in plasma neurofilament light chain (NfL) observed in patients treated with QALSODY. Continued approval for this indication may be contingent upon verification of clinical benefit in confirmatory trial(s).</p> <p><a href="/how-to-prescribe/qalsody-enrollment-form.html">Find forms</a></p> </div> </div> </article> <script type="text/javascript"> //$(document).ready(function () { // var cuMapSearchStr = ""; // if(cuMapSearchStr.length < 1){ cuMapSearchStr = ""; } // if(cuMapSearchStr.length > 0){ // contactUsChildMap(cuMapSearchStr, "js-contactusMap_VXNEfRQLTf"); // } //}); </script> </div> </div> <span id="end-list"></span> <div class="alphalist__row"> <h2 class="alphalist__header epsilon" id="dtR">R</h2> <div class="contactus_child"> <article class="contact-address row"> <h2 class="contact-address__title delta col-5"> REBYOTA® </h2> <div class="contact-address__details col-7"> <div class="contact-address__desc"> <p>REBYOTA® is a novel first-in-class microbiota-based live biotherapeutic indicated for the prevention of recurrence of Clostridioides difficile infection (CDI) in individuals 18 years of age and older, following antibiotic treatment for recurrent CDI.</p> <p><a href="/how-to-prescribe/rebyota-enrollment-form.html">Find forms</a></p> </div> </div> </article> <script type="text/javascript"> //$(document).ready(function () { // var cuMapSearchStr = ""; // if(cuMapSearchStr.length < 1){ cuMapSearchStr = ""; } // if(cuMapSearchStr.length > 0){ // contactUsChildMap(cuMapSearchStr, "js-contactusMap_AyrHhO75us"); // } //}); </script> </div> </div> <span id="end-list"></span> <div class="alphalist__row"> <h2 class="alphalist__header epsilon" id="dtS">S</h2> <div class="contactus_child"> <article class="contact-address row"> <h2 class="contact-address__title delta col-5"> Sapropterin<sup></sup> </h2> <div class="contact-address__details col-7"> <div class="contact-address__desc"> <p>Sapropterin is a generic and is a phenylalanine hydroxylase activator indicated to reduce blood phenylalanine (Phe) levels in adult and pediatric patients one month of age and older with hyperphenylalaninemia (HPA) due to tetrahydrobiopterin- (BH4-) responsive Phenylketonuria (PKU). Sapropterin is to be used in conjunction with a Phe-restricted diet.</p> </div> </div> </article> <script type="text/javascript"> //$(document).ready(function () { // var cuMapSearchStr = ""; // if(cuMapSearchStr.length < 1){ cuMapSearchStr = ""; } // if(cuMapSearchStr.length > 0){ // contactUsChildMap(cuMapSearchStr, "js-contactusMap_D7JeRoAisa"); // } //}); </script> </div> <div class="contactus_child"> <article class="contact-address row"> <h2 class="contact-address__title delta col-5"> Sucraid<sup style="font-size: 12.0px; line-height: 12.0px;">®</sup> </h2> <div class="contact-address__details col-7"> <div class="contact-address__desc"> <p>Sucraid<sup style="font-size: 9.0px;line-height: 9.0px;">®</sup> is an enzyme replacement therapy for the treatment of genetically determined sucrase deficiency, which is part of Congenital Sucrase-Isomaltase Deficiency (CSID).</p> <p><a href="/how-to-prescribe/sucraid-enrollment-forms.html">Find forms</a></p> </div> </div> </article> <script type="text/javascript"> //$(document).ready(function () { // var cuMapSearchStr = ""; // if(cuMapSearchStr.length < 1){ cuMapSearchStr = ""; } // if(cuMapSearchStr.length > 0){ // contactUsChildMap(cuMapSearchStr, "js-contactusMap_iXwKVVDG7U"); // } //}); </script> </div> </div> <span id="end-list"></span> <div class="alphalist__row"> <h2 class="alphalist__header epsilon" id="dtV">V</h2> <div class="contactus_child"> <article class="contact-address row"> <h2 class="contact-address__title delta col-5"> VOXZOGO® </h2> <div class="contact-address__details col-7"> <div class="contact-address__desc"> <p>VOXZOGO® is a C type natriuretic peptide (CNP) analog indicated to increase linear growth in pediatric patients with achondroplasia with open epiphyses. This indication is approved under accelerated approval based on an improvement in annualized growth velocity. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trial(s).</p> <p><a href="/how-to-prescribe/voxzogo-enrollment-forms.html">Find forms</a></p> </div> </div> </article> <script type="text/javascript"> //$(document).ready(function () { // var cuMapSearchStr = ""; // if(cuMapSearchStr.length < 1){ cuMapSearchStr = ""; } // if(cuMapSearchStr.length > 0){ // contactUsChildMap(cuMapSearchStr, "js-contactusMap_Z4GkSyYaMH"); // } //}); </script> </div> </div> <span id="end-list"></span> </div></div> </div> </div> </div> </div> </div> <div class="back-top"><a href="#main-content" id="back-top-fixed" class="back-to-top fixed hidden"> <span class="fa fa-lg fa-angle-up back-top__arrow" aria-hidden="true"></span> <span class="assistText">Top</span> </a> <span id="back-top-static" class="back-to-top static" style="visibility: hidden"> <span class="fa fa-lg fa-angle-up back-top__arrow" aria-hidden="true"></span>Top </span> 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