DALVANCE CONNECTS

Provides a comprehensive package of services, including access to:

  • Benefit verification
  • Billing and coding support
  • Prior authorization assistance
  • Financial patient assistance, based on eligibility

Call the DALVANCE CONNECTS program toll-free at:

1.855.387.2824

Program Coordinators are available from 8:00 AM to 8:00 PM ET, Monday through Friday, excluding holidays.

Introducing the DALVANCE CONNECTS Provider Portal (www.DALVANCECONNECTS.com)

The Provider Portal is a secure online resource for healthcare providers’ practices or offices to use when requesting benefit verifications. It offers a quick and easy way to enroll patients and maintain insurance verification status updates accessible through the website www.DALVANCECONNECTS.com.

The Portal Provides:

  • A convenient way for registered HCPs to enroll a patient online or check the patient’s status
  • Access to real-time information about the patient’s enrollment status that can be accessed according to the schedule of the user, along with reports and lists that can be tailored to the user’s needs
  • Secure online enrollment (requires one-time registration process)

Features of the Provider Portal available:

  • Online enrollment forms to facilitate enrollment and request services through DALVANCE CONNECTS℠ for your patients
  • Secure messaging to send and receive HIPAA-compliant communications to and from program representatives
  • Alert notifications to inform HCPs when different situations arise, such as when missing information is needed or when benefit verifications are completed
  • Patient profiles provide an overview of patient information and activities completed by DALVANCE CONNECTS℠
  • DALVANCE CONNECTS℠ reimbursement reference materials, such as the Coding and Billing Guide, Reimbursement-At-A-Glance Guide, or sample forms (Prior Authorization Form and Medical Necessity Form)
  • Electronic eligibility checks to view and initiate a non–product-specific insurance eligibility check to determine medical benefit coverage

Unsecured services available at all times without having to register will include key Forms and Resources on coverage, coding, and payment that support the access for DALVANCE (dalbavancin) for injection.

Financial assistance for patients

The DALVANCE CONNECTS℠ Co-Pay Assistance Program may provide eligible commercial insurance patients assistance with their out-of-pocket costs for DALVANCE.

  • Eligible patients with an out-of-pocket cost for DALVANCE of greater than $50 per infusion may qualify to receive assistance after the patient has paid the first $50 per infusion, when administered at any outpatient setting of care,* whether it is for the 1 dose infusion (1500 mg) or the first (1000 mg) or second (500 mg) IV infusion of the 2 dose regimen of DALVANCE
  • The program will provide a maximum of $800 in assistance over 1 or 2 infusions of DALVANCE within a 12-month period

Includes a practice-based or freestanding infusion center, hospital outpatient department, or home infusion service.

Here’s Who Is Eligible

Any patient who:

  • Is 18 years of age or older and has commercial insurance
  • Is a resident of, and is treated with DALVANCE in, the US (including Puerto Rico, US Virgin Islands, and Guam)
  • Is administered DALVANCE in an outpatient setting of care

This is not insurance. Subject to change or discontinuation by Allergan at any time.

Next: Resources

Reimbursement Specialist

For assistance with the reimbursement process—prior authorizations, benefit verification, coverage, coding, and payment for DALVANCE—get help from a reimbursement specialist.

Request a Specialist »

INDICATION & USAGE

DALVANCE® (dalbavancin) for injection is indicated for the treatment of adult patients with acute bacterial skin and skin structure infections (ABSSSI) caused by susceptible isolates of the following Gram-positive microorganisms: Staphylococcus aureus (including methicillin-susceptible and methicillin-resistant strains), Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus dysgalactiae, Streptococcus anginosus group (including S. anginosus, S. intermedius, S. constellatus) and Enterococcus faecalis (vancomycin-susceptible strains).

To reduce the development of drug-resistant bacteria and maintain the effectiveness of DALVANCE and other antibacterial agents, DALVANCE should be used only to treat infections that are proven or strongly suspected to be caused by susceptible bacteria.

IMPORTANT SAFETY INFORMATION
Contraindications

DALVANCE is contraindicated in patients with known hypersensitivity to dalbavancin.

Warnings and Precautions

Hypersensitivity Reactions

Serious hypersensitivity (anaphylactic) and skin reactions have been reported with glycopeptide antibacterial agents, including DALVANCE. Exercise caution in patients with known hypersensitivity to glycopeptides due to the possibility of cross-sensitivity. If an allergic reaction occurs, treatment with DALVANCE should be discontinued.

Infusion-related Reactions

Rapid intravenous infusion of DALVANCE can cause reactions, including flushing of the upper body, urticaria, pruritus, and rash.

Hepatic Effects

ALT elevations with DALVANCE treatment were reported in clinical trials.

Clostridium difficile-associated Diarrhea

Clostridium difficile-associated diarrhea (CDAD) has been reported with nearly all systemic antibacterial agents, including DALVANCE, with severity ranging from mild diarrhea to fatal colitis. Evaluate if diarrhea occurs.

Development of Drug-resistant Bacteria

Prescribing DALVANCE in the absence of a proven or strongly suspected bacterial infection is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.

Adverse Reactions

The most common adverse reactions in patients treated with DALVANCE were nausea (4.7%), headache (3.8%), and diarrhea (3.4%).

Use in Specific Populations

Please see Full Prescribing Information.

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IMPORTANT SAFETY INFORMATION
Contraindications

DALVANCE is contraindicated in patients with known hypersensitivity to dalbavancin.

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Warnings and Precautions

Hypersensitivity Reactions

Serious hypersensitivity (anaphylactic) and skin reactions have been reported with glycopeptide antibacterial agents, including DALVANCE. Exercise caution in patients with known hypersensitivity to glycopeptides due to the possibility of cross-sensitivity. If an allergic reaction occurs, treatment with DALVANCE should be discontinued.

Infusion-related Reactions

Rapid intravenous infusion of DALVANCE can cause reactions, including flushing of the upper body, urticaria, pruritus, and rash.

Hepatic Effects

ALT elevations with DALVANCE treatment were reported in clinical trials.

Clostridium difficile-associated Diarrhea

Clostridium difficile-associated diarrhea (CDAD) has been reported with nearly all systemic antibacterial agents, including DALVANCE, with severity ranging from mild diarrhea to fatal colitis. Evaluate if diarrhea occurs.

Development of Drug-resistant Bacteria

Prescribing DALVANCE in the absence of a proven or strongly suspected bacterial infection is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.

Adverse Reactions

The most common adverse reactions in patients treated with DALVANCE were nausea (4.7%), headache (3.8%), and diarrhea (3.4%).

Use in Specific Populations
  • There have been no adequate and well-controlled studies with DALVANCE in pregnant or nursing women. DALVANCE should only be used if the potential benefit justifies the potential risk in these populations.
  • In patients with renal impairment whose known creatinine clearance is less than 30 mL/min and who are not receiving regularly scheduled hemodialysis, the recommended regimen of DALVANCE is 1125 mg, administered as a single dose, or 750 mg followed one week later by 375 mg. No dosage adjustment is recommended for patients receiving regularly scheduled hemodialysis, and DALVANCE can be administered without regard to the timing of hemodialysis.
  • Caution should be exercised when prescribing DALVANCE to patients with moderate or severe hepatic impairment (Child-Pugh Class B or C) as no data are available to determine the appropriate dosing in these patients.

Please see Full Prescribing Information.