Acquiring SUNLENCA® for your practice
Once prescribed, SUNLENCA can be ordered through the Gilead-designated specialty pharmacy or an authorized specialty distributor as determined by your patient's insurance.
Specialty Pharmacy
If obtaining SUNLENCA through a pharmacy, SUNLENCA will only be available through the authorized specialty pharmacy,* which is equipped to facilitate dispensing, reimbursement, and case management.
CVS Specialty is the Specialty Pharmacy for SUNLENCA.
CVS Specialty may be able to:
- Provide benefits verification to confirm coverage for your patient
- Provide prior authorization and appeals support, if applicable
- Coordinate with your patient and office to deliver SUNLENCA around scheduled, twice-yearly injection appointments
- Collect any medication-related co-pays or co-insurance from your patient
- Coordinate with Advancing Access®, if applicable
In some cases, the authorized specialty pharmacy can be used to acquire SUNLENCA when it is covered under the patient's medical benefit, via an Assignment of Benefits (AOB) process.
Specialty Distributor (Buy-and-Bill Process)
With buy-and-bill, prescribed SUNLENCA can be acquired through an authorized specialty distributor if your patient's insurance requires it, or if you choose to utilize buy-and-bill. Your office will be responsible for storing the medication and having it available for your patient's scheduled injection appointment. Your practice will bill the health plan for reimbursement of SUNLENCA and collect the co-pay and coinsurance from each patient.
In many cases, only the injectable component will be covered under medical benefit and acquired via the buy-and-bill process.
The oral component of SUNLENCA is typically ordered from the specialty pharmacy. The specialty pharmacy will work with your office to coordinate the shipment of the oral component.
The list of authorized distributors is updated periodically and subject to change.
Please visit gilead.com/purpose/medication-access/authorized-distributors for updates.