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tools to
assist you.

 

These simple tools were created to help you enroll your patients in Acadia Connect™ and get them started on their prescription medication.

 

CONNECT WITH US
Monday through Friday, 8:30 am to 8:30 pm ET

 
 
 

formulary lookup.

 

Choose your patient’s medicine, select their insurance type and plan and click “Lookup Formulary.”

NUPLAZID® (pimavanserin)

 

34 MG CAPSULES

 

This information is intended as a guide. Coverage and costs may differ between private and government insurance plans, and are subject to change. Please check with the health plan to confirm coverage for individual patients.

Please see Indication and Important Safety Information, including Boxed WARNING, below.

 
 

 
 
 
 

prior authorization.

 

Your patient may need authorization to get insurance coverage. Complete the fields, and then submit when enrolling your patient in Acadia Connect.

 
 
 

 
 
 

other tools

 
 
Icon reflects Letter of Appeal template available for download by HCPs
 

LETTER OF APPEAL

Your patient may need a letter of appeal if a previous authorization request has been denied.

CREATE LETTER
 
 
Icon reflects Letter of Medical Necessity template available for download by HCPs
 

LETTER OF MEDICAL NECESSITY

You may need to document a patient’s medical necessity for treatment to get insurance coverage.

CREATE LETTER
 
 
 
about ICD-10 codes.
 

Here’s a quick list of what you need to know about ICD-10 codes for your patients:

 

For diagnostic codes in treating Parkinson’s disease (PD) psychosis*:

  • Coding must be to the highest level of specificity
  • Coding decisions are the responsibility of the prescribing healthcare provider
  • Coding combinations recognized for PD psychosis include G20 (Parkinson’s disease) plus one of the following ICD-10 codes1:
    • F06.0 Psychotic disorder with hallucinations due to known physiological condition
    • F06.2 Psychotic disorder with delusions due to known physiological condition
 

* Diagnostic codes are not required to complete the NUPLAZID treatment form.

 
Important Safety Information and Indication for NUPLAZID® (pimavanserin)


WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS

  • Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death.
  • NUPLAZID is not approved for the treatment of patients with dementia-related psychosis unrelated to the hallucinations and delusions associated with Parkinson’s disease psychosis.
  • Contraindication: NUPLAZID is contraindicated in patients with a history of a hypersensitivity reaction to pimavanserin or any of its components. Rash, urticaria, and reactions consistent with angioedema (e.g., tongue swelling, circumoral edema, throat tightness, and dyspnea) have been reported.
  • Warnings and Precautions: QT Interval Prolongation
    • NUPLAZID prolongs the QT interval. The use of NUPLAZID should be avoided in patients with known QT prolongation or in combination with other drugs known to prolong QT interval including Class 1A antiarrhythmics or Class 3 antiarrhythmics, certain antipsychotic medications, and certain antibiotics.
    • NUPLAZID should also be avoided in patients with a history of cardiac arrhythmias, as well as other circumstances that may increase the risk of the occurrence of torsade de pointes and/or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and presence of congenital prolongation of the QT interval.
  • Adverse Reactions: The common adverse reactions (≥2% for NUPLAZID and greater than placebo) were peripheral edema (7% vs 2%), nausea (7% vs 4%), confusional state (6% vs 3%), hallucination (5% vs 3%), constipation (4% vs 3%), and gait disturbance (2% vs <1%).
  • Drug Interactions:
    • Coadministration with strong CYP3A4 inhibitors (e.g., ketoconazole) increases NUPLAZID exposure. Reduce NUPLAZID dose to 10 mg taken orally as one tablet once daily.
    • Coadministration with strong or moderate CYP3A4 inducers reduces NUPLAZID exposure. Avoid concomitant use of strong or moderate CYP3A4 inducers with NUPLAZID.
 

Indication

NUPLAZID is indicated for the treatment of hallucinations and delusions associated with Parkinson’s disease psychosis.

Dosage and Administration

Recommended dose: 34 mg capsule taken orally once daily, without titration.

NUPLAZID is available as 34 mg capsules and 10 mg tablets.

Please read the full Prescribing Information, including Boxed WARNING.

NUPLAZID is a registered trademark of Acadia Pharmaceuticals Inc.

 
 
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Reference:
1. World Health Organization. International Statistical Classification of Diseases and Related Health Problems, ICD-10 version: 2015. https://icd.who.int/browse10/2015/en#/F02.3. Accessed August 4, 2020.