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Insurance verification

(Also known as benefit investigation or benefit verification)

  • Determine patient specific coverage for ORBACTIV® (oritavancin)
  • Identify patient’s cost-share responsibility (co-pay, co-insurance, deductible amounts)
  • Determine prior authorization requirements, if any
  • Determine if predetermination is required, if any
  • Requests received by 2:00 pm ET are typically completed the same day

Prior authorization

  • Advise provider on prior authorization (PA) requirements
  • Provide sample letter of medical necessity, if needed
  • Provide payer specific PA form, if needed
  • Once provider submits prior authorization documentation, follow up with payer to determine outcome

For insurance verification, please call the ORBACTIV® Support Programs at:

1-844-ORBACTIV (1-844-672-2284) Monday - Friday, 8:00 AM - 8:00 PM ET

orbactivassistanceprogram@themedco.com


To download the ORBACTIV® Physician/Patient Assistance Form, please click the PDF file below

Orbactiv® (oritavancin) for injection patient assistance form

DISCLAIMER

Content provided for informational purposes only. This information does not guarantee coverage or payment. Codes, coverage, and payment may vary from setting to setting, and from insurer to insurer. The provider submitting a claim is solely responsible for the accuracy of the codes submitted and for compliance with all coverage and reimbursement policies.

Decisions to prescribe ORBACTIV® are by providers working with their patients. The ORBACTIV® Assistance Program provides information about ORBACTIV® and about assistance that may be available to patients who meet certain criteria, including that they are not insured by a federal health care program. More information is available through the ORBACTIV® Assistance Program.

Melinta Therapeutics, Inc. does not guarantee, and assumes no responsibility for the quality, availability, or scope of the ORBACTIV® Assistance Program services. Melinta Therapeutics, Inc. reserves the right to rescind, revoke, or amend this offer at any time without notice. Void where prohibited by law.

INDICATION

ORBACTIV® (oritavancin) is indicated for the treatment of adult patients with acute bacterial skin and skin structure infections (ABSSSIs) caused or suspected to be caused by susceptible isolates of the following Gram-positive microorganisms: Staphylococcus aureus (including methicillin-susceptible [MSSA] and -resistant [MRSA] isolates), Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus dysgalactiae, Streptococcus anginosus group (includes S. anginosus, S. intermedius, and S. constellatus), and Enterococcus faecalis (vancomycin-susceptible isolates only).

Important Safety Information

Contraindications

Use of intravenous unfractionated heparin sodium is contraindicated for 120 hours (5 days) after ORBACTIV® administration because the activated partial thromboplastin time (aPTT) test results are expected to remain falsely elevated for approximately 120 hours (5 days) after ORBACTIV® administration.

ORBACTIV® is contraindicated in patients with known hypersensitivity to ORBACTIV®.

Warnings and Precautions

Coagulation test interference: ORBACTIV® has been shown to artificially prolong aPTT for up to 120 hours, and may prolong PT and INR for up to 12 hours, and ACT for up to 24 hours. ORBACTIV has also been shown to elevate D-dimer concentrations up to 72 hours.

Hypersensitivity reactions have been reported with the use of antibacterial agents including ORBACTIV®. Discontinue infusion if signs of acute hypersensitivity occur. Monitor closely patients with known hypersensitivity to glycopeptides.

Infusion Related Reactions: Administer ORBACTIV® over 3 hours to minimize infusion-related reactions. Stopping or slowing the infusion may result in cessation of these reactions.

Clostridium difficile-associated diarrhea: Evaluate patients if diarrhea occurs.

Concomitant warfarin use: ORBACTIV has been shown to artificially prolong PT and INR for up to 12 hours. Patients should be monitored for bleeding if concomitantly receiving ORBACTIV® and warfarin.

Osteomyelitis: Institute appropriate alternate antibacterial therapy in patients with confirmed or suspected osteomyelitis.

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

Adverse Reactions

The most common adverse reactions (≥3%) in patients treated with ORBACTIV® were headache, nausea, vomiting, limb and subcutaneous abscesses, and diarrhea.

See Full Prescribing Information

INDICATION

ORBACTIV® (oritavancin) is indicated for the treatment of adult patients with acute bacterial skin and skin structure infections (ABSSSIs) caused or suspected to be caused by susceptible isolates of the following Gram-positive microorganisms: Staphylococcus aureus (including methicillin-susceptible [MSSA] and -resistant [MRSA] isolates), Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus dysgalactiae, Streptococcus anginosus group (includes S. anginosus, S. intermedius, and S. constellatus, and Enterococcus faecalis (vancomycin-susceptible isolates only).

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