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Easy to prescribe

Starting patients on XDEMVY is as easy as 1-2-3

Simply ePrescribe to one of the following pharmacies supplying XDEMVY:

AllianceRx Walgreens Pharmacy

Phone: 1-800-424-9002

Fax: 1-800-874-9179

41460 Haggerty Circle South
Canton, MI 48188
NPI #: 1942303110

BlinkRx

Phone: 833-919-4942

Fax: 1-866-585-4631

4696 West Overland Road Suite 274
Boise, ID 83705
NPI #: 1891461885

Carepoint Pharmacy

Phone: 855-237-9112

Fax: 1-855-237-9113

9 E. Commerce Drive
Schaumburg, IL 60173
NPI #: 1598013864

CVS Specialty Pharmacy (2 locations)

Phone: 1-800-237-2767

Fax: 1-800-323-2445

800 Biermann Court Suite B
Mount Prospect, IL 60056
NPI #: 1134100134

105 Mall Boulevard
Monroeville, PA 15146
NPI #: 1043382302

Enter key information to streamline Rx processing

Pharmacies supplying XDEMVY will need the following information to process your ePrescription and to start the prior authorization (PA). If CoverMyMeds notification or fax is received, be sure to complete any missing information and sign PA.

For your patients with Demodex blepharitis, it is important to indicate the diagnosis and related ICD-10 diagnosis code(s), for example:
– B88.0 (Other acariasis)
– H01.00 (Unspecified blepharitis)
– H01.001: Unspecified blepharitis right upper eyelid
– H01.002: Unspecified blepharitis right lower eyelid
– H01.003: Unspecified blepharitis right eye, unspecified eyelid
– H01.004: Unspecified blepharitis left upper eyelid
– H01.005: Unspecified blepharitis left lower eyelid
– H01.006: Unspecified blepharitis left eye, unspecified eyelid
– H01.009: Unspecified blepharitis unspecified eye, unspecified eyelid
– H01.00A: Unspecified blepharitis right eye, upper and lower eyelids
– H01.00B: Unspecified blepharitis left eye, upper and lower eyelids

Please include patient date of birth, contact phone number, prescription plan name, and pharmacy member ID

Inform your patient on what to expect

The pharmacy will reach out to your patient to confirm their prescription and to navigate available assistance options
- Majority of patients may pay as little as $50 or less for XDEMVY*
XDEMVY will be delivered directly to your patient’s home free of charge^†

Find Support Through Tarsus Connect

*With payer coverage and available assistance options, based on eligibility requirements.
^†For CVS or Walgreens specialty pharmacies, patients may opt to pick up their XDEMVY prescription at their neighborhood store.
ICD-10=International Classification of Diseases, 10th Revision.

Get the info you need to send Demodex mites packing

Reference: Centers for Medicare & Medicaid Services. 2023 ICD-10-CM: April 1, 2023 UPDATE. Accessed October 26, 2023. https://www.cms.gov/medicare/coding-billing/icd-10-codes/2023-icd-10-cm

INDICATIONS AND USAGE
XDEMVY (lotilaner ophthalmic solution) 0.25% is indicated for the treatment of Demodex blepharitis.

IMPORTANT SAFETY INFORMATION:

WARNINGS AND PRECAUTIONS

Risk of Contamination: Do not allow the tip of the dispensing container to contact the eye, surrounding structures, fingers, or any other surface in order to minimize contamination of the solution. Serious damage to the eye and subsequent loss of vision may result from using contaminated solutions.

Use with Contact Lenses: XDEMVY contains potassium sorbate, which may discolor soft contact lenses. Contact lenses should be removed prior to instillation of XDEMVY and may be reinserted 15 minutes following its administration.

ADVERSE REACTIONS: The most common adverse reaction with XDEMVY was instillation site stinging and burning which was reported in 10% of patients. Other ocular adverse reactions reported in less than 2% of patients were chalazion/hordeolum and punctate keratitis.

To report SUSPECTED ADVERSE REACTIONS, contact Tarsus Pharmaceuticals, Inc. at 1-888-421-4002 or the FDA at 1-800-FDA-1088 (www.fda.gov/medwatch).

Please see full Prescribing Information.