KALBITOR Access® Enrollment
Because acute hereditary angioedema (HAE) attacks can occur at any time, it's critical that patients have access to on-demand treatment at all times. To help patients better understand the KALBITOR Access services available to them, we have designed this KALBITOR Access Information for Patients brochure. You can download it and review with your patient.
Once you and your patient have developed an individual treatment plan for how they will access KALBITOR® (ecallantide), follow these simple steps to get started.
Step 1
Download the KALBITOR Access Start Form and Patient Authorization Form.
- The KALBITOR Access Start Form serves as a prescription and provides information to help verify health insurance coverage for your patient.
- The Patient Authorization Form must be reviewed and signed by the patient in order to receive KALBITOR Access services. If your patients would like to use electronic signature, have them call 1-888-4KALBITOR for instructions.
Step 2
Fax the completed forms to KALBITOR Access at 1-888-806-4829.
Once Patients Are Enrolled
Once the completed forms are received, program staff will:
- Begin to review the most appropriate service option for your patient.
- Contact you and your patient to verify receipt of the forms and discuss treatment details.