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This document is a patient enrollment form for the SPARK support program, designed to assist patients in accessing and obtaining reimbursement for the medication Korlym (mifepristone).
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How to fill out patient enrollment form for
How to fill out Patient Enrollment Form for Korlym
01
Gather necessary patient information including name, contact details, and date of birth.
02
Provide details about the patient's medical history and current medications.
03
Indicate the patient's GABA level, if applicable.
04
Fill in insurance information and policy numbers if applicable.
05
Review the form for accuracy and completeness.
06
Sign and date the form where required.
07
Submit the completed form to the appropriate healthcare provider or facility.
Who needs Patient Enrollment Form for Korlym?
01
Patients with Cushing's syndrome who are being considered for treatment with Korlym.
02
Healthcare providers submitting forms on behalf of their patients.
03
Insurance companies may require this form for pre-authorization of Korlym treatment.
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People Also Ask about
What is Korlym approved for?
Korlym FDA Approval History Korlym (mifepristone) is a cortisol receptor blocker indicated to control hyperglycemia secondary to hypercortisolism in adult patients with endogenous Cushing's syndrome who have type 2 diabetes mellitus or glucose intolerance.
Do you need a prescription for Korlym?
Korlym is a prescription medicine used to treat high blood sugar (hyperglycemia) caused by high cortisol levels in the blood (hypercortisolism) in adults with endogenous Cushing syndrome who have type 2 diabetes mellitus or glucose intolerance and who cannot have surgery or for whom surgery has failed.
What is the generic for Korlym?
Korlym, also known by its generic name mifepristone, is a cortisol receptor blocker. It's used to manage high blood sugar levels in certain adults with Cushing's syndrome who have Type 2 diabetes.
Does Korlym help you lose weight?
Patients treated with Korlym experienced a significant 5.7% (6.3 kg) reduction in mean body weight at Week 24/ET.
Is mifepristone the same as Korlym?
Mifepristone (Korlym) is used to treat hyperglycemia (high blood sugar) in people with a certain type of Cushing's syndrome in which the body makes too much cortisol (a hormone) and who have failed surgery or cannot have surgery to treat this condition.
How long does it take for Korlym to work?
Everyone's experience with Korlym (mifepristone) can be different. So, it's hard to say when exactly the medication starts working for you. In a clinical study, some people had improvements in blood sugar and cholesterol levels, blood pressure, and other symptoms of Cushing's syndrome within 6 weeks of treatment.
How much does Korlym cost per month?
Korlym, which treats a type of Cushing's disease, can cost patients $16,000 to $64,000 a month and is a cash cow for Corcept, which generated almost $500 million in net revenue in the first nine months of 2024, ing to the company's most recent quarterly filing.
How to get Korlym?
Korlym is not available at your local retail pharmacy It is only available through a specialty pharmacy called SPARK, which will send Korlym directly to your home.
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What is Patient Enrollment Form for Korlym?
The Patient Enrollment Form for Korlym is a document required to register patients for treatment with Korlym (mifepristone), which is used for managing high blood sugar in adults with Cushing's syndrome.
Who is required to file Patient Enrollment Form for Korlym?
Healthcare providers who prescribe Korlym are required to file the Patient Enrollment Form for their patients to ensure they meet the necessary eligibility criteria for treatment.
How to fill out Patient Enrollment Form for Korlym?
To fill out the Patient Enrollment Form for Korlym, healthcare providers must provide patient information such as demographics, medical history, and confirm the patient's diagnosis of Cushing's syndrome, along with other required details.
What is the purpose of Patient Enrollment Form for Korlym?
The purpose of the Patient Enrollment Form for Korlym is to collect essential information to determine patient eligibility for treatment and to facilitate proper monitoring while on the medication.
What information must be reported on Patient Enrollment Form for Korlym?
Information that must be reported includes patient demographics, treatment history, medical conditions, laboratory results, confirmation of Cushing's syndrome diagnosis, and any concurrent medications.
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