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Treatment for adults with Dupuytren’s
contracture with a palpable cord

HelpfulDownloads

The XIAFLEX® Resource Center

Access downloadable forms and resources for your practice and your appropriate adult patients

Please print the full Prescribing Information, including Medication Guide.

Training Guide

Refer to this guide for instructions on the preparation and administration of XIAFLEX®

HCP Enrollment Form

Use this form to enroll in the managed distribution program

Healthcare Site Enrollment Form

Use this form to enroll your healthcare site in the managed distribution program

Coding Tables

Learn about possible codes associated with XIAFLEX® treatment

Chart Documentation Guide

Learn about specific clinical information typically required by payors in order to confirm coverage

 
Sample 1450 Form – Single Cord/Joint

A useful example that shows what the 1450 Form – Single Cord/Joint claim form looks like when properly filled out

Sample 1450 Form – Dual Cord/Joint, No Modifier Required

A useful example that shows what the 1450 Form – Dual Cord/Joint, No Modifier Required claim form looks like when properly filled out

Sample 1450 Form – Dual Cord/Joint, Modifier Required

A useful example that shows what the 1450 Form – Dual Cord/Joint, Modifier Required claim form looks like when properly filled out

Sample 1500 Form – Single Cord/Joint

A useful example that shows what the 1500 Form – Single Cord/Joint claim form looks like when properly filled out

Sample 1500 Form – Dual Cord/Joint, No Modifier Required

A useful example that shows what the 1500 Form – Dual Cord/Joint, No Modifier Required claim form looks like when properly filled out

Sample 1500 Form – Dual Cord/Joint, Modifier Required

A useful example that shows what the 1500 Form – Dual Cord/Joint, Modifier Required claim form looks like when properly filled out

XIAFLEX® Copay Card

Downloadable discount card, including terms and eligibility requirements, that pertain to your patient's XIAFLEX® Copay Program

Copay Program Reimbursement Form

For patients to apply for copay reimbursement when XIAFLEX® is ordered through a Specialty Distributor

Patient Assistance Program Application

For patients who require financial assistance with their XIAFLEX® copay

Prescription and Benefits Investigation Form

Use this form to initiate a benefits investigation

XIAFLEX® Letter of Medical Necessity

Use this form if additional support is needed to ensure coverage

XIAFLEX® Denied Injection Claim Appeal Letter

Use this form to appeal a denied injection claim

XIAFLEX® Denied Finger Extension Procedure Appeal Letter

Use this form to appeal a denied finger extension claim

XIAFLEX® Patient Brochure

Provides a patient-friendly overview of Dupuytren's contracture and treatment with XIAFLEX®

Finger Exercises Brochure

Provides a patient-friendly explanation of how to perform at-home finger exercises

Setting Patient Expectations Leaflet

Provides patient-friendly instructions to follow and potential side effects to be aware of after a XIAFLEX® procedure

Important access contact information

Specialty Distributor

Besse Medical

Phone: 1-800-543-2111

Fax: 1-800-543-8695

Besse.com

Specialty Pharmacy

US Bioservices

Phone: 1-855-534-8323

Fax: 1-888-418-7246

Usbioservices.com

Access Support

Endo Advantage

Phone: 1-877-XIAFLEX (1-877-942-3539)

Fax: 1-877-909-2337

Video Library

Get a closer look

View videos about Dupuytren's contracture and XIAFLEX® to enhance your experience

To become a trained injector, please refer to the Training Video

Please see full Prescribing Information, including Medication Guide.

Request aRepresentative

Want to learn more about XIAFLEX®?

Request a representative to provide assistance, register to receive updates about XIAFLEX®, or both

Please enter your contact information here

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Request A Representative

Specialty Sales Professional (SSP)

Your SSP is your primary resource for information and process support related to XIAFLEX®

Field Reimbursement Manager (FRM)

FRMs are trained to address any case-specific coding, billing, and reimbursement questions you or your office staff may have


Sign up to receive updates

Register here to receive communications about Duyputren's contracture, treating with XIAFLEX®, and more–delivered right to your inbox.

Endo Pharmaceuticals Inc. understands that your privacy is important. Please note that by providing your name, address, or other information, you are giving Endo and companies working with us permission to communicate with you via traditional mail, email, telephone, or text about XIAFLEX® and other Endo products, programs, and services. We will not sell or transfer your name, address, or other personally identifiable information about you to any party for its own marketing use. To view the privacy policy, please visit www.endo.com/privacy-legal.

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Important Safety Information
for XIAFLEX®

  • XIAFLEX® is contraindicated in patients with a history of hypersensitivity to XIAFLEX® or to collagenase used in any other therapeutic application or application method
  • In the controlled and uncontrolled portions of clinical trials in Dupuytren's contracture, flexor tendon ruptures occurred after XIAFLEX® injection. Injection of XIAFLEX® into collagen-containing structures such as tendons or ligaments of the hand may result in damage to those structures and possible permanent injury such as tendon rupture or ligament damage. Therefore, XIAFLEX® should be injected only into the collagen cord with a MP or PIP joint contracture, and care should be taken to avoid injecting into tendons, nerves, blood vessels, or other collagen-containing structures of the hand. When injecting a cord affecting a PIP joint of the fifth finger, the needle insertion should not be more than 2 to 3 mm in depth and avoid injecting more than 4 mm distal to the palmar digital crease
  • Other XIAFLEX®-associated serious local adverse reactions in the controlled and uncontrolled portions of the studies included pulley rupture, ligament injury, complex regional pain syndrome (CRPS), sensory abnormality of the hand, and skin laceration (tear). In a historically controlled post-marketing trial, the incidence of skin laceration (22%) was higher for subjects treated with two concurrent injections of XIAFLEX® compared with subjects treated with up to three single injections in the placebo-controlled premarketing trials (9%). Cases of skin laceration requiring skin graft after finger extension procedures have been reported post-marketing. Signs or symptoms that may reflect serious injury to the injected finger/hand should be promptly evaluated because surgical intervention may be required
  • In the controlled portions of the clinical trials in Dupuytren's contracture, a greater proportion of XIAFLEX®-treated patients (15%) compared to placebo-treated patients (1%) had mild allergic reactions (pruritus) after up to 3 injections. The incidence of XIAFLEX®-associated pruritus increased after more XIAFLEX® injections in patients with Dupuytren's contracture
  • Because XIAFLEX® contains foreign proteins, severe allergic reactions to XIAFLEX® can occur. Anaphylaxis was reported in a post-marketing clinical study in one patient who had previous exposure to XIAFLEX® for the treatment of Dupuytren's contracture. Healthcare providers should be prepared to address severe allergic reactions following XIAFLEX® injections
  • In the XIAFLEX® trials in Dupuytren's contracture, 70% and 38% of XIAFLEX®-treated patients developed an ecchymosis/contusion or an injection site hemorrhage, respectively. Patients with abnormal coagulation (except for patients taking low-dose aspirin, eg, up to 150 mg per day) were excluded from participating in these studies. Therefore, the efficacy and safety of XIAFLEX® in patients receiving anticoagulant medications (other than low-dose aspirin, eg, up to 150 mg per day) within 7 days prior to XIAFLEX® administration is not known. In addition, it is recommended to avoid use of XIAFLEX® in patients with coagulation disorders, including patients receiving concomitant anticoagulants (except for low-dose aspirin)
  • In the XIAFLEX® clinical trials for Dupuytren's contracture, the most common adverse reactions reported in ≥25% of patients treated with XIAFLEX® and at an incidence greater than placebo were edema peripheral (eg, swelling of the injected hand), contusion, injection site hemorrhage, injection site reaction, and pain in the injected extremity

Indication

XIAFLEX® is indicated for the treatment of adult patients with Dupuytren's contracture with a palpable cord.

Please see the full Prescribing Information, including Medication Guide.