Accessing Doptelet forms and resources
Image
Getting Started With Doptelet
Gives an overview of the Doptelet access process and the pathway options to initiate treatment from prescription through continuing care.
Image
Letter of Medical Necessity
Shows a sample letter that can be sent on behalf of patients when submitting a prior authorization request for Doptelet.
Image
Prior Authorization Resource Guide
Explains general steps in the prior authorization process to help HCP offices get patients started on Doptelet.
Image
Accessing Doptelet Through Specialty Pharmacies and Distributors
Lists contact information for the specialty pharmacies and distributors that are authorized to dispense or distribute Doptelet.
Image
Coding Resources
Provides codes to identify appropriate patients and assists with the billing and reimbursement of Doptelet.
Image
You’ve Prescribed Doptelet: Now What?
Outlines the process for patients to obtain a Doptelet prescription with a specialty pharmacy.
Doptelet Connect programs
Image
Doptelet Connect provides information regarding patient insurance coverage and financial assistance information that may be available to help patients with financial needs. Learn more about Doptelet Connect patient support programs below.
There are 3 ways to enroll a patient:
Image
Enroll your patients directly through the secure portal
Image
Download and complete the Prescription Enrollment Form below. After obtaining HCP signatures, submit the completed form 1 of 3 ways: upload it to the portal, fax it to 1-855-686-8729, or email it to DopteletConnect@AssistRx.com
Call Doptelet Connect at 1-833-368-2663
Monday–Friday 8:30 AM–7 PM ET
Doptelet Connect forms
| Doptelet Copay Assistance Program* | The Doptelet Copay Assistance Program is for eligible patients who have commercial prescription insurance. Patients may pay as little as $0 per prescription, up to a maximum benefit of $15,000 per calendar year. | |
| Doptelet Bridge Program† | The Doptelet Bridge Program can provide a limited supply of Doptelet at no cost to eligible patients experiencing a gap in coverage for Doptelet. | |
| Doptelet Patient Assistance Program† | The Doptelet Patient Assistance Program provides Doptelet at no cost to patients who meet the program eligibility requirements. |
*In order to participate in the Doptelet Copay Assistance Program (“Program”), a patient must be aged ≥18 years and have commercial prescription insurance for Doptelet. This Program is not valid for patients whose prescription claims are reimbursed, in whole or in part, by any state or federal government program, including (but not limited to) Medicaid, Medicare, Medigap, Department of Defense (DoD), Veterans Affairs (VA), TRICARE, Puerto Rico Government Insurance, or any state patient or pharmaceutical assistance program. This offer is not valid for patients paying with cash. The Program is void where prohibited by law. Certain rules and restrictions apply. Sobi reserves the right to revoke, rescind, or amend this offer without notice.This Program is not insurance.
†Program subject to eligibility requirements and program terms and conditions.
HCP=healthcare professional.
Doptelet Connect resources
Image
Doptelet Connect Overview
Summary of the different access and reimbursement support options that help patients access Doptelet.
Image
Doptelet Connect Process Flow for Healthcare Professional Office
Explains the relationship between the HCP offices and Doptelet Connect and steps each may take during the access and reimbursement process.
See formulary status in your area*
Do you have questions on getting access to therapy for your patients related to COVERAGE, PRIOR AUTHORIZATION, or STEP EDITS?
Consult with your field reimbursement manager at Doptelet.escalation@sobi.com.
Please include the following information with each email inquiry:
1) Practice Name 2) Contact Name 3) Direct Phone Number 4) State and ZIP Code 5) Issue Needing Assistance
§Coverage and reimbursement information is provided for your information only and is subject to change. For specific information, please contact the patient’s insurer. Third-party payment for prescription drugs is affected by numerous factors, and Sobi makes no representation or guarantee concerning reimbursement or coverage for Doptelet or any other service or item.
TPO-RA=thrombopoietin receptor agonist.
Get help from a Field Reimbursement Manager
Start patients on Doptelet with expert support for access, coverage, and financial assistance.
Image
- DOPTELET (avatrombopag) [prescribing information]. Morrisville, NC: AkaRx, Inc; 2025.
- Data on file. Doptelet vs competitors. 2025: Sobi, Inc.