Get answers to your patient's questions about the Sandostatin® NHIP for your patients with severe diarrhea and flushing associated with carcinoid syndrome or your patients with acromegaly.
Click below for answers to frequently asked questions.
- Am I eligible for this program based on my medical and pharmaceutical coverage?
- According to my disease state, am I a candidate for this program?
- What are the main benefits of the Sandostatin® LAR Depot Nurse Home Injection Program?
- Is flexible scheduling available?
- How is my nurse selected?
- How does my Sandostatin® LAR Depot get to my home?
- Will I still see my physician regularly?
- Does this involve a lot of paperwork on my part?
To print a complete list of questions and answers, click here
Frequently asked questions
Q: Am I eligible for this program based on my medical and pharmaceutical insurance coverage?
A: The Sandostatin® LAR Depot NHIP is intended as a benefit for all eligible patients for whom Sandostatin® LAR Depot has been prescribed. Residents of all states except Massachusetts, Michigan, Minnesota, and Rhode Island can participate. Currently, reimbursement for home injections is provided to members of most commercial plans (eg, HMO, PPO). Patients with government-provided medical insurance (eg, Medicare Parts B and D, or Medicaid) are not covered. Eligibility can be determined by calling BioScrip®, the company that coordinates this program on behalf of Novartis Pharmaceuticals Corporation. Anyone can call 1-888-LAR-4759 (1-888-527-4759) for confirmation of eligibility.
Q: According to my disease state, am I a candidate for this program?
A: This program is for patients with acromegaly or carcinoid syndrome. If the patient has been prescribed Sandostatin® LAR Depot for the first time, the initial dose of therapy must be given in a physician's office or clinic. Further evaluation by each patient's physician of his/her disease state and comorbidities may determine whether or not the patient is a candidate. Those who receive Sandostatin® LAR Depot for other conditions are not eligible at this time. If the patient has an approved insurance plan and qualifies clinically, enrollment is easy. Call 1-888-LAR-4759 (1-888-527-4759) to enroll.
Q: What are the main benefits of the Sandostatin® LAR Depot NHIP?
A: The Program provides appropriately and conveniently delivered therapy.
- Patients receive the right dose at the right time using the right technique
- Patients have the assurance of knowing that a specially trained registered nurse will come to their home to administer Sandostatin® LAR Depot
The program offers nursing evaluation and follow-up
- Provides ample time for nurses to answer treatment-related questions
- The nurse reports to the patient's physician after each visit
- The nurse makes the next appointment and will follow up with a reminder
Q: Is flexible scheduling available?
A: The home visit provides the convenience of home care with the quality of a clinical experience. This program enables patients to receive therapy beyond the traditional office hours if necessary, including evenings and weekends, or even when they are traveling out of town.
Q: How is my nurse selected?
A: Specially trained registered nurses are selected by the NHIP to administer injections in the home. All nurses are fully knowledgeable about carcinoid syndrome and acromegaly, the prescribing information for Sandostatin® LAR Depot, and the mixing and injection process. All nurses in the program are continuously monitored by Nurse Coordinators at the NHIP and are in regular contact with the prescribing physician to provide them with updates.
Q: How does my Sandostatin® LAR Depot get to my home?
A: Patients may continue to get their prescriptions for Sandostatin® LAR Depot in their current manner. Insurance coverage for the drug is independent of coverage eligibility for home injections. Depending on a patient's pharmacy coverage, the drug may be shipped to the patient's home or local pharmacy for pickup. These details can be worked out with a NHIP Case Coordinator.
NOTE: Sandostatin® LAR Depot must be refrigerated immediately upon receipt and until use.
Q: Will I still see my physician regularly?
A: Yes. Physician evaluation and biochemical testing will still occur at appropriate intervals as determined by the patient's physician. Many patients with acromegaly are tested every 3 months and some are evaluated every 6 months. Patients will still adhere to the office schedule directed by their physicians. The only difference is that monthly injections will be administered at home. Schedules are planned according to nursing orders from the physician.
Q: Does this involve a lot of paperwork on my part?
A: No. The enrollment form, which you can download here, will be filled out at the physician's office, signed by the patient, and sent to BioScrip®. Most of the communication after this takes place by phone. The Nurse Coordinator calls patients for interviews and assessments prior to the first visit. All scheduling is done by the nurses and is communicated to the scheduler at BioScrip®.
INDICATIONS AND USAGE
Sandostatin® LAR Depot (octreotide acetate for injectable suspension) is indicated for patients in whom initial treatment with immediate release Sandostatin® (octreotide acetate) Injection has been shown to be effective and tolerated for:
- Long-term maintenance therapy in acromegalic patients who have had inadequate response to surgery and/or radiotherapy or for whom surgery and/or radiotherapy is not an option (the goal of treatment in acromegaly is to reduce GH and IGF-1 levels to normal).
- Long-term treatment of the severe diarrhea and flushing episodes associated with metastatic carcinoid tumors.
- Long-term treatment of the profuse watery diarrhea associated with VIP-secreting tumors.
In patients with carcinoid syndrome and VIPomas, the effect of Sandostatin Injection and Sandostatin LAR Depot on tumor size, rate of growth and development of metastases has not been determined.
IMPORTANT SAFETY INFORMATION
Warnings and Precautions:
- Gallbladder abnormalities may occur: Patients should be monitored periodically.
- Glucose Metabolism: Hypoglycemia or hyperglycemia may occur. Blood glucose levels should be monitored when Sandostatin LAR Depot treatment is initiated or when the dose is altered. Antidiabetic treatment should be adjusted accordingly.
- Thyroid Function: Hypothyroidism may occur. Baseline and periodic assessment of thyroid function (TSH, total and/or free T4) is recommended.
- Cardiac Function: Bradycardia, arrhythmia, conduction abnormalities, and other EKG changes may occur. The relationship of these events to octreotide acetate is not established because many of these patients have underlying cardiac disease. Use with caution in at-risk patients.
- Nutrition: Octreotide may alter absorption of dietary fats. Monitoring of vitamin B12 levels is recommended during therapy with Sandostatin LAR Depot. Patients on total parenteral nutrition (TPN) and octreotide should have periodic monitoring of zinc levels.
Drug Interactions: The following drugs require monitoring and possible dose adjustment when used with Sandostatin LAR Depot: cyclosporine, insulin, oral hypoglycemic agents, beta-blockers, bromocriptine. Octreotide has been associated with alterations in nutrient absorption, so it may have an effect on absorption of orally administered drugs. Drugs mainly metabolized by CYP3A4 and which have a low therapeutic index should be used with caution.
Adverse Reactions: The most common adverse reactions occurring in patients receiving Sandostatin LAR Depot are:
- Acromegaly: biliary abnormalities (52%), diarrhea (36-48%), cholelithiasis (13-38%), abdominal pain or discomfort (11-29%), flatulence (26%), influenza-like symptoms (20%), constipation (19%), headache (15%), anemia (15%), hyperglycemia (15%), injection site pain (2-14%), hypertension (13%), dizziness (12%), fatigue (11%), nausea (10%), vomiting (7%), hypothyroidism (2%), hypoglycemia (2%), and goiter (2%).
- Carcinoid Tumors and VIPomas: biliary abnormalities (62%), injection site pain (20-50%), nausea (24-41%), abdominal pain (10-35%), fatigue (8-32%), headache (16-30%), hyperglycemia (27%), back pain (8-27%), constipation or vomiting (15-21%), dizziness (18-20%), sinus bradycardia (19%), pruritus (18%), URTI (10-18%), myalgia (4-18%), flatulence (9-16%), arthropathy (8-15%), rash (15%), generalized pain (4-15%), sinusitis (5-12%), conduction abnormalities (9%), hypoglycemia (4%), and arrhythmia (3%).
