How to Help Your Patients Find Phyrago in Stock: A Provider's Guide

When you prescribe Phyrago (dasatinib) to a patient with Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML) or Ph+ acute lymphoblastic leukemia (Ph+ ALL), you're not just writing a prescription — you're initiating a multi-step access process that your patient may find unfamiliar and frustrating. As their oncology provider, you play a critical role in ensuring that access to this specialty medication is as fast and smooth as possible.

This guide walks through every step of the Phyrago access pathway — from the moment you decide to prescribe through to the patient receiving their first dose at home.

Step 1: Document the Clinical Rationale Before Prescribing

Before submitting the prescription, ensure your clinical notes document:

• Confirmed Ph+ CML (phase: chronic, accelerated, or blast) or Ph+ ALL diagnosis with cytogenetic or molecular confirmation

• Concurrent use of PPIs or H2RAs (essential for overcoming step therapy requirements — this is Phyrago's clinical differentiator)

• Prior therapy history if applicable (treatment-naïve vs. imatinib-resistant/intolerant)

• BCR-ABL mutation profile if available (relevant for payer medical necessity letters)

Step 2: Route the Prescription Through Cycle Vita or Directly to Onco360

Phyrago is dispensed exclusively through Onco360 specialty pharmacy. Do not route the prescription to a retail pharmacy or other specialty pharmacy — they will not be able to fill it.

The recommended pathway is through Cycle Vita, Cycle Pharmaceuticals' hub program, which adds a layer of patient support to the dispensing process. Your practice can:

• Download and complete the Phyrago enrollment form from phyrago.com/hcp/enroll/ and fax it with the prescription

• Have a staff member call 888-360-8482 to initiate the enrollment process

• Work with your Cycle Pharmaceuticals field representative if available

Step 3: Use the Cycle Vita Starter Supply to Bridge the PA Gap

One of the most valuable features of the Cycle Vita program is the free starter supply available to commercially insured patients while prior authorization is being processed. For CML and Ph+ ALL patients, treatment delays have real clinical consequences. Leverage this starter supply proactively — don't wait for PA approval before starting the patient.

The Cycle Vita team will simultaneously work on benefit verification and prior authorization while the patient receives their initial supply. Commercially insured eligible patients may ultimately pay as little as $0 per month with the copay assistance program.

Step 4: Anticipate and Prepare for Prior Authorization Challenges

Most commercial insurance plans will require prior authorization for Phyrago. Common PA criteria that plans look for include:

• Confirmed FDA-indicated diagnosis (Ph+ CML or Ph+ ALL)

• Prescriber is an oncologist or hematologist

• For step therapy override: documentation that generic dasatinib is inappropriate due to concurrent PPI/H2RA use, with clinical data cited

• For some plans: failure, contraindication, or intolerance to generic dasatinib may be required (check Blue Cross Blue Shield criteria)

The Cycle Vita team handles PA submissions but benefits from your office providing a detailed clinical note. The more specific and clinical your documentation, the faster the authorization typically processes.

Step 5: Counsel Your Patients on What to Expect

Patients who have taken retail medications before are often blindsided by the specialty pharmacy process. Set expectations at the prescription visit:

• Phyrago will arrive by mail, not from a local pharmacy

• They may receive a call from an unfamiliar number — this is the Cycle Vita team or Onco360

• Insurance approval may take 1–3 weeks but a free starter supply can bridge that gap

• Out-of-pocket cost with the copay card may be as low as $0 for commercially insured patients

Using medfinder for Pharmacy Locating Support

For patients who need additional support navigating pharmacy availability — particularly those in rural areas or those experiencing access delays — medfinder.com/providers provides a service that calls pharmacies on behalf of patients to check availability and texts results. This is a useful complement to the Cycle Vita program. See also our Phyrago access guide for prescribers for more clinical detail.