There are 3 options for prescribing BESREMi:
1Complete and submit the PharmaEssentia SOURCE Enrollment Form. It includes a section that serves as your patient’s first prescription.
2Prescribe BESREMi for fulfillment through one of our specialty pharmacy partners, including Biologics or Onco360, and the medication will be shipped directly to your patient.
3Dispense BESREMi in the office (for oncology GPO members).
For product information about BESREMi, including specialty pharmacy and distribution network and storage and handling instructions, download this flashcard.
Complete the Enrollment Form to request reimbursement support and indicate your preferred pharmacy.
Fax the Enrollment Form to PharmaEssentia SOURCE at 800-700-5065.
If you have any questions about pharmacy qualifications, call PharmaEssentia SOURCE at 800-700-5053 between 8:00 AM and 8:00 PM ET, Monday through Friday.