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RELiZORB (iMMOBILIZED LIPASE) CARTRIDGE

Access RELiZORB Resources and Support

Find answers to RELiZORB questions and assistance with insurance, financial support, and more

RELiZORB Support Services (RSS) is a support program committed to helping patients who have been prescribed RELiZORB

Your RELiZORB patient access experts

RELiZORB Support Services (RSS) is a support program committed to providing patients prescribed RELiZORB with product education, insurance assistance, help with delivery of RELiZORB, and financial support.

RELiZORB Support Services helps patients with:

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How to use
RELiZORB
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Insurance
coordination
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Delivery of
RELiZORB
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Financial
assistance

To prescribe RELiZORB for your patient, submit the completed RELiZORB Patient Enrollment Form along with any appropriate clinical documentation.

RELiZORB Support Services has played a critical role in helping my patients navigate access and adherence. Their team streamlines the insurance process and provides timely support, which allows me to focus more on clinical care and less on logistical hurdles.

— Sivan Kinberg, MD

Our Case Managers offer personalized support throughout your patient’s journey

Encourage your RELiZORB-prescribed patients to complete the Patient Authorization Form or Patient Representative Authorization Form to connect them with their RSS Case Manager.

Our dedicated support team will offer your patients personalized support and will:

  • Help them obtain prior authorization (when necessary) and submit claims
  • Assist with the appeal process in case of an insurance denial
    • Most commercial and state Medicaid plans cover RELiZORB
  • Coordinate ordering and delivery of RELiZORB through a specialty pharmacy
  • Support your patient beyond initial access with refill coordination, navigating insurance changes, and providing ongoing education
A RELiZORB Case Manager providing personalized phone support to a patient

Connect with a RELiZORB Support Services Case Manager at 1-844-632-9271 or email [email protected] for information on enrolling your patient.

Enrollment and authorization forms

Resources for your practice

There was a challenging time in our world where my insurance company was struggling to maintain coverage for [my son]’s RELiZORB, and RELiZORB Support Services was fantastic. They were very supportive. They helped me through every question I had, every challenge I had, they spoke with my insurance company directly. I’m really grateful to have had the support from RELiZORB.

— Pam C., mom of patient with cystic fibrosis who is using RELiZORB

HCPCS billing code

Effective January 1, 2019, RELiZORB has a permanent, separately billable Medicare billing code (B4105).

In addition, RELiZORB was assigned the PE04 (Enteral Equipment and/or Supplies) Product and Service Code, which may be relevant for certain patients under the July 11, 1984, Medicare National Coverage Determination for Enteral and Parenteral Nutritional Therapy (180.2).

Ordering information for hospitals and clinics

RELiZORB can be ordered directly from Alcresta Therapeutics, Inc:

  • To order RELiZORB directly from Alcresta, send your purchase order to the following email address: GMB-SPS-ALCRESTA
    @cordlogistics.com    .
    You may reference SKU# 100300, Description: RELiZORB
  • RELiZORB is supplied in boxes of 30 cartridges.
    1 box = 30 cartridges
  • RELiZORB UDI:
    - Individual RELiZORB cartridge: 00862205000250
    - 30ct Box
  • For pricing information or other hospital ordering-related questions, please contact Hospital Order Support at GMB-SPS-ALCRESTA
    @cordlogistics.com

Distributor and GPO information

Distributor Product number table

To report an adverse reaction, complaint, or product safety concern, please complete the  Complaint Report Form and return to Alcresta Quality Assurance at [email protected].

Stay up to date on RELiZORB

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HCPCS=healthcare common procedure coding system.

RELiZORB is indicated for use in pediatric (including neonates and infants) and adult patients to hydrolyze fats during enteral feeding.

Warnings
  • RELiZORB is for use with enteral tube feeding only.
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RELiZORB is indicated for use in pediatric (including neonates and infants) and adult patients to hydrolyze fats during enteral feeding.

Warnings
  • RELiZORB is for use with enteral tube feeding only.
  • RELiZORB should not be connected to any intravenous (IV) line, setup, or system.
  • Medications should not be administered through the RELiZORB cartridge. Do not add medications to the enteral nutrition or tubing before RELiZORB. The passage of medications through RELiZORB may adversely affect the medications or the ability of RELiZORB to hydrolyze fats.
  • Fibrosing Colonopathy - Fibrosing colonopathy is a rare, serious adverse reaction associated with high-dose use of pancreatic enzyme replacement therapy in the treatment of patients with cystic fibrosis. The underlying mechanism of fibrosing colonopathy remains unknown. Patients with fibrosing colonopathy should be closely monitored because some patients may be at risk of progressing to stricture formation. RELiZORB contains lipase enzyme that is not from a porcine source. The lipase is bound to the beads, and this lipase-bead complex (iLipase) is retained within the RELiZORB cartridge. Continue to follow your physician’s guidance and porcine pancreatic enzyme labeling regarding porcine pancreatic enzyme use when used in conjunction with RELiZORB.
Cautions and Precautions
  • Do not re-use RELiZORB. RELiZORB is a single-use product. Re-use may result in contamination of the product. If re-used, RELiZORB may not effectively hydrolyze fats.
  • Do not break, alter, or place excess pressure on any part of RELiZORB. Any compromise of the structural integrity of RELiZORB may lead to improper connection to enteral feeding supplies, leakage or risk of contamination.
  • Do not use RELiZORB after the date marked on the pouch.
  • Enteral nutrition administered through RELiZORB is for immediate consumption through an enteral feeding tube. RELiZORB should not be used to process enteral nutrition for later use. This has not been tested and may result in safety issues.
  • RELiZORB is designed for use with enteral feeding pump systems with low flow/no flow alarms and enteral syringes for manual bolus by syringe (push or gravity). A detailed listing of enteral nutrition, pumps, and enteral feeding supplies compatible with RELiZORB can be found at www.relizorbhcp.com/compatibility.
  • Patients less than 1 year old may be particularly vulnerable to unplanned interruptions of feeding.
  • Do not use blenderized formulas with RELiZORB. A detailed listing of enteral nutrition compatible with RELiZORB can be found at www.relizorbhcp.com/compatibility.
  • Powdered formulas should be mixed periodically during feedings.
  • Do not use excessive force on the plunger when using RELiZORB with bolus syringe feeding method.
  • Do not rush bolus feeds. Follow guidance from your healthcare professional on how long it should take you to complete your tube feeding. Ensure all inlet and outlet connectors on RELiZORB and enteral feeding supplies are clean and dry prior to making connections.
  • In order to ensure product performance, store RELiZORB in its pouch either refrigerated or at room temperature (2°C to 27°C; 36°F to 80°F).
  • RELiZORB is indicated for use with enteral feeding only; patients should follow physician’s guidance for pancreatic enzyme replacement therapy (PERT) use for meals and snacks. Patients and patient caregivers should follow physician’s guidance regarding the need for pancreatic enzyme replacement therapy (PERT) during enteral feeding.

Review full product information for RELiZORB in the Instructions for Use.