The Arbor Assistance Program is a dedicated resource to help you understand your insurance coverage for GLIADEL Wafer.

What to expect when you contact the Arbor Assistance Program:

•  Understanding of coverage, coding and payment issues

•  General prior authorization information

•  Provide general guidance for appealing a denied claim

•  Payer policy information

Arbor Pharmaceuticals offers a Patient Assistance Program (PAP) which provides Arbor medicines at no cost to financially needy patients who meet program eligibility criteria. Patients who meet the eligibility requirements and wish to be considered for participation must complete and submit a Patient Assistance Program (PAP) Application. To download an application, follow the link to Gliadel PAP APPLICATION, located to the right (under Forms). It is important that the patient complete all requested information and sign where indicated, as incomplete applications will delay the application process.

To contact the Arbor Assistance Program or to inquire about the Patient Assistance Program:

Phone: (877)-438-9759

Fax: (866) 448-1960

Email: reimbursement@arborpharma.com

Hours: Monday – Friday, 8:00 AM to 5:00 PM CST

  • Forms
  • Action
  • Gliadel PAP Eligibility Guidelines
  • DOWNLOAD
  • Gliadel PAP Application Checklist
  • DOWNLOAD

Please submit completed applications via fax, or E-mail to:

Fax #: (866) 448-1960

E-mail: reimbursement@arborpharma.com

INDICATIONS

GLIADEL Wafer (carmustine implant) is indicated for the treatment of patients with newly-diagnosed high-grade glioma as an adjunct to surgery and radiation.

GLIADEL Wafer is also indicated in patients with recurrent glioblastoma as an adjunct to surgery.

IMPORTANT SAFETY INFORMATION

You should not be given GLIADEL Wafer if you are allergic to carmustine or any of the components of GLIADEL Wafer.

If you are undergoing surgery and implantation of GLIADEL Wafer, you should be monitored closely for known complications, including convulsions, infections, abnormal wound healing, and swelling of the brain.

If you are pregnant or are planning to become pregnant, you should understand that carmustine, the active component of GLIADEL Wafer, can cause harm to the fetus if given to a pregnant woman. It is not known if either carmustine, or other components of GLIADEL Wafer are excreted in human milk. Many drugs are excreted in human milk and there is a risk for serious side effects from carmustine in nursing infants; therefore discontinuation of nursing is recommended if you will be receiving GLIADEL Wafer.

It is possible that if GLIADEL Wafers are not implanted properly, they could block the flow of cerebrospinal fluid and might cause abnormal accumulation of fluid in the brain (obstructive hydrocephalus).

The short-term and long-term safety of GLIADEL Wafer when given together with chemotherapy is not fully known.

Following surgery to remove a brain tumor and implantation of GLIADEL Wafer, the following side effects have been reported in clinical studies:

Seizures (convulsions): In clinical studies, seizures have occurred within days or several weeks following implantation of GLIADEL Wafer. Both new seizures and worsening of seizures have been reported.

Brain Swelling: Brain swelling has occurred in clinical studies. In some cases, brain swelling may require another surgery, and removal of GLIADEL Wafers or remnants of the wafers may be required.

Abnormal wound healing: In clinical studies, abnormal healing of the surgical wound has occurred following implantation of GLIADEL Wafer. These abnormalities included reopening of the surgical area, leaking of brain or spinal fluid, delays in healing, or other abnormalities in how the wound heals.

Brain Infections: In clinical studies, brain infections, including meningitis, have occurred following implantation of GLIADEL Wafer.

ADVERSE REACTIONS

The most common adverse reactions in newly-diagnosed high-grade glioma patients are cerebral edema, asthenia, nausea, vomiting, constipation, wound healing abnormalities and depression.

The most common adverse reactions in recurrent high-grade glioma patients are urinary tract infection, wound healing abnormalities and fever.

The Important Safety Information does not include all the information needed to use GLIADEL safely and effectively. For additional safety information, please consult the full Prescribing Information for GLIADEL.

To report SUSPECTED ADVERSE REACTIONS, contact Azurity Pharmaceuticals, Inc. at 1-800-461-7449 or FDA at www.fda.gov/medwatch or call 1-800-FDA-1088.