HCP portal / Prescribe & Enroll

submit the Prescription and Enrollment Form to initiate Acadia Connect^® support.

Once your patient is enrolled, Acadia Connect^® provides insurance navigation, affordability support, prescription management, and proactive alerts to avoid any treatment interruptions.

Need assistance?

Call us at 1-844-737-2223

Monday-Friday, 8:00 AM to 8:00 PM ET

The enrollment form has the following sections:

STEPS TO ENROLL

Patient Information

Insurance Information

Diagnosis & Prescriber Information

Prescription Information

Authorization & Submit

e-Prescribing?

Select RareMed Solutions in your EHR system when e-prescribing NUPLAZID^® to submit an electronic prescription directly to Acadia Connect^®.

Not submitting online?

Download the form and fax to 1-844-737-2224 or email it to [email protected].

Download the Prescription and Enrollment Form

NUPLAZID Free 30-Day Quick Start

Available upon enrollment for eligible patients.^† Be sure to fill out the NUPLAZID Free 30‑Day Quick Start section under Prescription Information on the form.

^†Terms and conditions apply. Available for eligible patients starting therapy. This offer is limited to one per patient and is not transferable. The free trial is not health insurance.

thank you

Your patient is now signed up for Acadia Connect^®. If you haven't done so, please have your patient or their caregiver complete the patient consent.

what happens after you submit the Prescription and Enrollment Form?

01

Your Patient is Assigned a Care Coordinator

A dedicated Care Coordinator contacts your patient within 2 business days.

02

Insurance & Benefits Verification

The Care Coordinator works with you and your staff as well as the payer to verify coverage and coordinate access support.

03

Ongoing Support

Your patients receive continued support through insurance changes, refill coordination, and affordability assistance.

Important Safety Information and Indication for NUPLAZID^® (pimavanserin)

Indication

NUPLAZID is indicated for the treatment of hallucinations and delusions associated with Parkinson’s disease psychosis.

Important Safety Information

WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS

Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death.
NUPLAZID is not approved for the treatment of patients with dementia who experience psychosis unless their hallucinations and delusions are related to Parkinson’s disease.

Contraindication: NUPLAZID is contraindicated in patients with a history of a hypersensitivity reaction to pimavanserin or any of its components. Rash, urticaria, and reactions consistent with angioedema (e.g., tongue swelling, circumoral edema, throat tightness, and dyspnea) have been reported.
Warnings and Precautions: QT Interval Prolongation

NUPLAZID prolongs the QT interval. The use of NUPLAZID should be avoided in patients with known QT prolongation or in combination with other drugs known to prolong QT interval (e.g., Class 1A antiarrhythmics, Class 3 antiarrhythmics, certain antipsychotics or antibiotics).
NUPLAZID should also be avoided in patients with a history of cardiac arrhythmias, as well as other circumstances that may increase the risk of the occurrence of torsade de pointes and/or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and presence of congenital prolongation of the QT interval.

Adverse Reactions: The adverse reactions (≥2% for NUPLAZID and greater than placebo) were peripheral edema (7% vs 2%), nausea (7% vs 4%), confusional state (6% vs 3%), hallucination (5% vs 3%), constipation (4% vs 3%), and gait disturbance (2% vs <1%).
Drug Interactions:

Coadministration with strong CYP3A4 inhibitors increases NUPLAZID exposure. Reduce NUPLAZID dose to 10 mg taken orally as one tablet once daily.
Coadministration with strong or moderate CYP3A4 inducers reduces NUPLAZID exposure. Avoid concomitant use of strong or moderate CYP3A4 inducers with NUPLAZID.

Please read the full Prescribing Information, including Boxed WARNING, also available at NUPLAZIDhcp.com.

Dosage and Administration

Recommended dose: 34 mg capsule taken orally once daily, without titration, with or without food.

NUPLAZID is available as 34 mg capsules and 10 mg tablets.

submit the Prescription and Enrollment Form to initiate Acadia Connect® support.