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RELiZORB (iMMOBILIZED lipase) cartridge

Access RELiZORB Resources and Support

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

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

RELiZORB Support Services is a support program for tube-fed patients who have been prescribed RELiZORB to help break down fats. RELiZORB Support Services is available to help provide patients with the resources they need to ensure a positive RELiZORB experience, and our dedicated case management team works directly with payers to gain patient approvals.

Your Patient

will be assigned a dedicated RELiZORB Program Coordinator who is available by phone or email to help with:

  • #Understanding how to use RELiZORB
  • # Insurance assistance
  • #Ordering and delivery of RELiZORB
  • #Out-of-Pocket Assistance Program
    (for eligible US patients)

Your Practice

will have access to a RELiZORB Program Coordinator dedicated to helping you and your office staff along the way with:

  • #Insurance verification
  • #Claims management and appeals assistance
  • #Patient authorizations, reimbursement, and financial assistance
  • #Patient eligibility for the RELiZORB Out-of-Pocket Assistance Program

The RELiZORB Support Services team is made up of highly skilled and trained individuals, such as:

  • Pediatric Nurse Practitioner
  • Pediatric Occupational Therapist, MBA, MPH
  • Pediatric ICU RN
  • Pediatric Respiratory Therapist

Team members have fluency in Spanish, Mandarin, Arabic, and French. With geographic distribution across the US, RELiZORB Support Services offers local market support with regional payer expertise.

Support is just a phone call away at 1-844-632-9271, or email [email protected]

Resources for healthcare professionals and practices

RELiZORB patient enrollment for outpatient and hospital discharge

For a patient to be eligible to receive RELiZORB, the Patient Enrollment Form and the Patient Authorization Form are needed. You and your patient (or their representative) can work together to complete the required forms; just follow these 3 easy steps:

  1. Ask your patient (or their representative) to complete the Patient Authorization Form and sections 1 and 2 of the Patient Enrollment Form
  2. You complete sections 3 through 6 of the Patient Enrollment Form, which serves as the patient prescription
  3. Submit both completed forms and supporting clinical documentation to RELiZORB Support Services by emailing them to [email protected] or faxing them to 1-844-233-3146

Downloadable resources

The following resources are for use by healthcare professionals only. Depending on the individual patient you are treating, to help avoid delays in RELiZORB cartridge approval or to assist with managing a denial, the following materials may be helpful.

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

RELiZORB can be ordered directly from Alcresta Therapeutics, Inc:

  • To order RELiZORB directly from Alcresta, send your purchase order to the following email address: [email protected]. You may reference the UDI 00862205000254, or the SKU# 100300, Description: RELiZORB
  • RELiZORB is supplied in boxes of 30 cartridges. 1 box = 30 cartridges
  • The RELiZORB UDI is 00862205000254
  • For pricing information outside of the provided GPO or other hospital ordering-related questions, please contact Hospital Order Support at [email protected]

Distributor and GPO information

Distributor Product number table

Alcresta Therapeutics contracts with the following GPO:

GPO Product number table

Adverse event reporting

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 with RELiZORB

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GPO=group purchasing organization; HCPCS=healthcare common procedure coding system.

RELiZORB is indicated for use in pediatric patients (ages 2 years and above) and adult patients to hydrolyze fats in enteral formula.

Warnings
  • RELiZORB is for use with enteral feeding only.
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RELiZORB is indicated for use in pediatric patients (ages 2 years and above) and adult patients to hydrolyze fats in enteral formula.

Warnings
  • RELiZORB is for use with enteral 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 formula 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, enteral formula leakage or risk of contamination.
  • Do not use RELiZORB after the date marked on the pouch.
  • Do not use blenderized formulas with RELiZORB. A detailed listing of enteral formulas compatible with RELiZORB can be found at www.relizorbhcp.com/compatibility.
  • RELiZORB is designed for use with enteral feeding pump systems with low flow/no flow alarms and enteral syringes for bolus syringe push. A detailed listing of formulas, pumps, and enteral feeding supplies compatible with RELiZORB can be found at www.relizorbhcp.com/compatibility.
  • Do not use excessive force when using RELiZORB with enteral syringe push feeding methods.
  • 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.