Forms & Resources
Our dedicated Case Managers are standing by to help in whatever way they can. But if you're looking for something specific, or just more information, check out the resources below.
Deciphera AccessPoint™ Enrollment Form
A form that connects your patients to the many services of Deciphera AccessPoint
Deciphera AccessPoint Enrollment Form Instructions
This guide explains how to obtain, fill out, and submit the form to help patients access services quickly
Sample Letter of Medical Necessity
A letter template that you can customize based on the patient's condition and plan requirements to help speed the prior authorization process for Qinlock™ (ripretinib)
Sample Letter of Appeal
A letter template that you can customize based on the patient's condition and plan requirements to help navigate the appeals process for Qinlock
Qinlock™ (ripretinib) Fact Sheet and Ordering Information
Product information about Qinlock, including the specialty pharmacy and distribution network, and storage and handling instructions
Download fact sheet
Deciphera AccessPoint™ Brochure for HCPs
An overview of the many services available to support HCPs and office staff in helping patients access Qinlock
Deciphera AccessPoint™ Brochure for Patients
An overview of the financial and insurance support options available to patients
Medicare Overview Brochure for HCPs
Information for HCPs and office staff about Medicare and the Low-Income Subsidy ("Extra Help") program
Medicare Overview Brochure for Patients
Information for patients about Medicare and the Low-Income Subsidy ("Extra Help") program
Helpful Resources Brochure for Patients
A large collection of valuable resources, available in one convenient download
Insurance & financial support
We provide solutions to help you get patients started faster.
Qinlock is available through a limited network of specialty pharmacies and distributors.
Enroll a patient
Find out how to enroll patients in Deciphera AccessPoint or the Commercial Copay Program.