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PERMISSION TO CALL PATIENT

Submit this form and a dedicated Altogether You nurse will be in touch with your patient.

1. Healthcare Professional Details
2. Patient Details

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Tailored support for your patients

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Regular contact with a dedicated nurse

  • Regular contact with a nurse.
  • Offer individualised education and coaching around their condition, treatment and personal health goals, such as diet and quitting smoking.
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Reminders

  • Patients are offered optional dose reminders, via email/SMS or both.
  • New patients will also receive a reminder notification at 12 weeks after commencing treatment to make an appointment with their healthcare professional and complete pathology (if required) to continue with Cosentyx.
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Device training

  • Training on how to use Cosentyx provided online, or over the phone.
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Home delivery for supplies

  • Insulated carry bag, sharps containers and alcohol wipes.
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Contact

Contact Altogether You Program Support on: 0800 267 368

Privacy and Patient Safety Statement

By providing your personal information to Novartis New Zealand Ltd or its related bodies corporate (Novartis), you consent to Novartis collecting, storing and using your personal information in accordance with the Novartis Privacy Policy at www.novartis.com.au/privacy-policy. In particular, you consent to Novartis using your personal information to communicate with you about Novartis products and/or to support your use of those products, and you consent to Novartis using your personal information for audit or inspection purposes. Novartis reserves the right to use aggregated and de-identified data collected through this Activity. You also consent to Novartis using your personal information to (where applicable) invite you to, or arrange your participation in, activities managed by (or on behalf of) Novartis.

Novartis has engaged third party service providers (Approved Contractors) for the purposes of the Altogether You Program (Activity). Approved Contractors, for the purposes of the Activity, may include Medical Safety Systems Corporate Pty Ltd trading as RXMX Australia (RXMX). You consent to the Approved Contractor collecting, storing and using your personal information in connection with the Activity, including to organise your participation in the Activity or to communicate with you in relation to the Activity, in accordance with the Novartis Privacy Policy.

Novartis is committed to patient safety. In accordance with regulatory obligations for reporting safety information Novartis processes reports of adverse events experienced by patients on Novartis products when identified by a Novartis representative (or by a third party acting on behalf of Novartis). Novartis Patient Safety may contact you in order to collect further information on the adverse event. This information may be shared with health authorities or other pharmaceutical companies with whom Novartis has a license agreement, and third parties we work with for the purpose of safety reporting.

Your information may be stored on servers located in jurisdiction outside of New Zealand. Some of those countries may not offer the same level of privacy protection as in New Zealand. However, Novartis will enter into agreements with its third party service providers to keep your information secure and provide adequate protection for your data.

You are not obliged to provide personal information. However, if you do not provide information you may not, for example, be able to participate fully in activities managed by us.

You have the right to access, update or correct your personal information and/or decline to receive communications from Novartis. To find out how, please refer to www.novartis.com.au/privacy-policy or contact our Privacy Officer at Novartis New Zealand Ltd, PO Box 99102, Newmarket 1149 New Zealand. Phone: +64 9 523 8500, Email: privacy.au@novartis.com.

COSENTYX® (secukinumab) 150 mg/mL Solution for Injection. Before prescribing consult the Data Sheet, (available at www.medsafe.govt.nz) for information on dosage, contraindications, precautions, interactions and adverse events. Cosentyx® is registered and fully funded for Plaque Psoriasis, Psoriatic Arthritis and Ankylosing Spondylitis under Special Authority Criteria, please refer to www.pharmac.govt.nz. Cosentyx is a registered trademark of Novartis AG, Switzerland. Novartis New Zealand Limited, Auckland. Phone: 0800 354 335. PRESCRIPTION MEDICINE. NZ-01375 TAPS-MR10110. Date of preparation: Mar 2024.