Pemgarda (pemivibart)
Order Form

PEMGARDA™ (pemivibart)

PEMGARDA™ is an investigational medicine that has received emergency use authorization (EUA) by the FDA. PEMGARDA™ is authorized for use for pre-exposure prophylaxis to help prevent COVID-19 in adults and children 12 years of age and older who weigh at least 88 pounds (40 kg) who:

  • are not currently infected with SARS-CoV-2 and who have not been known to be exposed to someone who is infected with SARS-CoV-2 and
  • have moderate-to-severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments and are unlikely to mount an adequate immune response to COVID-19 vaccination.

For more information, please refer to the PEMGARDA™ website, prescribing information, and/or FDA fact sheet.

Note: Please speak with your healthcare provider for more information if you think this therapy might be right for you.

How do I make a referral or transition my treatment to Infusion Associates?

Customized Care

1. Ask your healthcare provider to fax us a completed order form for your medication, clinical notes, demographics and your insurance card to (833) 957-2188.

2. Providers can find order forms on our medications page.

On Staff Pharmacist

3. One of our intake specialists will contact your healthcare provider to confirm receipt of your referral.

4. We will then verify benefits, obtain any required prior authorizations, and contact you to schedule an appointment.