Peer Network

Frequently Asked Questions

PEER Network Basics

• What is the PEER Network?

  The PEER Network is a patient-to-patient program that enables those who are considering or who have recently started treatment for pulmonary arterial hypertension to speak one-to-one with an experienced Tyvaso® (treprostinil) Inhalation Solution or Remodulin® (treprostinil) Injection patient called a PEER Mentor.

• Who are PEER Mentors?

  PEER Mentors are pulmonary arterial hypertension (PAH) patients, or caregivers of patients, currently receiving Tyvaso® (treprostinil) Inhalation Solution or Remodulin® (treprostinil) Injection who have volunteered to share their personal PAH disease and treatment experiences to provide others with the unique support that comes from first-hand knowledge.

• How does the PEER Network operate?

  PEER Mentors exchange confidential e-mails with their Mentees through a secure Web site. These messages cannot be viewed by anyone other than the Mentor and Mentee. Mentors will be available to share their personal experiences with pulmonary arterial hypertension diagnosis and disease management, as well as managing the practicalities of Tyvaso® (treprostinil) Inhalation Solution or Remodulin® (treprostinil) Injection therapy. Mentors do not offer medical advice and will refer all patients to their doctors for answers to medical questions.

• Who benefits from the PEER Network?

  The PEER Network has been developed to support pulmonary arterial hypertension (PAH) patients and their caregivers who are:

  • Considering a prostacyclin therapy
  • Considering therapy on Tyvaso® (treprostinil) Inhalation Solution or Remodulin® (treprostinil) Injection
  • On a United Therapeutics Corporation therapy or are considering United Therapeutics inhaled or infused therapy options
  • Transitioning from Flolan® (epoprostenol sodium) to Remodulin
  • Switching from one route of administration of Remodulin to another
  • Recently diagnosed or providing care to someone who has been recently diagnosed with PAH, or who is new to using a United Therapeutics therapy

• Is the PEER Network open to non-US citizens?

  The PEER Network is intended for U.S. audiences only. This PEER Network program and Web site are sponsored by United Therapeutics Corporation. Program participation, product copy and claims are intended only for residents of the United States. Products sold under the same brand names may be subject to different regulatory approvals and standards. If you are located outside of the United States, please consult with your local physician or pharmacy for information about Tyvaso® (treprostinil) Inhalation Solution or Remodulin® (treprostinil) Injection.

Registration

• What are the steps required to connect with a PEER Mentor?

  1. Go to www.peernetwork.net 2. Click on the Connect with a Mentor link on the Homepage 3. Indicate whether you wish to communicate with a Tyvaso® (treprostinil) Inhalation Solution or Remodulin® (treprostinil) Injection Mentor 4. Choose how you would like to communicate with a PEER Mentor (E-mail or Phone)

  If E-mail communication is preferred:
  

  1. Select the E-mail option 2. Review the Mentor options listed; or Narrow your Mentor search (optional) 3. Choose one Mentor with whom you would like to communicate 4. Click on Contact Me to connect with your Mentor 5. Fill out the E-mail Registration Form and submit form electronically 6. E-mail your new Mentor through a secure e-mail interface

  If phone communication is preferred:
  

  1. Select the Phone option 2. Fill out a Phone Registration Form 3. Submit the form electronically 4. PEER Network staff will contact you and arrange a phone conversation with a Mentor

• Can I change my PEER Mentor after registering?

  Yes. If you are dissatisfied with your PEER Mentor and would like to connect with a different Mentor, please contact the PEER Network by e-mailing info@peernetwork.net or calling 1-866-505-7337. PEER Network staff will deactivate your current Mentor relationship and give you permission to re-register and choose a new Mentor.

Communicating with PEER Mentors

• How do PEER Mentors communicate with pulmonary arterial hypertension patients and/or caregivers?

  After registering at www.peernetwork.net, patients are directed to a private and secure e-mail interface. The PEER Network enables patients to exchange private e-mails with the PEER Mentor of their choice over a secure Web-based system. E-mail exchanges are not monitored or viewed by anyone else and all information is stored on a password-protected server.
  If a patient does not have access to e-mail, or prefers to speak to a Mentor over the phone, they may register to do so instead of communicating via e-mail.

• Does it cost anything for patients and/or caregivers to sign up to communicate with a PEER Mentor?

  No. Patients and/or caregivers do not need to pay to communicate with a PEER Mentor.

• How long can I communicate with my PEER Mentor?

  In order to respect the time of your volunteer PEER Mentor, program rules allow for a maximum communication period of four months between you and your Mentor.

• Can I communicate with more than one PEER Mentor at a time?

  No. You will only be able to communicate with one PEER Mentor at any given time. If you would like to change your Mentor, please contact the PEER Network at info@peernetwork.net or call 1-866-505-7337. PEER Network staff will deactivate your current Mentor relationship and give you permission to re-register and choose a new Mentor.

• What if I don’t receive a response from my PEER Mentor within 48 hours of registration?

  Please know the PEER Mentors are volunteers and may not be checking their e-mail every day. However, if you do not receive a response from your Mentor within 48 hours of registration, please e-mail the PEER Network at info@peernetwork.net or call 1-866-505-7337. PEER Network Staff will look into the delay and, if necessary, connect you with a new Mentor.

• What if I don’t have e-mail?

  If you do not have e-mail, you may speak with a PEER Mentor over the phone. As soon as the Phone Registration Form that you fill out is received, PEER Network staff will search for a Mentor who will best suit your needs. PEER Network staff will contact the Mentor to be sure he/she is available to talk to you and arrange the call. Network staff will follow-up with you after the call to be sure you were satisfied with your Mentor experience.

• Can I speak with a Mentor over the phone?

  Yes. The phone program allows for you to have a conversation over the phone with a PEER Mentor. As soon as the Phone Registration Form that you fill out is received, PEER Network staff will search for a Mentor who will best suit your needs. PEER Network staff will contact the Mentor to be sure he/she is available to talk to you and arrange the call. PEER Network staff will follow up with you after the call to be sure you were satisfied with your Mentor experience.

Mentors

• How are PEER Mentors recruited?

  PEER Mentors are primarily recruited through physician offices. PEER Network staff members contact physician offices and explain the program in detail. If the office would like to refer a patient to the program, they will receive a packet that includes patient invitation letters and PEER Network Release Forms, which they will distribute to those they feel will be appropriate Mentors.
  Once a signed Release Form is received from a patient or a caregiver, PEER Network staff will follow up via telephone to further explain the program and to hear more about the patient’s personal experience with pulmonary arterial hypertension.

• Are PEER Mentors paid?

  No. PEER Mentors volunteer to share their pulmonary arterial hypertension disease and treatment experiences with others. They do not receive compensation for their time.

• How can I become a PEER Mentor?

  Volunteer PEER Mentors are required to have been on Tyvaso® (treprostinil) Inhalation Solution or Remodulin® (treprostinil) Injection for at least six months or be the caregiver of a pulmonary arterial hypertension (PAH) patient who has used one of these therapies for at least six months.
  
  If you meet this description and you would like to share your PAH disease and treatment experiences with patients and/or caregivers who would benefit from talking with you, please fill out a Release Form or contact the PEER Network via e-mail at info@peernetwork.net or call 1-866-505-7337 for more information.

Opt Out of PEER Network

• Can I opt out of the program after registering?

  Yes. You can opt out of the program at any time. All PEER Network e-mails sent to you after registering include an opt out option. You can also e-mail the Network at info@peernetwork.net or call 1-866-505-7337 to opt out.

Privacy

• How will the information that I fill out on the registration page be used?

  Patients provide basic contact and demographic information when registering. Patient information is not in any way used, sold, or assigned for any purpose other than to communicate with patients about the program and as otherwise required by law. Please see the PEER Network Web site Privacy Policy for full information.

• Can I see a history of my messages after my four months are up?

  No. In support of our commitment to your privacy, all of the e-mails between you and your Mentor will be deleted four months after you register for the PEER Network program.

• Will my conversations with my PEER Mentor be private?

  Yes. After registering, you will be directed to a secure, online e-mail interface where you can exchange private e-mails with your PEER Mentor. E-mail exchanges are not monitored or viewed by anyone other than you and your Mentor and all information is stored on a password protected server. If you choose to speak with your Mentor via phone, the conversation will be private.

Therapies and PEER Network Sponsors

• Who sponsors and manages the PEER Network?

  The PEER Network is sponsored exclusively by United Therapeutics Corporation. It is managed by Health Advocacy Strategies™ (H.A.S.), a health communications company in Seattle, Washington. H.A.S. staffs the PEER Network and other similar programs that help empower people to share their personal disease and treatment experiences. H.A.S. staff members are not employees of United Therapeutics Corporation.

• Why is United Therapeutics sponsoring the PEER Network?

  At United Therapeutics Corporation’s request, Health Advocacy Strategies™ (H.A.S.), a health communications company in Seattle, Washington, evaluated whether a patient-to-patient program would be of value for the pulmonary arterial hypertension community. The evaluation, which included phone interviews with physicians, nurses, distributors, patients and representatives of the Pulmonary Hypertension Association, concluded that a patient-to-patient program would be a unique resource valued by patients and healthcare providers.

• What is Tyvaso® (treprostinil) Inhalation Solution?

  Indication

  Tyvaso is a prescription medicine used in adults to treat pulmonary arterial hypertension (PAH) (WHO Group 1), which is high blood pressure in the arteries of your lungs. Tyvaso can improve exercise ability in people who also take bosentan (an endothelin receptor antagonist) or sildenafil (a phosphodiesterase-5 inhibitor). The effects decrease over 4 hours; treatment timing can be adjusted for planned activities.

  Studies establishing effectiveness included predominately patients with NYHA Functional Class III symptoms and etiologies of idiopathic or heritable PAH (56%) or PAH associated with connective tissue diseases (33%).

  Important Safety Information for Tyvaso

  • Tyvaso is breathed in (inhaled) through your mouth into your lungs. Tyvaso should only be used with the Tyvaso Inhalation System. • The effects of Tyvaso are unknown in patients with lung disease (such as asthma or chronic obstructive pulmonary disease) and in patients under 18 years of age. • If you have low blood pressure, Tyvaso may cause symptomatic hypotension (low blood pressure). • Because Tyvaso reduces the ability of your blood to clot (coagulate), it may increase your risk for bleeding if you are taking blood thinners (anticoagulants), such as warfarin or heparin. • The use of Tyvaso with diuretics (water pills), antihypertensives (medications used to treat high blood pressure or heart disease), or other vasodilators (medications that lower blood pressure) may increase your risk for hypotension (low blood pressure)

  Other medical conditions and medicines may affect your use of Tyvaso by increasing the risk of side effects or decreasing effectiveness. It is important to tell your doctor about your medical conditions and any medicines you may be taking, including:

  • If you are taking gemfibrozil (for high cholesterol) or rifampin (for infection), your Tyvaso dosage may need adjustment. • If you have liver or kidney problems, your ability to tolerate Tyvaso may be affected. • If you are pregnant, breast-feeding, or planning to become pregnant, talk with your healthcare provider about whether you should take Tyvaso.

  The most common side effects of Tyvaso are coughing, headache, throat irritation and pain, nausea, reddening of the face and neck (flushing), and fainting or loss of consciousness. These are not all the possible side effects of Tyvaso. Tell your doctor about any side effects that bother you or do not go away. Your doctor may be able to help you manage the side effects.

  For additional information about Tyvaso, please see accompanying Full Prescribing Information, Patient Package Insert, and the Tyvaso Inhalation System Instructions for Use manual, visit www.tyvaso.com or call 1- 877-864-8437.

• What is Remodulin® (treprostinil) Injection?

  Indication

  Remodulin is a prostacyclin vasodilator indicated for the treatment of pulmonary arterial hypertension (PAH) (WHO Group 1) to diminish symptoms associated with exercise. Studies establishing effectiveness included patients with NYHA Functional Class II-IV symptoms and etiologies of idiopathic or heritable PAH (58%), PAH associated with congenital systemic-to-pulmonary shunts (23%), or PAH associated with connective tissue diseases (19%). It may be administered as a continuous subcutaneous infusion or continuous intravenous infusion; however, because of the risks associated with chronic indwelling central venous catheters, including serious blood stream infections, continuous intravenous infusion should be reserved for patients who are intolerant of the subcutaneous route, or in whom these risks are considered warranted.

  In patients with PAH requiring transition from Flolan® (epoprostenol sodium), Remodulin is indicated to diminish the rate of clinical deterioration. The risks and benefits of each drug should be carefully considered prior to transition.

  Important Safety Information for Remodulin

  • Chronic intravenous infusions of Remodulin are delivered using an indwelling central venous catheter. This route is associated with the risk of blood stream infections (BSI) and sepsis, which may be fatal. Therefore, continuous subcutaneous infusion is the preferred mode of administration. • Remodulin should be used only by clinicians experienced in the diagnosis and treatment of PAH. • Remodulin is a potent pulmonary and systemic vasodilator. It lowers blood pressure, which may be further lowered by other drugs that also reduce blood pressure. • Remodulin inhibits platelet aggregation and therefore, may increase the risk of bleeding, particularly in patients on anticoagulants. • Remodulin dosage adjustment may be necessary if inhibitors or inducers of CYP2C8 are added or withdrawn. • Initiation of Remodulin must be performed in a setting with adequate personnel and equipment for physiological monitoring and emergency care. • Therapy with Remodulin may be used for prolonged periods, and the patient’s ability to administer Remodulin and care for an infusion system should be carefully considered. • Remodulin dosage should be increased for lack of improvement in, or worsening of, symptoms and it should be decreased for excessive pharmacologic effects or for unacceptable infusion site symptoms. • Abrupt withdrawal or sudden large reductions in dosage of Remodulin may result in worsening of PAH symptoms and should be avoided. • Caution should be used in patients with hepatic or renal insufficiency. • The most common side effects of Remodulin included those related to the method of infusion. For subcutaneous infusion, infusion site pain and infusion site reaction (redness and swelling) occurred in the majority of patients. These symptoms were often severe and could lead to treatment with narcotics or discontinuation of Remodulin. For intravenous infusion, line infections, sepsis, arm swelling, tingling sensations, bruising, and pain were most common. General side effects (>5% more than placebo) were diarrhea, jaw pain, vasodilatation and edema.

  For additional information about Remodulin, please see the Full Prescribing information, visit http://www.remodulin.com, or call 1-877-864-8437).

• What is Living PAH?

  Living PAH is a program that brings together a comprehensive network of support, assistance, and education for people with pulmonary arterial hypertension (PAH) who are taking Tyvaso® (trepostinil) Inhalation Solution or Remodulin®(treprostinil) Injection. With Living PAH, you can learn more about your disease and its treatment. You can also access assistance with reimbursement, clinical nurses for non-medical advice and more. The program is free. For more information or to enroll, call (877) 948-9137 or visit the Living PAH Web site.

THE PEER NETWORK IS INTENDED FOR U.S. AUDIENCES ONLY. This PEER Network program and Web site are sponsored by United Therapeutics Corporation. Program participation, product copy and claims are intended only for residents of the United States. Products sold under the same brand names outside of the United States may be subject to different regulatory approvals and standards. If you are located outside of the United States, please consult with your local physician or pharmacy for information about Tyvaso® (treprostinil) Inhalation Solution or Remodulin® (treprostinil) Injection.

Reporting Adverse Events
Please note that this Web site does not collect or report adverse events. If you are taking Tyvaso or Remodulin and have experienced or are experiencing a potential adverse event, please inform your healthcare provider.

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