Terms and Conditions

Healthcare Professional Terms & Conditions

You agree to read the Hyrimoz^® (adalimumab) Product Information.

You are aware that the Startz Patient Program is available to patients meeting all the eligibility criteria as outlined in the Healthcare Professional Guides.

You agree to explain the risks and benefits of Hyrimoz compared with existing therapies to your patients.

You agree to gain informed consent from your patient prior to enrolment into the Startz Program, including consenting to the privacy statement.

You have explained to eligible patients that Startz Access will cease if Sandoz decides to close Startz Access, in which case advance notice will be provided. If the program is closed, patients who are receiving clinical benefit will still be eligible to receive Hyrimoz through the current PBS reimbursement criteria.

You have explained to the patient that the patient will no longer be eligible for Startz Access if:

• the patient no longer meets the eligibility criteria for the Program;
• the patient is not demonstrating an ongoing clinical benefit with Hyrimoz; or
• Sandoz decides to close the program, in which case 26 weeks advance notice will be provided.

You understand that failure to submit a Startz Access patient continuation/discontinuation form within 26 weeks following enrolment date, will result in automatic patient discontinuation. Requests to reactivate discontinued patients will be granted within 48 hours of discontinuation. After this time period, patients must be re-enrolled as new.

As a healthcare professional participating in this activity sponsored by Sandoz, I have read and understood the enclosed privacy and adverse event collection statement and I agree with it. I understand that information relating to an adverse event with a Sandoz product that is identified during this Program will be forwarded to Sandoz Patient Safety department for safety reporting.

I understand that my participation in this activity indicates my consent for Sandoz’ Patient Safety department to contact me for further information regarding any adverse event identified as part of this activity. If the activity also involves patients, I acknowledge that I must check with my patient before providing the requested follow-up information.

Patient Terms & Conditions

You have read the Patient Information provided to you by your healthcare professional and consented to participate in Startz, the Hyrimoz patient support program.

You are receiving Hyrimoz® (adalimumab) treatment in Australia.

You understand you may withdraw from the program at any time.

You understand that in order to manage the program, your personal information will be accessed by the Program Administrator who will collect and store your information in accordance with the privacy policy.

You have read, understand and agree to the privacy policy.