2020 Guide to Patient Support Services

Genentech

Genentech Access Solutions offers a suite of programs and services to help facilitate access to Genentech BioOncology medicines for eligible patients. Support services include coverage and reimbursement assistance, financial assistance, and resource support. The list of oncology medicines from Genentech is provided in the Table.

Financial Assistance

The assistance provided by Genentech Access Solutions varies based on the patient’s insurance status.

Eligible patients who meet specified criteria may qualify to receive their Genentech medication at no cost through the Genentech Patient Foundation.

Patients with private or commercial insurance plans may be eligible to receive copay assistance through the Genentech BioOncology Co-pay Assistance Program.

Benefits Assistance

Genentech Access Solutions can conduct a benefits investigation to facilitate an understanding of the patient’s health insurance coverage and potential costs associated with treatment; each investigation is medication-specific. The investigation may determine whether the treatment is covered, requires prior authorization, or is denied. If treatment is denied, an Access Solutions representative can help determine the next steps to take.

Reimbursement Assistance

The program also offers resource support for questions related to billing and coding, as well as appeals for denied claims.

If the patient’s coverage for a Genentech BioOncology medicine is denied, it is important to first understand the reason(s) for the denial, which should be explained in a letter from the insurer or the patient’s explanation of benefits.

An Access Solutions representative can then provide resources during the development of an appeal; tips and checklists are available for appeals processes.

Additional services and resources may be available. For more information call 866-422-2377.

ELIGIBILITY

Genentech Patient Foundation

Eligible patients who meet specified insurance and financial criteria may qualify for this program.

  • Uninsured patients, certain insured patients, as well as those who have been denied coverage for a prescribed Genentech drug(s) may qualify for the Genentech Patient Foundation program if they meet the eligibility criteria
  • Uninsured patients must have a household adjusted gross income of ≤$150,000
  • Patients whose insurance covers Genentech medicines may qualify if their household adjusted gross income is ≤$150,000
  • Patients who have insurance must have pursued all other assistance options, including medication-­specific copay cards and support from copay assistance foundations.

For more information about the Genentech Patient Foundation eligibility requirements, visit GenentechPatientFoundation.com.

Genentech BioOncology Co-pay Assistance Program

Genentech also offers assistance options to help patients cover the out-of-pocket costs associated with their Genentech medications.

To be eligible for this program, patients must:

  • Be covered by commercial or private insurance
  • Be aged ≥18 years
  • Reside and receive treatment in the United States or Puerto Rico
  • Not be insured by state- or government-funded health plans, such as Medicare, Medicaid, Medigap, or TRICARE.

This program has no income requirements. With this program, patients will pay a $5 copay per prescription or infusion, with an annual benefit limit of $25,000. Visit CopayAssistanceNow.com or call 855-692-6729 to learn more about copay assistance for specific Genentech medications.

Copay Foundations

Genentech Access Solutions staff also can connect patients to independent copay assistance foundations. Drug-specific listings of copay assistance foundations are available at Genentech-Access.com.

APPLICATION & ENROLLMENT

To enroll in the Genentech BioOncology Access Solutions program, physicians should complete the Prescriber Service Form. The form may be completed via the online My Patient Solutions tool.

Access Solutions representatives can assist in educating how to complete these forms.

Patients who wish to enroll in the Genentech Patient Foundation should complete the Genentech Patient Foundation Enrollment Form.

TABLE GENENTECH ONCOLOGY DRUGS

Drugs
Indications
Patient support programs

Drug
Actemra (tocilizumab) injection
Indications
Treatment of cytokine release syndrome induced by CAR T-cell therapy
Patient support programs

Drug
Alecensa (alectinib)
Indications
Metastatic NSCLC with ALK mutation
Patient support programs

Drug
Avastin (bevacizumab)
Indications
Patient support programs

Drug
Cotellic (cobimetinib)
Indications
Unresectable or metastatic melanoma
Patient support programs

Drug
Erivedge (vismodegib)
Indications
Metastatic basal-cell carcinoma
Patient support programs

Drug
Gazyva (obinutuzumab)
Indications
First-line treatment of CLL, in combination with chlorambucil, ibrutinib, or venetoclax; follicular lymphoma refractory to rituximab-containing regimen, in combination with bendamustine, then obinutuzumab monotherapy
Patient support programs

Drug
Herceptin (trastuzumab)
Indications
HER2-positive breast cancer
Patient support programs

Drug
Herceptin Hylecta (trastuzumab + hyaluronidase-oysk) injection
Indications
Adjuvant treatment of HER2-positive breast cancer, in combination with chemotherapy, or alone after multiple anthracycline-based therapies; treatment of HER2-positive metastatic breast cancer, after ≥1 chemotherapies for metastatic disease
Patient support programs

Drug
Kadcyla (ado-trastuzumab emtansine)
Indications
Treatment of metastatic HER2-positive breast cancer; adjuvant treatment of HER2-positive early breast cancer in patients with residual invasive disease after neoadjuvant taxane and trastuzumab-based therapy
Patient support programs

Drug
Perjeta (pertuzumab)
Indications
Treatment of HER2-positive breast cancer
Patient support programs

Drug
Polivy (polatuzumab vedotin-piiq) for injection
Indications
Treatment of adults with relapsed/refractory DLBCL, in combination with bendamustine and rituximab or its biosimilar, after ≥2 therapies
Patient support programs

Drug
Rituxan (rituximab)
Indications
Low-grade or follicular CD20-positive non-Hodgkin lymphoma; CD20-positive CLL
Patient support programs

Drug
Rituxan Hycela (rituximab and hyaluronidase human) injection
Indications
Relapsed or refractory follicular lymphoma; first-line treatment of follicular lymphoma, in combination with chemotherapy, and as maintenance monotherapy in patients with complete or partial response to rituximab plus chemo­therapy; as monotherapy for nonprogressing follicular lymphoma after first-line chemotherapy; untreated DLBCL, in combination with chemotherapy; CLL, in combination with fludarabine and cyclophosphamide
Patient support programs

Drug
Rozlytrek (entrectinib)
Indications
Treatment of metastatic NSCLC and ROS1 mutation
Patient support programs

Drug
Tarceva (erlotinib)
Indications
Advanced pancreatic cancer; advanced NSCLC
Patient support programs

Drug
Tecentriq (atezolizumab)
Indications
Patient support programs

Drug
Venclexta (venetoclax)
Indications
Treatment of adults with CLL or SLL; first-line treatment of CLL or SLL, in combination with obinutuzumab or rituximab; treatment of newly diagnosed acute myeloid leukemia, in combination with azacitidine or decitabine or low-dose cytarabine, in adults aged ≥75 years, or whose comorbidities preclude use of intensive induction chemotherapy
Patient support programs

Drug
Xeloda (capecitabine)
Indications
Treatment of colon cancer; metastatic CRC; metastatic breast cancer
Patient support program

Drug
Zelboraf (vemurafenib)
Indications
Unresectable metastatic melanoma with BRAF mutation
Patient support programs

CLL indicates chronic lymphocytic leukemia; CRC, colorectal cancer; DLBCL, diffuse large B-cell lymphoma; NSCLC, non–small-cell lung cancer; SLL, small lymphocytic lymphoma.

Avastin (bevacizumab) Indications

First- or second-line treatment of metastatic CRC, in combination with 5-fluorouracil–based chemotherapy; second-line treatment of metastatic CRC, in combination with fluoropyrimidine/irinotecan- or fluoropyrimidine-oxaliplatin–based chemotherapy in patients whose disease progressed with a first-line regimen containing tocilizumab; first-line treatment of unresectable, locally advanced, recurrent or metastatic nonsquamous NSCLC, in combination with carboplatin and paclitaxel; recurrent glioblastoma in adults; metastatic renal-cell carcinoma, in combination with interferon-alfa; persistent, recurrent, or metastatic cervical cancer, in combination with paclitaxel and cisplatin, or paclitaxel and topotecan; treatment of stage III or IV epithelial ovarian, fallopian tube, or primary peritoneal cancer, in combination with carboplatin and paclitaxel, followed by tocilizumab monotherapy, or in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan for platinum-resistant recurrent disease after ≤2 chemotherapy regimens, or in combination with carboplatin and paclitaxel or carboplatin and gemcitabine, followed by tocilizumab monotherapy, for platinum-sensitive recurrent disease

Tecentriq (atezolizumab) Indications

Locally advanced or metastatic urothelial carcinoma in patients ineligible for cisplatin-based chemotherapy and whose tumors express PD-L1, as determined by an FDA-approved test, or for patients ineligible for platinum-based chemotherapy, regardless of PD-L1 status, or those whose disease progressed during or after platinum-based chemotherapy within 12 months of neoadjuvant or adjuvant chemotherapy; first-line treatment of metastatic nonsquamous NSCLC with no EGFR or ALK mutations, in combination with bevacizumab, paclitaxel, and carboplatin; metastatic NSCLC that progressed during or after platinum-based chemotherapy; first-line NSCLC, in combination with paclitaxel protein-bound; first-line treatment of extensive-stage small-cell lung cancer, in combination with carboplatin and etoposide; unresectable, locally advanced or metastatic triple-negative breast cancer expressing PD-L1, as determined by an FDA-approved test

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