Eli Lilly

Featured Drug Company Program


Lilly PatientOne Access Services

866-472-8663
www.lillypatientone.com

Eli Lilly and Company offers financial assistance to qualified patients who are prescribed Lilly’s oncology medications and who are unable to afford their medications.

The Lilly PatientOne Access Services program may be able to provide financial assistance, reimbursement assistance, or Lilly Oncology drugs at no cost to patients who are uninsured, underinsured, insured, denied a claim, or have difficulty affording their copay or coinsurance.

The Lilly PatientOne Access Services program includes the Reimbursement Assistance Program, the Patient Assistance Program through the Lilly Cares Foundation, and the Lilly PatientOne Co-Pay Support Program.

Lilly PatientOne Access Services also provides information on charitable assistance foundations that may be able to help underinsured patients. Lilly PatientOne Assistance Program is provided by the Lilly Cares Foundation. PatientOne collects information on behalf of the Lilly Cares Foundation.

The complete list of oncology drugs available from Lilly Oncology is provided in the Table.

Table Lilly Oncology Drugs
Drug Indications Patient support programs Contact information
Alimta
(pemetrexed) for injection
Advanced non–small-cell lung cancer Reimbursement Assistance Program www.lillypatientone.com
Lilly Cares Foundation Patient Assistance Program
Lilly PatientOne Co-Pay Support Program
Cyramza
(ramucirumab)
Metastatic colorectal cancer; gastric cancer; non–small-cell lung cancer Reimbursement Assistance Program www.lillypatientone.com
Lilly Cares Foundation Patient Assistance Program
Lilly PatientOne Co-Pay Program www.cyramzahcp.com/resources/co-pay-program.html
Erbitux
(cetuximab)
KRAS wild-type and EGFR-positive metastatic colorectal cancer; locally or regionally advanced relapsed or refractory head and neck cancer Reimbursement Assistance Program www.lillypatientone.com
Lilly PatientOne Co-Pay Program
Lilly Cares Foundation Patient Assistance Program
Gemzar
(gemcitabine hydrochloride)
Advanced relapsed or refractory ovarian cancer; first-line metastatic breast cancer; non–small-cell lung cancer; pancreatic cancer Lilly Cares Foundation Patient Assistance Program www.lillypatientone.com
Lartruvo
(olaratumab)
Adults with soft-tissue sarcoma, for which an anthracycline-containing regimen is appropriate, and which is not amenable to radiotherapy or surgery, in combination with doxorubicin Lilly PatientOne Reimbursement Assistance Program www.lillypatientone.com
Lilly Cares Foundation Patient Assistance Program
Lilly PatientOne Co-Pay Program
Portrazza
(necitumumab injection)
Advanced squamous non–small-cell lung cancer, in combination with gemcitabine and cisplatin Lilly PatientOne Reimbursement Assistance Program www.lillypatientone.com
Lilly Cares Foundation Patient Assistance Program
Lilly PatientOne Co-Pay Program

Eligibility

Reimbursement Assistance Program

To be eligible for this program, patients must be:

  • Permanent, legal US residents
  • Administered a qualifying Lilly Oncology drug within the United States.

Patient Assistance Program

Lilly PatientOne Assistance Program is provided through the Lilly Cares Foundation. To be eligible for this program, patients must:
  • Meet the requirements for seeking reimbursement assistance
  • Currently be receiving ongoing therapy
  • Not have insurance, or have insurance that does not cover therapy
  • Have an income at or below 500% of the federal poverty level
  • Have a service date within 180 days from the date PatientOne receives their application
  • Receive treatment in an outpatient setting.

Lilly PatientOne Co-Pay Support Program

To be eligible for this program, patients must:
  • Be 18 years or older and receive a prescription for an FDA-approved indication for Alimta (pemetrexed) for injection, Cyramza (ramucirumab), Erbitux (cetuximab), Lartruvo (olaratumab), or Portrazza (necitumumab injection)
  • Be commercially insured
  • Have an annual gross household income that does not exceed $100,000 or 500% of the federal poverty level.
In the Co-Pay Support Program, eligible patients pay no more than $25 per dose of Alimta (pemetrexed) for injection, Cyramza (ramuciru­mab), Erbitux (cetuximab), Lartruvo (olaratumab), or Portrazza (necitumumab) injection. For questions about patient eligibility requirements, call 866-472-8663.

Application & Enrollment

To apply for Lilly Oncology patient support services or access services (reimbursement services, copay or coinsurance assistance, or no-cost Lilly Oncology drugs), only 1 application form (available at www.lillypatientone.com/forms-library-patientone-application.html) needs to be completed and submitted.

The PatientOne Enrollment Form also includes the physician’s acknowledgment of medical necessity and the patient’s written authorization for the collection, use, and disclosure of his or her protected health information. Completed application forms should be faxed to 877-366-0585.

Receiving Lilly Oncology Medications

Once patients are approved for the Patient Assistance Program, the medication will be sent directly to the provider’s office.