SeaGen Secure is a comprehensive patient assistance program from Seattle Genetics that offers several resources related to coverage and reimbursement, as well as assistance to patients who cannot afford their prescribed Adcetris (brentuximab vedotin) therapy (Table).
Adcetris is indicated for the treatment of patients with:
- Classical Hodgkin lymphoma after failure of autologous stem-cell transplantation (ASCT) or after failure of at least 2 multiagent chemotherapy regimens in patients who are not ASCT candidates
- Classical Hodgkin lymphoma at high risk for disease relapse or progression after autologous hematopoietic stem-cell transplantation
- Systemic anaplastic large-cell lymphoma after failure of at least 1 chemotherapy regimen.
SeaGen Secure Assistance ProgramsThe SeaGen Secure program is available to patients who are underinsured (with commercial or government-funded insurance) and to uninsured patients. SeaGen Secure assists in conducting a benefits investigation for each patient to determine their coverage.
Depending on their coverage status, patients may have 1 of the following options:
- Underinsured patients who need help with their coinsurance may be eligible for the SeaGen Secure Commercial Assistance Program or may be referred to an independent foundation for assistance
- For insured patients whose insurance does not cover Adcetris, SeaGen Secure will help with their claims appeal process. Patients whose appeal is rejected may be eligible for patient assistance
- Uninsured patients may be eligible for the SeaGen Secure Assistance Program.
EligibilityTo be eligible for the SeaGen Secure Assistance Program, patients must:
- Permanently live in the United States
- Meet income and diagnosis guidelines.
Application & EnrollmentTo avail SeaGen Secure patient assistance and reimbursement support services, the Enrollment Form must first be completed (available at www.seagensecure.com). Enrollment forms can be submitted electronically via the website.
Completed forms can also be faxed to 855-557-2480 or e-mailed to CaseManager@seagensecure.com. Benefits investigation results will be faxed within 48 hours.
Prescribers are required to provide their information, provide the patient’s information and diagnosis, including an ICD-10 diagnosis code, indicate whether the patient has received a transplant and if the transplant was autologous or allogeneic, and indicate previous regimens that have been used. Patient information, including health insurance information, employer information, and gross annual family household income, must be provided.
SeaGen Secure provides additional services.
SeaGen Secure helps patients and providers to secure prior authorization, depending on the requirement of the insurance company. SeaGen Secure will also provide coding to assist with the billing process.
If the patient is insured but coverage was denied, SeaGen Secure can assist in the appeals process.
The patient or the provider needs to send a copy of the claim, a copy of the explanation of benefits, and/or any letters used in the appeal to SeaGen Secure. SeaGen Secure Case Managers can also provide a sample medical necessity letter to assist in appeals.
Connecting patients and caregivers with an experienced Oncology Nurse Advocate who will work with the patient to identify concerns before they become obstacles and offer solutions to help address specific needs; provide ongoing support throughout the treatment experience; and offer referrals to advocacy organizations for emotional support, transportation assistance, peer-to-peer connection programs, and resources for balancing work and cancer.
Patients will speak with the same Oncology Nurse Advocate every time they call SeaGen Secure.