Bristol-Myers Squibb

Patient Support Services Guide 2018


BMS Access Support
800-861-0048

BMS Patient Assistance Foundation
800-736-0003

Through its Access Support program, Bristol-Myers Squibb (BMS) offers a variety of oncology support options for patients receiving outpatient treatment in the United States and Puerto Rico, and, in certain circumstances, the Virgin Islands.

The BMS Access Support program offers a variety of oncology support options for eligible patients who are unable to afford their medications. These may include reviewing patient insurance coverage for BMS medications, the BMS Oncology Co-Pay Assistance Program, navigating prior authorization and claims appeals if coverage is denied, or referring the patient to other financial assistance options for the uninsured or underinsured.

The Table lists the oncology and oncology supportive drugs that are included in the BMS Access Support program. Oral drugs may be shipped to the provider or patient.

The BMS Access Support program can refer you to independent charitable foundations that may be able to provide financial support, including the Bristol-Myers Squibb Patient Assistance Foundation, a charitable organization that provides medicine, free of charge, to eligible, uninsured patients who have an established financial hardship.

The BMS Patient Assistance Foundation accepts the Access Support application. For more information, visit BMSPAF.org.

Eligibility

BMS Oncology Co-Pay Assistance Program

This program is designed for commercially insured patients who need financial assistance with out-of-pocket deductibles, copays, or coinsurance, as indicated in the Explanation of Benefits form.

The program covers select BMS oncology drugs, including Empliciti (elotuzumab), Opdivo (nivolumab), and Yervoy (ipilimumab).

Eligible patients pay the first $25 of their copay for an infusion, or for patients receiving 2 BMS medications on the same day, BMS will cover the remainder of their copay, up to $25,000 annually per medication, or up to $50,000 annually for a 2-drug combination. Enrollment must be renewed every 12 months.

Patients whose infusions are covered by a federal healthcare program, such as Medicare, Medicaid, or TRICARE are not eligible for this program.

For patients with no medical insurance, BMS Access Support can make a referral to independent charitable foundations, including the Bristol-Myers Squibb Patient Assistance Foundation, which may be able to provide financial support for BMS medications.

BMS Patient Assistance Foundation

Eligible patients may qualify to receive medications free of charge for up to 1 year. To be eligible, patients:

  • Must be receiving outpatient treatment in the United States, Puerto Rico, or the US Virgin Islands by a US-licensed healthcare provider
  • Must meet the income limits for the requested medication and other insurance criteria; the annual income must be ≤300% of the federal poverty level
  • May also be eligible if they are uninsured or have been denied coverage for the requested medication.

For more information on this program, visit BMSPAF.org, or call 800-736-0003.

Application & Enrollment

BMS Oncology Co-Pay Assistance Program

To enroll in the BMS Oncology Co-Pay Assistance Program, the enrollment form must be completed either online or faxed to 888-776-2370. Enrollment forms are available online.

The BMS Access Support program will determine the patient’s eligibility, including verification of insurance coverage and benefits amount. An explanation of benefits must be submitted within 180 days of receiving each dose. For more information on Sprycel Assist or the Sprycel One Card, visit Sprycel.com/sprycel-assist or call 855-777-9235.

BMS Patient Assistance Foundation

An application to be filled out by the patient and healthcare provider is required to enroll in the Bristol-Myers Squibb Patient Assistance Foundation. Proof of income should be submitted with the application, and returned to the foundation by fax to 888-776-2370.

The enrollment form is available at BMSPAF.org. Enrollment is valid for 1 year; re-enrollment every year is required to continue in the program. For more information on this program, call 800-736-0003.

Other Services

Patients prescribed Yervoy can receive ongoing support during their treatment through the complimentary Yervoy with You program. By registering for Yervoy with You, patients and caregivers can receive helpful support tools and materials by mail or e-mail, and sign up to speak with a registered nurse who can answer questions about their treatment. For more information on this program, visit this website, or call 855-493-7869.

BMS Oncology Drugs

Drugs
Indications
Patient support programs

Drug
Droxia (hydroxyurea)
Indication
Melanoma; chronic myeloid leukemia; ovarian cancer; squamous-cell head and neck cancer (primary)
Patient support program
Good Days
877-968-7233

Drug
Empliciti (elotuzumab)
Indication
Multiple myeloma, in combination with lenalidomide and dexamethasone

Drug
Etopophos (etoposide phosphate)
Indication
Refractory testicular tumors; small-cell lung cancer
 

Drug
Ixempra (ixabepilone)
Indication
Metastatic or locally advanced breast cancer
Patient support program

Drug
Lysodren (mitotane)
Indication
Adrenal cortical carcinoma of functional and nonfunctional types
 

Drug
Opdivo (nivolumab)
Indication
Unresectable or metastatic melanoma with BRAF V600 wild-type; metastatic NSCLC; advanced renal-cell carcinoma; classical Hodgkin lymphoma that relapsed or progressed after autologous HSCT; recurrent or metastatic squamous-cell head and neck cancer; locally advanced or metastatic urothelial carcinoma that progressed during or after platinum-containing chemotherapy or within 12 months of neoadjuvant or adjuvant platinum-containing chemotherapy; patients ≥12 years with MSI-H or dMMR metastatic colorectal cancer that progressed after a regimen of fluoropyrimidine, oxaliplatin, and irinotecan; hepatocellular carcinoma after sorafenib therapy

Drug
Opdivo (nivolumab) + Yervoy (ipilimumab)
Indication
Unresectable or metastatic melanoma
Patient support program

Drug
Sprycel (dasatinib)
Indication
Ph+ acute lymphoblastic leukemia; newly diagnosed Ph+ chronic myeloid leukemia; chronic, accelerated, or myeloid or lymphoid blast phase Ph+ chronic myeloid leukemia resistant or intolerant to previous therapy

Drug
Yervoy (ipilimumab)
Indication
Unresectable or metastatic melanoma

dMMR indicates mismatch repair deficient; HSCT, hematopoietic stem-cell transplantation; MSI-H, microsatellite instability-high; NSCLC, non–small-cell lung cancer; Ph+, Philadelphia chromosome–positive.