Lilly Oncology

Patient Support Services Guide 2018


Lilly PatientOne Access Services
866-472-8663

Verzenio Continuous Care
844-837-9364

Eli Lilly and Company, through Lilly Oncology, offers financial assistance to qualified patients who are prescribed oncology medications and who need help in paying for their cancer medications.

The Lilly PatientOne Access Services program provides support to patients who are prescribed many Lilly Oncology drugs, including Alimta (pemetrexed), Cyramza (ramucirumab), Erbitux (cetuximab), Lartruvo (olaratumab), and Portrazza (necitumumab).

The Verzenio Continuous Care program provides personalized care support to patients who are prescribed the Lilly Oncology medication Verzenio (abemaciclib).

The complete list of Lilly Oncology drugs and their respective programs is provided in the Table.

Lilly PatientOne Access Services

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

For eligible, insured patients, the Lilly PatientOne Co-pay Program may be able to provide assistance with their copay for many Lilly Oncology drugs, as listed in the Table.

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.

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

Verzenio Continuous Care

For patients who are prescribed Verzenio, Lilly Oncology provides support through its Verzenio Continuous Care, which includes several support services.

Verzenio Continuous Care provides personalized support for patients who have been prescribed Verzenio, including access and financial assistance, by conducting benefits investigations and researching in-network specialty pharmacy options to identify the lowest out-of-pocket cost available. It also offers patient support services, such as reinforcing Verzenio treatment information, and connecting patients with advocacy groups or disease- and treatment-related resources.

The Verzenio Continuous Care Bridge Program provides free medication for commercially insured patients who have been newly prescribed Verzenio and are experiencing a delay in their insurance coverage for this medication. This program provides eligible patients with 1 cycle (28 days) of free supply of Verzenio, with the option for an additional 28-day supply if the coverage delay persists.

The Verzenio Savings Card offers eligible, commercially insured patients free Verzenio for the first 3 months. After that period, the patient pays no more than $10 monthly, and this program pays eligible patients up to a maximum of $25,000 for a 12-month period.

Eligibility

Reimbursement Assistance Criteria

To be eligible for reimbursement assistance, patients must:

  • Be permanent, legal residents of the United States or Puerto Rico
  • Take a qualifying Lilly Oncology drug within the United States.

Lilly PatientOne Co-pay Program

To be eligible for this program, patients must:

  • Be aged ≥18 years and receive a prescription for an FDA-approved indication for 1 of the following drugs, including Alimta for injection, Cyramza, Erbitux, Lartruvo, or Portrazza injection
  • Have commercial health insurance
  • Have an annual gross household income that does not exceed $100,000 or 500% of the federal poverty level.

Eligible patients who are enrolled in the Co-pay Program pay ≤$25 per dose of Alimta, Cyramza, Erbitux, Lartruvo, or Portrazza. For questions about patient eligibility requirements, call 866-472-8663.

Patient Assistance Program

The Patient Assistance Program provides patient assistance through the Lilly Cares Foundation. To be eligible for this program, patients must:

  • Meet the requirements for seeking reimbursement assistance
  • Receive ongoing treatment
  • Have no insurance, or have insurance that does not cover medications
  • Have an income ≤500% of the federal poverty level
  • Receive the medication within 180 days from the date Lilly PatientOne approves their application
  • Receive treatment in an outpatient setting.

Verzenio Continuous Care

To be eligible for the Verzenio Continuous Care program, patients must have been prescribed Verzenio for an FDA-approved indication and meet the eligibility requirements.

Verzenio Continuous Care Bridge Program

To be eligible for the Verzenio Continuous Care Bridge Program, patients must:

  • Have commercial health insurance
  • Be prescribed a new prescription for Verzenio for an FDA-approved indication
  • Experience a delay in insurance coverage of ≥5 days
  • Enroll in the Verzenio Continuous Care program.

The Verzenio Continuous Care Bridge Program may not be combined with other offers.

Verzenio Savings Program

To be eligible for this program, patients must:

  • Have commercial health insurance
  • Not be eligible to have their prescription claims for Verzenio reimbursed, in whole or part, by any government-sponsored program, including Medicaid, Medicare, and Medicare Part D
  • Reside in the United States or Puerto Rico.

Application & Enrollment

Lilly PatientOne Access Services

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 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.

Verzenio Continuous Care

To enroll in this program, the prescriber and the patient must complete the enrollment form and fax it to 855-545-5957. To learn more about the Verzenio Continuous Care program, call 844-837-9364.

Verzenio Continuous Care Bridge Program

To enroll in this program, patients and their prescribers must complete the applicable section of the Verzenio Continuous Care enrollment form.

Verzenio Savings Card

Eligible patients can download or activate a Verzenio Savings Card online. For more information about this program, call 844-837-9364.

Lilly Oncology Drugs

Drugs
Indications
Patient support programs

Drug
Alimta (pemetrexed) for injection
Indication
Advanced NSCLC, as first-line treatment, in combination with cisplatin; advanced NSCLC, as monotherapy, after previous chemotherapy; unresectable malignant pleural mesothelioma, as initial treatment, in combination with cisplatin

Drug
Cyramza (ramucirumab)
Indication
Metastatic gastric cancer, as monotherapy, or in combination with paclitaxel; metastatic NSCLC, in combination with docetaxel; metastatic colorectal cancer, in combination with irinotecan, folinic acid, and 5-fluorouracil

Drug
Erbitux (cetuximab)
Indication
Locally or regionally advanced relapsed or refractory squamous head and neck cancer; KRAS wild-type and EGFR-positive metastatic colorectal cancer

Drug
Gemzar (gemcitabine hydrochloride)
Indication
Advanced relapsed or refractory ovarian cancer; metastatic breast cancer, as first-line therapy; NSCLC; pancreatic cancer
Patient support program

Drug
Lartruvo (olaratumab)
Indication
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

Drug
Portrazza (necitumumab) injection
Indication
Advanced squamous NSCLC, in combination with gemcitabine and cisplatin

Drug
Verzenio (abemaciclib)
Indication
HR-positive, HER2-negative advanced or metastatic breast cancer, in combination with fulvestrant, for disease that progressed after endocrine therapy; HR-positive, HER2-negative advanced or metastatic breast cancer, as monotherapy, for disease that progressed after endocrine therapy and previous chemotherapy in the metastatic setting

HR indicates hormone receptor; NSCLC, non–small-cell lung cancer.