Sandoz One Source: Patient Support Services

Patient Support Services Guide 2018


Sandoz One Source
844-726-3691

Sandoz, through Sandoz One Source, offers a comprehensive patient support program designed to help simplify patient access to Zarxio (filgrastim-sndz).

Zarxio (Table) is indicated for the treatment of patients with cancer receiving myelosuppressive chemotherapy; patients with acute mye­loid leukemia receiving induction or consolidation chemotherapy; patients with cancer undergoing bone marrow transplantation or those undergoing autologous peripheral blood progenitor cell collection and therapy; and patients with severe chronic neutropenia.

Sandoz One Source

The Sandoz One Source program offers customized support services for patients who are prescribed Zarxio, including:

  • Comprehensive insurance verifi­cations
  • Prior authorization support when required by the insurance company
  • Billing and coding information
  • Information on claims tracking, denials, and appeals
  • Payer policy research.

In addition, Sandoz One Source offers financial assistance to eligible patients.

Co-Pay Program

The Sandoz One Source Co-Pay Program assists commercially insured patients with reducing their out-of-pocket prescription costs.

There is no income eligibility requirement. Patients pay $0 for the first dose, and $10 for subsequent doses for up to 12 months. The maximum annual benefit is $10,000.

Patient Assistance Program

This program provides access to medicines for those most in need. Patients may be eligible to receive Zarxio at no cost if they are experiencing financial hardship and have no third-party insurance coverage for their medicine.

Eligibility

Sandoz One Source Co-Pay Program

To be eligible for this program, the following requirements must be met:

  • The patient must be insured
  • The patient’s prescription must be for an approved indication
  • Patients who are paying cash or are uninsured are not eligible
  • The prescriptions must not be paid, in whole or in part, by any state or federally funded programs, including, but not limited to, Medicare (including Part D, even in the coverage gap), Medicaid, Medigap, Veterans Affairs, Department of Defense or TRICARE, a private indemnity, or HMO insurance plans that reimburse the patient for the entire cost of prescription drugs, or where prohibited by law
  • Patients can participate for a maximum of 12 months
  • The Sandoz One Source Co-Pay Program may not be combined with any other rebate, coupon, or offer
  • The Sandoz One Source Co-Pay Program has no cash value.

Patient Assistance Program

To be eligible for the Patient Assistance Program, patients must meet Novartis Patient Assistance Foundation eligibility criteria, including:

  • Patients must be US residents
  • Provide proof of income within program guidelines
  • Not have public or private prescription coverage.

For more information about this program and its eligibility requirements, patients and their physicians can call Sandoz One Source at 844-726-3691 or visit PatientAssistanceNow.com.

Application & Enrollment

Enrollment to the Sandoz One Source program, which includes the Sandoz One Source Co-Pay Program and the Patient Assistance Program, requires the completion of the Sandoz One Source enrollment form (available at SandozOneSource.com) and faxing it to the number provided on the form (844-726-3695) or mailing it to the address on the form.

Physicians must complete the appropriate sections, sign the form, and attach the brand name prescription; patients must submit the required documents with their completed sections.

Table Sandoz Oncology Supportive Care Drug

Drug
Indications
Patient support programs

Drug
Zarxio (filgrastim-sndz)
Indication
Decrease febrile neutropenia in patients using myelosuppressive anticancer drugs; reduce time to neutrophil recovery and duration of fever after induction or consolidation chemotherapy in patients with acute myeloid leukemia; reduce the duration of neutropenia and neutropenia-related sequelae in patients receiving myeloablative chemotherapy followed by bone marrow transplantation; mobilize autologous hematopoietic progenitor cells; reduce the incidence and duration of sequelae of severe neutropenia in symptomatic patients with congenital neutropenia‚ cyclic neutropenia‚ or idiopathic neutropenia