Sanofi

Patient Support Services Guide 2018


Sanofi Patient Connection
888-847-4877

Sanofi Patient Connection is a comprehensive set of patient support services designed to facilitate access to Sanofi’s medications to patients who are unable to afford them.

Sanofi’s oncology and oncology supportive care drugs, their indications, and support services programs are listed in the Table.

Sanofi Patient Connection

Patient Assistance Connection provides medication at no cost to patients who meet the program’s eligibility requirements. This support is made possible through the Sanofi Foundation for North America.

Reimbursement Connection helps patients and providers in determining insurance verification, prior authorization verification, coding and billing, and claims management and appeals assistance.

Resource Connection assists patients in finding additional resources and support, including clinical support services, transportation, and home care services support.

Eligibility

To be eligible for Sanofi Patient Connection, patients must:

  • Be a US citizen or resident
  • Be under the care of a US-licensed provider who is authorized to prescribe medicines
  • Have no insurance coverage or no access to the prescribed drug or treatment through their insurance
  • Not be eligible for Medicare or Medicaid
  • Patients enrolled in Medicare Part D can be assessed for eligibility if they are not eligible for Medicare’s Low Income Subsidy, and do not have coverage for a generic drug equivalent
  • Have out-of-pocket total drug costs of 5% of their household’s annual income
  • Have an annual household income of ≤500% of the poverty level.

Application & Enrollment

The application form for the Sanofi Patient Connection program is available online.

To enroll in the program, the completed application must be submitted by fax to 888-847-1797 or by mail to the address provided on the application form.

Applications can also be initiated by calling 888-847-4877. In addition, healthcare providers can use the secure provider portal to submit the application.

It is required that a licensed healthcare provider who is authorized to prescribe, dispense, and administer medicines in the United States fills out and signs the application form and provides the treatment and prescribing information, including a diagnosis code.

Proof of income is not required, and Sanofi Patient Connection will estimate patients’ income by using their date of birth, Social Security number, and/or additional demographic information to access their credit information.

Patients and their healthcare providers are notified of their eligibility and enrollment into the program. Patient eligibility is valid for up to 12 months, and patients may re­apply on an annual basis for longer assistance with paying for their Sanofi medication.

Resource Connection

Sanofi’s Resource Connection provides patient education and assists patients with finding additional resources to obtain help with access to:

  • Clinical support services
  • Transportation
  • Health supply/cosmetic aids (eg, wigs, scarves)
  • Home care services support (eg, shelter, utilities)
  • Nutritional supplements (eg, groceries, food bank)
  • Patient advocacy.

Other Services

Leukine Direct Reimbursement Support Line

Sanofi provides patients who are prescribed Leukine (sargramostim) reimbursement consultants through the Leukine Direct Reimbursement Support Line. Patients and physicians can speak with reimbursement consultants by calling 888-479-5385. The reimbursement consultants have experience with all payer types; reimbursement and coverage policy; and can help with claims appeal and identify payment sources for uninsured or underinsured patients.

MOZOBILDirect Reimbursement Assistance

For patients who are prescribed Mozobil (plerixafor injection), Sanofi offers MOZOBILDirect, a reimbursement support program. Patients and providers can call 877-466-9624 to receive assistance with insurance verification; coding and billing; claims, denials, and appeals; prior authorization assistance; Patient Assistance Programs; and access to counselors who can determine whether there are alternative services available.

Sanofi Oncology/Supportive Care Drugs

Drugs
Indications
Patient support programs

Drug
Clolar (clofarabine)
Indication
Relapsed or refractory acute lymphoblastic leukemia in patients aged 1-21 years, after ≥2 previous regimens
Patient support program

Drug
Elitek (rasburicase)
Indication
Management of plasma uric acid levels in patients with leukemia, lymphoma, or solid tumors who are receiving anticancer therapy
Patient support program

Drug
Jevtana (cabazitaxel)
Indication
Metastatic castration-resistant prostate cancer, with prednisone, after docetaxel-containing regimen
Patient support program

Drug
Leukine (sargramostim)
Indication
Reduce time to neutrophil recovery after chemotherapy induction in acute myelogenous leukemia; mobilization and after transplant of autologous peripheral blood progenitor cells; myeloid reconstitution after bone marrow transplant; bone marrow transplant failure or engraftment delay

Drug
Mozobil (plerixafor injection)
Indication
For autologous transplant in non-Hodgkin lymphoma or multiple myeloma, with granulocyte colony-stimulating factor

Drug
Taxotere (docetaxel)
Indication
Locally advanced or metastatic breast cancer; as adjuvant treatment of operable, node-positive breast cancer, with doxorubicin and cyclophosphamide; locally advanced or metastatic NSCLC after failing platinum therapy; unresectable, locally advanced or metastatic untreated NSCLC, with cisplatin; metastatic hormone- refractory prostate cancer, with prednisone; advanced, untreated gastric adenocarcinoma (including gastroesophageal junction), with cisplatin and fluorouracil; induction treatment of locally advanced squamous-cell carcinoma of the head and neck, with cisplatin and fluorouracil
Patient support program
Good Days
877-968-7233

Drug
Zaltrap (ziv-aflibercept)
Indication
Metastatic colorectal cancer, in combination with 5-fluorouracil, leucovorin, and irinotecan
Patient support program

NSCLC indicates non–small-cell lung cancer.