Patient Guide to Support Services

Clovis Oncology

Rubraca Connections
844-779-7707

Clovis Oncology’s Rubraca Connections is a comprehensive patient support services program designed to help patients who are prescribed Rubraca (rucaparib) tablets. This includes coordinating ­Rubraca delivery and pick-up, finding financial support programs, and connecting patients with a specialty pharmacy team.

Rubraca is a poly ADP-ribose polymerase (PARP) inhibitor indicated as monotherapy for the treatment of patients with advanced ovarian cancer associated with germline and/or somatic deleterious BRCA mutation who have received ≥2 chemotherapies, and for the maintenance treatment of patients with recurrent ovarian cancer who have had a complete or partial response to platinum-based chemotherapy.

Rubraca Connections Services

Rubraca Connections provides several support services for patients who have been prescribed Rubraca.

Rubraca $0 Co-Pay Program

The Rubraca $0 Co-Pay Program provides the out-of-pocket costs for eligible patients. Patients with private or commercial insurance may qualify for the Rubraca $0 Co-Pay Program, which provides 100% of the patient’s out-of-pocket drug costs for Rubraca for up to $30,000 annually, regardless of the patient’s income.

Rubraca Connections QuickStart Program

The Rubraca Connections QuickStart Program may provide the first 15 days of Rubraca at no cost, up to 3 refills (or 60 days). This program is for eligible patients who have private (commercial) or government insurance and are experiencing delays in coverage for Rubraca.

Rubraca Connections Patient Assistance Program

The Rubraca Connections Patient Assistance Program provides free medication to eligible uninsured or underinsured patients. Patients without health insurance or with insurance that does not cover the cost of Rubraca may be eligible for the Rubraca Connections Patient Assistance Program.

Eligibility

Rubraca $0 Co-Pay Program

To be eligible for the Rubraca $0 Co-Pay Program, patients must:

  • Be a resident of the United States, Puerto Rico, or US territories
  • Have private or commercial ­insurance
  • Not be covered by federal- or state-funded insurance
  • Not be cash-paying patients without commercial insurance.

Rubraca Connections Patient Assistance Program

To be eligible for the Rubraca Connections Patient Assistance Program, patients must:

  • Have a household income that is based on financial or income evaluation
  • Be a resident of the United Staes
  • Be uninsured or rendered uninsured
  • Have a prescription for an FDA-­approved indication for Rubraca.

Rubraca Connections QuickStart Program

To be eligible for the Rubraca Connections QuickStart Program, patients must:

  • Have a prescription for Rubraca for an FDA-approved indication
  • Have a private (commercial) or government insurance and be experiencing a delay in medication coverage
  • Not bill the cost of Rubraca provided through this program to an insurance provider
  • Obtain a separate QuickStart prescription for the pharmacy supporting the program.

Application & Enrollment

Rubraca $0 Co-Pay Program

Eligible patients can enroll in the Rubraca $0 Co-Pay Program by completing the online enrollment form or by calling Rubraca Connections at 844-779-7707.

Rubraca Connections Patient Assistance Program

To enroll a patient in this program, patients and their prescribers can complete the Rubraca Connections prescription form and fax it to 844-779-7717, or mail it to the address listed on the form. Alternatively, patients can enroll by calling Rubraca Connections at 844-779-7707.

Rubraca Connections QuickStart Program

To enroll in the Rubraca Connections QuickStart Program, the patient should complete the Rubraca Prescription Form, along with the prescribing physician, and fax the completed form to 844-779-7717, or to a network specialty pharmacy. Enrollees can also submit their prescription online via Rubraca eRx and eSupport Solutions.

Table Clovis Oncology Drug

Drug
Indications
Patient support programs

Drug
Rubraca (rucaparib) tablets
Indication
Advanced ovarian cancer associated with germline and/or somatic deleterious BRCA mutation, after ≥2 chemotherapies; maintenance treatment of recurrent ovarian cancer with a complete or partial response to platinum-based chemotherapy

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