Patient Guide to Support Services

Heron Therapeutics

Heron Connect
844-437-6611

Heron Therapeutics’s Heron Connect offers comprehensive support and access services for patients who have been prescribed Sustol (granisetron) extended-release injection and/or Cinvanti (aprepitant) injectable emulsion (Table).

Sustol, a serotonin-3 receptor antagonist, is indicated in combination with other antiemetics, in adults for prevention of acute or delayed chemotherapy-induced nausea and vomiting (CINV) associated with moderately emetogenic chemotherapy or with anthracycline plus cyclophosphamide combination chemotherapy regimens. Cinvanti, a substance P/neurokinin-1 receptor antagonist, is indicated in combination with other antiemetic agents, in adults for prevention of acute or delayed CINV associated with highly emetogenic chemotherapy.

Heron Connect

Heron Connect offers a suite of support services for patients prescribed Sustol and/or Cinvanti, including:

  • Financial assistance for patients with different insurance coverages and financial needs
  • Access solutions to assist with patient enrollment in Heron Connect programs, insurance verification, prior authorization, billing, appeals support, reimbursement, claims tracking, and more.

The 3 financial assistance options available for patients prescribed Sustol and/or Cinvanti include the Copay Assistance Program, Patient Assistance Program, and the Heron Commitment Program.

Copay Assistance Program

The Copay Assistance Program helps patients with out-of-pocket prescription costs. Eligible patients pay a $0 copay per dose annually. When applicable, deductible assistance up to $200 per treatment may be available for eligible patients. Cash-paying patients may receive $150 per prescription up to $1800 annually.

Patient Assistance Program

The Patient Assistance Program allows eligible patients with financial hardship to receive Sustol and/or Cinvanti at no cost.

Heron Commitment Program

The Heron Commitment Program provides financial compensation to oncology practices for the cost of medication administered to eligible, commercially insured patients in the event of a qualifying claim denial.

Eligibility

Copay Assistance Program

To qualify for the Copay Assistance Program, patients must:

  • Have commercial insurance that provides a copay or coinsurance for Sustol and/or Cinvanti
  • Have a valid prescription for Sustol and/or Cinvanti
  • Not be participating in federally or state-funded insurance programs, including Medicare or Medicaid
  • Have prescriptions filled in the United States and its territories
  • Be aged ≥18 years
  • Have received treatment within 120 days of their program enrollment date.

Oncology practices must submit their request for reimbursement within 180 days of treatment. Program eligibility is for 12 months, after which the patient will need to reapply for continued assistance.

Patient Assistance Program

To receive Sustol and/or Cinvanti free of cost, patients must:

  • Be uninsured or have limited drug coverage (including all outpatient medications excluded by the insurer, specific drug exclusion or benefit exclusion pending review by the insurer, and have hospital-only coverage)
  • Have noncommercial insurance that was rendered uninsured after first level of appeal is denied for the initial treatment
  • Have annual income ≤500% of the Federal Poverty Level
  • Be a resident of the United States or its territories
  • Be using Sustol and/or Cinvanti as prescribed
  • Receive treatment that is provided in an outpatient setting.

Program eligibility is for 12 months, after which the patient will need to reapply for continued assistance.

Heron Commitment Program

To qualify for the Heron Commitment Program, commercially insured patients prescribed Sustol and/or Cinvanti with confirmed medication coverage before drug administration with claims denials must have met the following criteria (with necessary documentation):

  • Verification of benefits (conducted by the provider and/or by Heron Connect) that meets all the payer criteria and/or the policy requirements
  • Submitted claim for Sustol and/or Cinvanti is denied by the commercial payer
  • Claim is denied again after the first level of appeals process has been followed.

For more information about patient assistance options, call Heron Connect at 844-437-6611.

Application & Enrollment

Heron Connect

Patients may be enrolled in the Heron Connect program by completing the Insurance Verification and Program Enrollment Form, and faxing it to 844-504-8652.

Copay Assistance Program

Patients can be enrolled in the Copay Assistance Program by completing the Insurance Verification and Program Enrollment Form and faxing it to 844-504-8652. Alternatively, practices may also use a simplified registration process by directly applying via an online application or by completing 2 enrollment forms. First, a one-time Copay Assistance Program Practice Enrollment Form specific to the prescriber’s practice must be submitted to Heron Connect. Following enrollment of the practice, the completed Copay Assistance Program Patient Registration Form for the patient, along with a patient factsheet (containing the patient’s name, address, phone number, date of birth, gender, and insurance information), must be faxed to 844-504-8652. After administration, the patient’s explanation of benefits and copy of the claim form that was submitted to the insurance company must be provided to Heron Connect within 180 days of treatment.

Patient Assistance Program

Enrollment in this program requires completion of the Insurance Verification and Program Enrollment Form and faxing it to 844-504-8652.

Heron Commitment Program

Practices may be enrolled in the Heron Commitment Program by completing a one-time Heron Commitment Program Practice Enrollment Form. After the second claim denial, all required documentation must be submitted to Heron Connect, including an explanation of benefits, appeal denial, a copy of the original invoice for Sustol and Cinvanti, and a W-9 form.

Table Heron Therapeutics Oncology Supportive Care Drugs

Drugs
Indications
Patient support programs

Drug
Sustol (granisetron) extended-release injection
Indication
In combination with other antiemetics in adults for prevention of nausea and vomiting associated with MEC or with anthracycline + cyclophosphamide chemotherapy regimens

Drug
Cinvanti (aprepitant) injectable emulsion
Indication
In combination with other antiemetic agents in adults for prevention of nausea and vomiting associated with HEC, including high-dose cisplatin, or with MEC

HEC indicates highly emetogenic chemotherapy; MEC, moderately emetogenic chemotherapy.

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