TerSera Therapeutics Support Services

Patient Support Services Guide 2019


Support Service
844-864-3014
Support Service
866-255-8702

TerSera Therapeutics offers a range of support services, including financial assistance programs and coverage support, for patients who are prescribed Varubi (rolapitant) or Zoladex (goserelin acetate implant).

Varubi is a substance P/neurokinin receptor antagonist indicated, in combination with other antiemetic agents, for the prevention of delayed nausea and vomiting in adults who are receiving emetogenic cancer chemotherapy, including highly emetogenic chemotherapy.

Zoladex is a gonadotropin-releasing hormone agonist indicated for the management of localized prostate cancer, in combination with flutamide; as palliative treatment for advanced prostate cancer; and as palliative treatment for pre- or perimenopausal women with advanced breast cancer (Table).

Tersera Support Programs

Drug-Specific Co-Pay Cards

Through the Varubi Co-Pay Card, eligible patients who have commercial insurance may have a $0 copay per month for Varubi, with a maximum benefit of $2000 annually.

Through the Zoladex Co-Pay Card, eligible patients who have commercial insurance may have a co-pay of $0 per month for Zoladex, with a maximum benefit of $2000 annually. Cash-paying eligible patients will receive $500 off each 1-month supply of Zoladex.

Patient Assistance Programs

For patients without commercial insurance, TerSera Support Source will offer assistance with the cost of Varubi.

For patients without commercial insurance, the Zoladex Patient Assistance Program may provide Zoladex for free for up to 1 year before renewal is required. The medicine is sent in a 90-day supply to the patient’s home or the prescribing physician’s office.

Zoladex Support Source

The Zoladex Support Source provides oncology practices a range of support services, including reimbursement and coverage support, benefits investigation, prior authorization information, and appeals support. This program is offered by TerSera in partnership with eBlu Solutions. For more information regarding a specific service, call 502-805-2361 or visit the eBlu Solutions Site.

Eligibility

Commercial Co-Pay Programs

To qualify for the Varubi or the Zoladex Co-Pay Card, patients must:

  • Have commercial insurance
  • Not be covered by any state- or federally funded programs, including Medicare or Medicaid
  • Reside in the United States.

For additional information call 866-255-8702 regarding Varubi, or 844-864-3014 regarding Zoladex.

Patient Assistance Programs

To qualify for the patient assistance programs for Varubi or for Zoladex, patients must:

  • Not have prescription drug coverage that helps pay for their medication
  • Be prescribed Varubi or Zoladex
  • Be a US resident, or for Zoladex, have a Green Card or Work Visa
  • Meet certain household income requirements (for Zoladex).

Through this program, patients may receive free Zoladex for up to 1 year, with medicines sent in a 90-day supply. For more details on the patient assistance programs for Varubi or for Zoladex, call 855-686-8725.

Application & Enrollment

Co-Pay Programs

Patients can enroll in the Varubi Co-Pay Card online. Similarly, patients can enroll in the Zoladex Co-Pay Card online. For additional information, call 866-255-8702 for Varubi, or 844-864-3014 for Zoladex.

Patient Assistance Programs

To enroll in the Varubi Patient Assistance Program, patients should complete the enrollment form, and fax it to 855-836-3066. The patient and the prescribing physician will be notified of the patient’s eligibility. If eligible, the prescribed quantity of Varubi will be shipped to the preferred address. A maximum of 6 doses per shipment will be sent to the patient’s address, unless otherwise specified. Additional shipments may be allowed, pending the patient’s continued eligibility. For more information, call 855-686-8725.

To enroll in the Zoladex Patient Assistance Program, eligible patients should complete the enrollment form. Completed forms, along with necessary documents, must be mailed to the address on the form or faxed to 855-836-3066. Documents include proof of household income, such as income tax returns, W2 or 1099, pay stubs, or a Social Security Income Yearly Benefits Statement.

Table TerSera Oncology/Supportive Care Drugs

Drugs
Indications
Patient support programs

Drug
Varubi (rolapitant)
Indication
Prevention of delayed nausea and vomiting in adults associated with emetogenic cancer chemotherapy, including highly emetogenic chemotherapy, in combination with other antiemetic agents

Drug
Zoladex (goserelin acetate implant)
Indication
Management of localized prostate cancer, in combination with flutamide; palliative treatment of advanced prostate cancer; palliative treatment of advanced breast cancer in pre- and peri­menopausal women