Back To TOP

Co-pay Assistance Foundations Referring a Patient to a Co-pay Assistance Foundation

If your patients need help with their medication co-pays, Avastin® Access Solutions can connect them to co-pay assistance foundations* supporting their disease state.

 

 

 

Key points to remember about co-pay assistance foundations:

 

  • For some foundations, approval can occur in less than 30 days with possible contingent approval sooner
  • If the patient is denied assistance by one foundation, he or she can be referred to a different foundation, if one is available
  • Although each foundation offers some form of assistance, it might not be a full award
  • The application process might require some form of financial verification
  • All aspects of application processing can vary by foundation and are determined by each foundation
  • Patients should be sure to submit the application and required documentation in a timely manner to avoid delays or gaps in coverage

 

* Genentech does not influence or control the operations of these co-pay assistance foundations, but Avastin Access Solutions can assist patients in navigating the process of seeking co-pay assistance by making an appropriate referral based on a patient’s diagnosis and by assisting with the application process. We cannot guarantee co-pay assistance once a patient has been referred by Avastin Access Solutions. The foundations to which we refer patients each have their own criteria for patient eligibility, including financial eligibility.

Listing of Co-pay Assistance Foundations

Select from the available disease states below for a list of foundations.This information is updated regularly.

  •  Advanced Non-Small Cell Lung Cancer
    • Patient Access Network Foundation (PANF)
      P.O. Box 221858
      Charlotte, NC 28222-1858
      Toll Free: 866-316-PANF (7263)
      www.panfoundation.org



      NOTE: PANF is only covering advanced non-small cell lung cancer Medicare patients

  •  Glioblastoma
    • CancerCare Co-Payment Assistance Foundation
      275 Seventh Avenue, 22nd Floor
      New York, NY 10001
      Toll Free: 1-866-55-COPAY (866-552-6729)
      www.cancercarecopay.org

  •  Metastatic Colon Cancer
    • Patient Access Network Foundation (PANF)
      P.O. Box 221858
      Charlotte, NC 28222-1858
      Toll Free: 866-316-PANF (7263)
      www.panfoundation.org


      NOTE: PANF is only covering metastatic colon cancer Medicare patients.

    • Chronic Disease Fund
      6900 N. Dallas Parkway, Suite 200
      Plano, TX 75024
      Toll Free: 1-877-968-7233
      www.cdfund.org



      NOTE: Per CDF's policy, they will no longer support Xeloda colorectal patients. If you have further questions, please call CDF.

  •  Metastatic Renal Cell Carcinoma
    • Patient Access Network Foundation (PANF)
      P.O. Box 221858 
      Charlotte, NC 28222-1858
      Toll Free: 866-316-PANF (7263)
      www.panfoundation.org

       

       

      NOTE: PANF is only covering metastatic renal cell carcinoma Medicare patients

Learn More About
Avastin
  • LEARN about treatment with Avastin
  • **Important Information Regarding Counterfeit Drug **
  • LEARN HOW the Genentech BioOncology Co-pay Card can help with the out-of-pocket costs for Avastin
  • Download: new forms for enrollment in GATCF
  • Form Statement of Medical Necessity
  • Form Patient Authorization and Notice of Release of Information

INDICATIONS

Glioblastoma (GBM)
Avastin is indicated for the treatment of glioblastoma as a single agent for adult patients with progressive disease following prior therapy. The effectiveness of Avastin in glioblastoma is based on an improvement in objective response rate. There are no data demonstrating an improvement in disease-related symptoms or increased survival with Avastin.

Metastatic colorectal cancer (MCRC)
Avastin is indicated for the first- or second-line treatment of patients with metastatic carcinoma of the colon or rectum in combination with intravenous 5-fluorouracil–based chemotherapy.

Avastin, in combination with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy, is indicated for the second-line treatment of patients with metastatic colorectal cancer who have progressed on a first-line Avastin-containing regimen.

Limitation of Use: Avastin is not indicated for adjuvant treatment of colon cancer.

Non-squamous non-small cell lung cancer (NSCLC)
Avastin is indicated for the first-line treatment of unresectable, locally advanced, recurrent or metastatic non–squamous non–small cell lung cancer in combination with carboplatin and paclitaxel.

Metastatic renal cell carcinoma (mRCC)
Avastin is indicated for the treatment of metastatic renal cell carcinoma in combination with interferon alfa.

Boxed WARNINGS

  • Gastrointestinal (GI) perforation

    - Serious and sometimes fatal GI perforation occurs at a higher incidence in Avastin-treated patients compared to controls

    - The incidences of GI perforation ranged from 0.3% to 2.4% across clinical studies

    - Discontinue Avastin in patients with GI perforation

  • Surgery and wound healing complications

    - The incidence of wound healing and surgical complications, including serious and fatal complications, is increased in Avastin-treated patients

    - Do not initiate Avastin for at least 28 days after surgery and until the surgical wound is fully healed. The appropriate interval between termination of Avastin and subsequent elective surgery required to reduce the risks of impaired wound healing/wound dehiscence has not been determined

    - Discontinue Avastin at least 28 days prior to elective surgery and in patients with wound healing complications requiring medical intervention

  • Hemorrhage

    - Severe or fatal hemorrhage, including hemoptysis, GI bleeding, hematemesis, central nervous system hemorrhage, epistaxis, and vaginal bleeding, occurred up to 5-fold more frequently in patients receiving Avastin. Across indications, the incidence of grade ≥3 hemorrhagic events among patients receiving Avastin ranged from 1.2% to 4.6%

    - Do not administer Avastin to patients with serious hemorrhage or recent hemoptysis (≥1/2 tsp of red blood)

    - Discontinue Avastin in patients with serious hemorrhage (ie, requiring medical intervention)

Additional serious adverse events

  • Additional serious and sometimes fatal adverse events with increased incidence in the Avastin-treated arm vs control included

    - Non-GI fistula formation (≤0.3%)

    - Arterial thromboembolic events (grade ≥3, 2.6%)

    - Proteinuria (nephrotic syndrome, <1%)

  • Additional serious adverse events with increased incidence in the Avastin-treated arm vs control included

    - Hypertension (grade 3–4, 5%–18%)

    - Reversible posterior leukoencephalopathy syndrome (RPLS) (<0.1%)

  • Infusion reactions with the first dose of Avastin were uncommon (<3%), and severe reactions occurred in 0.2% of patients
  • Inform females of reproductive potential of the risk of ovarian failure prior to starting treatment with Avastin

Most common adverse events

  • Across indications, the most common adverse reactions observed in Avastin patients at a rate >10% and at least twice the control arm rate were
    - Epistaxis - Proteinuria - Lacrimation disorder
    - Headache - Taste alteration - Back pain
    - Hypertension - Dry skin - Exfoliative dermatitis
    - Rhinitis - Rectal hemorrhage  
  • Across all studies, Avastin was discontinued in 8.4% to 21% of patients because of adverse reactions

Pregnancy warning

  • Avastin may impair fertility
  • Based on animal data, Avastin may cause fetal harm
  • Advise patients of the potential risk to the fetus during and following Avastin and the need to continue adequate contraception for at least 6 months following the last dose of Avastin
  • For nursing mothers, discontinue nursing or Avastin, taking into account the importance of Avastin to the mother

You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch.

You may also report side effects to Genentech at (888) 835-2555.

Please see accompanying full Prescribing Information, including Boxed WARNINGS, for additional important safety information.

Avastin® and the Access Solutions logo are registered trademarks of Genentech, Inc.