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Co-pay Assistance Foundations Referring a Patient to a Co-pay Assistance Foundation for Avastin Access Solutions

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.

 

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

    • Musella Foundation
      1100 Peninsula Blvd 
      Hewlette, NY 11557
      Toll Free Phone: 888-295-4740
      Direct Phone: 516-295-4740
      Fax: 516-295-2870
      http://www.virtualtrials.com/musella.cfm

  •  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

  •  Metastatic Renal Cell Carcinoma
    • No funds are available at this time.

      Please call Genentech Access Solutions at (866) 4ACCESS / (866) 422-2377. We may be able to help.

* Genentech does not influence or control the operations of these co-pay assistance foundations, but Avastin Access Solutions can assist patients by making an appropriate referral to a foundation that may be able to help. 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.
Learn More About
Avastin
  • LEARN about treatment with Avastin
  • 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

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