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NEXT TOPICBuy and Bill 

Buy and Bill

 

“Buy and bill” is a term used by health care providers when an office or facility purchases LUCENTIS, then bills an insurer for reimbursement. Once the bill is submitted, your office is reimbursed for the product. With buy and bill, you maintain a stock of LUCENTIS, giving you the flexibility to treat your patients when clinically appropriate. If you qualify to continue using the CMS 1500 claim form, follow these steps:

 

  1. Manual bill: Submit a hard copy of the CMS 1500 claim form with J9035 or other code designated by the insurer.
  2. Respond promptly to the insurer’s request for additional information. Failure to submit the documentation before the deadline is a common reason for denial.
  3. Claim is processed. (If denied, see Appeals.)

 

Authorized Specialty Pharmacies

 

Genentech has contracted with a network of authorized specialty distributors and wholesalers to service customers that choose to purchase LUCENTIS® (ranibizumab injection) through the buy and bill model. Customers can purchase LUCENTIS through authorized specialty distributors and wholesalers that have made a commitment to product integrity. These partners have agreed to distribute only products purchased directly from Genentech and not distribute LUCENTIS through secondary channels.

Please contact us for a list of authorized distributors.

NEXT TOPICSpoilage Replacement Program 

Spoilage Replacement Program

 

If the LUCENTIS prescribed for a labeled indication was spoiled and unable to be administered, the product might be eligible for replacement through the Genentech Spoilage Replacement Program.*

 

Potential reasons for replacement

 

LUCENTIS has been reconstituted and is unusable due to one of the following events:

  • LUCENTIS was reconstituted and patient missed appointment
  • LUCENTIS was accidentally dropped
  • LUCENTIS was not appropriately refrigerated or was frozen
  • Patient expired/coded
  • LUCENTIS was not administered due to unforeseen symptoms

 

For all quality- or stability-related issues, please contact Genentech Medical Communications at (800) 821-8590.

 

For expired product returns, please contact Genentech Customer Operations at (800) 551-2231.

 

Replacement procedure

 

To request replacement product:

 

  1. Contact Genentech Customer Operations at (800) 551-2231 to obtain the Genentech Spoilage Replacement Program form.
  2. Complete the Genentech Spoilage Replacement Program form. Please write legibly and fill in ALL required fields to prevent delays.
  3. Fax the form to (877) 329-6737.
  4. The request might take up to 3 business days to review. If approved, instructions for how to return the spoiled product or verify spoilage are provided at this time.
  5. Replacement product ships within 11 business days following receipt of the spoiled product or Certification of Destruction form (provided by Customer Operations).

 

Please be sure to retain all intact vials. Unless the vial(s) is broken, all products must be returned. If the vial(s) is broken, a completed Certification of Destruction form is required.

 

* Subject to certain limitations and conditions. The Spoilage Replacement Program covers infused or injected Genentech products. Genentech has the right to modify or discontinue the Spoilage Replacement Program at any time without notice.
 

Compass for Patient Access

Find the right
patient assistance program
for your patients 

Did you know...

 

If you have more questions about buy and bill, read our Buy and Bill Tips.

Learn More About
Lucentis
  • LEARN about treatment with LUCENTIS
  • FIND the right patient assistance program with our Compass for Patient Access tool
  • LEARN HOW the LUCENTIS Co-pay Card can help with the out-of-pocket costs for LUCENTIS
  • Form NEW: Statement of Medical Necessity
  • Form Patient Authorization and Notice of Release of Information (Current Version)

LUCENTIS Indications and Important Safety Information

INDICATIONS

LUCENTIS® (ranibizumab injection) is indicated for the treatment of patients with:

  • Neovascular (wet) age-related macular degeneration (wAMD)
  • Macular edema following retinal vein occlusion (RVO)
  • Diabetic macular edema (DME)

IMPORTANT SAFETY INFORMATION

LUCENTIS is contraindicated in patients with ocular or periocular infections or hypersensitivity to ranibizumab or any of the excipients in LUCENTIS.

Intravitreal injections, including those with LUCENTIS, have been associated with endophthalmitis, retinal detachment, and iatrogenic traumatic cataract.

Increases in intraocular pressure have been noted both pre-injection and post-injection with LUCENTIS.

Although there was a low rate of arterial thromboembolic events (ATEs) observed in the LUCENTIS clinical trials, there is a potential risk of ATEs following intravitreal use of VEGF inhibitors. ATEs are defined as nonfatal stroke, nonfatal myocardial infarction, or vascular death (including deaths of unknown cause).

In the LUCENTIS Phase III clinical trials, the most common ocular side effects included conjunctival hemorrhage, eye pain, vitreous floaters, and increased intraocular pressure. The most common non-ocular side effects included nasopharyngitis, headache, influenza, sinusitis, cough, and nausea.

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.

For additional safety information, please see LUCENTIS full Prescribing Information.