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

If your patients need help with their medication co-pays, PERJETA 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 PERJETA 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 PERJETA Access Solutions. The foundations to which we refer patients each have their own criteria for patient eligibility, including financial eligibility.

 

 

NEXT TOPICListing of Foundations 

Listing of Co-Pay Assistance Foundations

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

  •  Breast 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

FAQs

 
Q:

When should I refer my patient to PERJETA Access Solutions for help?

 
A: 

At any point after you have prescribed PERJETA® (pertuzumab), you can refer your patients to PERJETA Access Solutions. Learn more in See How We Can Help.

 

 

Q:

 

Can PERJETA Access Solutions assist with co-pay issues?

 
A: 

Yes. We can help with co-pay issues in two ways, for both privately and publicly insured patients. Learn more in Find Patient Assistance.

 

 

Q:

 

Is there assistance for uninsured patients who have been prescribed PERJETA?

 
A: 

Yes. The Genentech® Access to Care Foundation provides help for qualified patients. These include patients who are uninsured or whose health plans have denied payment for PERJETA. They must meet certain financial and medical requirements.

 

 

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

PERJETA Indication and Important Safety Information

INDICATION

PERJETA® (pertuzumab) is a HER2/neu receptor antagonist indicated in combination with trastuzumab and docetaxel for the treatment of patients with HER2-positive metastatic breast cancer who have not received prior anti-HER2 therapy or chemotherapy for metastatic disease.

Boxed WARNING: Embryo-Fetal Toxicity

  • Exposure to PERJETA can result in embryo-fetal death or birth defects. Studies in animals have resulted in oligohydramnios, delayed renal development, and death. Advise patients of these risks and the need for effective contraception

Additional Important Safety Information

  • Left ventricular dysfunction, including cases of congestive heart failure and decreases in left ventricular ejection fraction (LVEF), occurred in patients in the PERJETA-treated group. Assess LVEF prior to initiation of PERJETA and at regular intervals during treatment to ensure that LVEF is within your institution’s normal limits. Discontinue PERJETA and trastuzumab if the LVEF has not improved or has declined further
  • PERJETA has been associated with infusion and hypersensitivity reactions/anaphylaxis. When all drugs were administered on the same day, the most common infusion reactions in the PERJETA-treated group (≥1.0%) were fatigue, dysgeusia, hypersensitivity, myalgia, and vomiting
  • Detection of HER2 protein overexpression is necessary for selection of patients appropriate for PERJETA therapy
  • The most common adverse reactions (≥30%) seen with PERJETA in combination with trastuzumab and docetaxel were diarrhea, alopecia, neutropenia, nausea, fatigue, rash, and peripheral neuropathy 

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 PERJETA full Prescribing Information including Most Serious Side Effect for additional Important Safety Information.