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, Pulmozyme® 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 is 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 Pulmozyme 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 Pulmozyme 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

This information is updated regularly.

  •  Cystic Fibrosis
    • Cystic Fibrosis Foundation
      6931 Arlington Road; 2nd Floor
      Bethesda, MD 20814
      Toll Free: 1-888-315-4154
      www.cfpaf.org

 

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

Pulmozyme Indication and Important Safety Information

INDICATION

Daily administration of Pulmozyme Inhalation Solution in conjunction with standard therapies is indicated in the management of cystic fibrosis (CF) patients to improve pulmonary function. In patients with an FVC ≥40% of predicted, daily administration of Pulmozyme has also been shown to reduce the risk of respiratory tract infections requiring parenteral antibiotics. Safety and efficacy of daily administration have not been demonstrated in patients for longer than 12 months.

IMPORTANT SAFETY INFORMATION

  • Pulmozyme is contraindicated in patients with known hypersensitivity to dornase alfa, Chinese hamster ovary cell products, or any component of the product
  • Pulmozyme should be used in conjunction with standard therapies for CF
  • Most common reported adverse events associated with the use of Pulmozyme include: voice alteration, pharyngitis, laryngitis, rash, chest pain, and conjunctivitis

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 full prescribing information for Pulmozyme, including additional Important Safety Information.