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Authorized Distributors


Genentech has contracted with a network of authorized specialty distributors and wholesalers to service customers who choose to purchase Rituxan® (rituximab) through the buy and bill model. Through the streamlined Enhanced Product Distribution Model, customers purchase Rituxan through authorized specialty distributors and wholesalers who have made a commitment to product integrity. These partners have agreed to distribute only products purchased directly from Genentech and not distribute Rituxan through secondary channels.


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Buy and Bill


Genentech has contracted with a network of authorized specialty distributors and wholesalers to service customers who choose to purchase Rituxan® (rituximab) for rheumatoid arthritis (RA) through the buy and bill model.

Customers can purchase Rituxan 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 Rituxan through secondary channels.

“Buy and bill” is a term used by health care providers when an office or facility purchases Rituxan, 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 Rituxan, giving you the flexibility to treat your patients when clinically appropriate.


If you qualify to continue using the CMS 1500 claim form, follows 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.)

Spoilage Replacement Program


If the Rituxan 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


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

  • Rituxan was reconstituted and patient missed appointment
  • Rituxan was accidentally dropped
  • Rituxan was not appropriately refrigerated or was frozen
  • Patient expired/coded
  • Rituxan 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 product 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.
Learn More About
Rituxan for RA
  • LEARN about treatment with Rituxan
  • FIND the right patient assistance program with our Compass for Patient Access tool
  • LEARN HOW the Genentech Rheumatology Co-pay Card Program can help with the out-of-pocket costs for Rituxan for RA. It provides up to $10,000 per 12-month period.
  • Download: new forms for enrollment in GATCF
  • Form Statement of Medical Necessity
  • Form Patient Authorization and Notice of Release of Information

Rituxan Indications and Important Safety Information


  • Rituxan® (rituximab), in combination with methotrexate, is indicated for the treatment of adult patients with moderately- to severely-active rheumatoid arthritis (RA) who have had an inadequate response to one or more TNF antagonist therapies
  • Limitations of Use: Rituxan is not recommended for use in patients with severe, active infections

BOXED WARNINGS and Additional Important Safety Information

BOXED Warnings

Infusion Reactions: Rituxan administration can result in serious, including fatal, infusion reactions. Deaths within 24 hours of Rituxan infusion have occurred. Approximately 80% of fatal infusion reactions occurred in association with the first infusion. Monitor patients closely. Discontinue Rituxan infusion for severe reactions and provide medical treatment for Grade 3 or 4 infusion reactions.

Severe Mucocutaneous Reactions: Severe, including fatal, mucocutaneous reactions can occur in patients receiving Rituxan. Discontinue Rituxan in patients who experience a severe mucocutaneous reaction.

Hepatitis B Virus (HBV) Reactivation: HBV reactivation can occur in patients treated with Rituxan, in some cases resulting in fulminant hepatitis, hepatic failure, and death. Screen all patients for HBV infection before treatment initiation, and monitor patients during and after treatment with Rituxan. Discontinue Rituxan and concomitant medications in the event of HBV reactivation.

Progressive Multifocal Leukoencephalopathy (PML): PML, including fatal PML, can occur in patients receiving Rituxan. Discontinue Rituxan and consider discontinuation or reduction of any concomitant chemotherapy or immunosuppressive therapy in patients who develop PML.

Warnings and Precautions

Tumor Lysis Syndrome (TLS): Administer aggressive intravenous hydration and anti hyperuricemic therapy in patients at high risk for TLS. Correct electrolyte abnormalities, monitor renal function and fluid balance, and administer supportive care, including dialysis as indicated.

Infections: Serious, including fatal, bacterial, fungal, and new or reactivated viral infections can occur during and following the completion of Rituxan-based therapy. Infections have been reported in some patients with prolonged hypogammaglobulinemia (defined as hypogammaglobulinemia >11 months after Rituxan exposure). Discontinue Rituxan for serious infections and institute appropriate anti-infective therapy.

Cardiovascular: Discontinue infusions for serious or life threatening cardiac arrhythmias. Perform cardiac monitoring during and after all infusions of Rituxan for patients who develop clinically significant arrhythmias, or who have a history of arrhythmia or angina.

Bowel Obstruction and Perforation: Abdominal pain, bowel obstruction and perforation, in some cases leading to death, can occur in patients receiving Rituxan in combination with chemotherapy. Evaluate if symptoms of obstruction such as abdominal pain or repeated vomiting occur.

Immunization: The safety of immunization with live viral vaccines following Rituxan therapy has not been studied and vaccination with live vaccines is not recommended. For RA patients, physicians should follow current immunization guidelines and administer non-live vaccines at least 4 weeks prior to a course of Rituxan.

Laboratory Monitoring: Obtain complete blood counts (CBC) and platelet counts at 2- to 4-month intervals during Rituxan therapy. The duration of cytopenias caused by Rituxan can extend months beyond the treatment period.

Concomitant Use With Biologic Agents and DMARDs Other Than Methotrexate in RA, GPA, and MPA: Limited data are available on the safety of the use of biologic agents or DMARDs other than methotrexate in RA patients exhibiting peripheral B-cell depletion following treatment with Rituxan. Observe patients closely for signs of infection if biologic agents and/or DMARDs are used concomitantly. Use of concomitant immunosuppressants other than corticosteroids has not been studied in GPA or MPA patients exhibiting peripheral B-cell depletion following treatment with Rituxan.

Use in Patients With RA Who Had No Prior Inadequate Response to TNF Antagonists: While the efficacy of Rituxan was supported in 4 controlled trials in patients with RA with prior inadequate responses to non-biologic DMARDs and in a controlled trial in MTX-naive patients, a favorable risk-benefit relationship has not been established in these populations. The use of Rituxan in patients with RA who have not had prior inadequate response to one or more TNF antagonists is not recommended.

Adverse Reactions

Rheumatoid Arthritis

Among all exposed patients, adverse reactions reported in greater than 10% of patients include infusion related reactions, upper respiratory tract infection, nasopharyngitis, urinary tract infection, and bronchitis.

In placebo-controlled studies, adverse reactions reported in ≥5% of patients were hypertension (8% vs 5%), nausea (8% vs 5%), upper respiratory tract infection (7% vs 6%), arthralgia (6% vs 4%), pyrexia (5% vs 2%), and pruritus (5% vs 1%) in Rituxan-treated vs placebo, respectively.

Infusion Reactions: In the Rituxan RA pooled, placebo-controlled studies, incidence of any adverse event within 24 hours of an infusion was 32% vs 23% after the first infusion, and 11% vs 13% after the second infusion in the Rituxan-treated patients and placebo group, respectively. Incidence of acute infusion reactions was 27% vs 19% after the first infusion, 9% vs 11% after the second infusion in the Rituxan-treated patients and placebo group, respectively. Serious acute infusion reactions were experienced by <1% of patients in either treatment group. Acute infusion reactions required dose modification (stopping, slowing, or interruption of the infusion) in 10% and 2% of patients receiving Rituxan or placebo, respectively, after the first course.

Infections: In the pooled, placebo-controlled studies, incidence of any type of infection was 39% vs 34%, Rituxan-treated vs placebo, respectively. The most common infections were nasopharyngitis, upper respiratory tract infections, urinary tract infections, bronchitis, and sinusitis. The incidence of serious infections was 2% vs 1%, Rituxan-treated vs placebo group, respectively.

In the experience with Rituxan in 2578 RA patients, the rate of serious infection was 4.31 per 100 patient-years. The most common serious infections (≥0.5%) were pneumonia or lower respiratory tract infections, cellulitis, and urinary tract infections. Fatal serious infections included pneumonia, sepsis, and colitis. Rates of serious infection remain stable in patients receiving subsequent courses.

In 185 Rituxan treated RA patients with active disease, subsequent treatment with a biologic DMARD, the majority of which were TNF antagonists, did not appear to increase the rate of serious infection.

Cardiac Events: In the pooled, placebo-controlled studies, incidence of serious cardiovascular reactions was 1.7% vs 1.3%, Rituxan-treated vs placebo, respectively. Three cardiovascular deaths occurred during the double-blind period of the RA studies including all Rituxan regimens (3/769=0.4%) as compared to none in the placebo treatment group (0/389). In the experience with Rituxan in 2578 RA patients the rate of myocardial infarction (MI) was consistent with MI rates in the general RA population. Rituxan should be discontinued in the event of a serious or life-threatening cardiac event.

Hypophosphatemia and Hyperuricemia: In the pooled, placebo-controlled studies, newly-occurring hypophosphatemia (<2.0 mg/dL) was 12% vs 10%, Rituxan-treated vs placebo, respectively. Hypophosphatemia was more common in patients who received corticosteroids. Newly-occurring hyperuricemia (>10 mg/dL) was observed in 1.5% vs 0.3%, Rituxan-treated vs placebo, respectively.

Immunogenicity: A total of 273/2578 (11%) patients with RA tested positive for anti-human anti-chimeric antibody (HACA) at any time after receiving Rituxan. HACA positivity was not associated with increased infusion reactions or other adverse reactions. Upon further treatment, the proportions of patients with infusion reactions were similar between HACA-positive and HACA-negative patients, and most reactions were mild to moderate. Four HACA-positive patients had serious infusion reactions, and the temporal relationship between HACA positivity and infusion reaction was variable. The clinical relevance of HACA formation in Rituxan treated patients is unclear.

You may report side effects to the FDA at (800) FDA-1088 or You may also report side effects to Genentech at (888) 835-2555.

For additional safety information, please see the full prescribing information, including BOXED WARNINGS and Medication Guide.

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