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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, Tarceva® 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 and OSI Pharmaceuticals does not influence or control the operations of these co-pay assistance foundations, but Tarceva 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 Tarceva 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

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

  •  Pancreatic Cancer
    • Chronic Disease Fund
      6900 N. Dallas Parkway, Suite 200
      Plano, TX 75024
      Toll Free: 1-877-968-7233
      www.cdfund.org

    • 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

Learn More About
Tarceva
  • LEARN about treatment with Tarceva
  • NEW: LEARN about the Tarceva Sure Start Program
  • LEARN HOW the Genentech BioOncology Co-pay Card can help with the out-of-pocket costs for Tarceva
  • Form Statement of Medical Necessity
  • Form Patient Authorization and Notice of Release of Information (Current Version)

Tarceva Indications and Important Safety Information

INDICATIONS

Non-small cell lung cancer (NSCLC)
Tarceva monotherapy is indicated for:

  • the maintenance treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) whose disease has not progressed after four cycles of platinum-based first-line chemotherapy.
  • the treatment of patients with locally advanced or metastatic non-small cell lung cancer after failure of at least one prior chemotherapy regimen.

Results from two, multicenter, placebo-controlled, randomized, Phase III trials conducted in first-line patients with locally advanced or metastatic NSCLC showed no clinical benefit with the concurrent administration of Tarceva with platinum-based chemotherapy [carboplatin and paclitaxel or gemcitabine and cisplatin] and its use is not recommended in that setting.

Pancreatic cancer
Tarceva in combination with gemcitabine is indicated for the first-line treatment of patients with locally advanced, unresectable or metastatic pancreatic cancer.

Important safety information

  • There have been reports of serious interstitial lung disease (ILD)-like events, including fatalities, in patients receiving Tarceva for treatment of advanced NSCLC, advanced pancreatic cancer, or other advanced solid tumors.
  • Cases of hepatic failure, hepatorenal syndrome, acute renal failure (all including fatalities), and renal insufficiency have been reported during use of Tarceva.
  • Gastrointestinal perforation (including fatalities) has been reported in patients receiving Tarceva.
  • Bullous, blistering, and exfoliative skin conditions have been reported, including cases suggestive of Stevens-Johnson syndrome/toxic epidermal necrolysis, which in some cases were fatal.
  • In the pancreatic cancer trial, other serious adverse reactions associated with Tarceva plus gemcitabine and that may have included fatalities were myocardial infarction/ischemia, cerebrovascular accident, and microangiopathic hemolytic anemia with thrombocytopenia.
  • Corneal perforation and ulceration have been reported during use of Tarceva.
  • International Normalized Ratio (INR) elevations and bleeding events, including gastrointestinal and non-gastrointestinal bleeding (including fatalities), have been associated with concomitant warfarin administration.
  • Tarceva is pregnancy category D. When receiving Tarceva therapy, women should be advised to avoid pregnancy or breastfeeding.
  • The most common adverse reactions in patients with advanced NSCLC receiving single-agent Tarceva 150 mg were rash and diarrhea.
  • The most common adverse reactions in patients with advanced pancreatic cancer receiving Tarceva 100 mg plus gemcitabine were fatigue, rash, nausea, anorexia, and diarrhea.

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 Important Safety Information, please see accompanying full prescribing information.