The Genentech® Access to Care Foundation (GATCF) was established to help patients who are uninsured—or who have been denied coverage for XOLAIR® (omalizumab) by their health plans. GATCF might be able to help those patients receive XOLAIR treatment if they meet specific financial and medical criteria.
For your patient to be eligible for help from GATCF, certain specific criteria must be met:
To apply to GATCF, you must complete and submit the Statement of Medical Necessity and have your patient complete and submit a Patient Authorization and Notice of Release of Information form.
When completing the Statement of Medical Necessity, be sure to complete all sections of the form.
Once we receive your patient’s information, XOLAIR Access Solutions then contacts the patient within 24 hours with further instructions. This might include verifying financial eligibility.
Additional GATCF program details:
GATCF has the right to modify or end this program at any time and to verify the accuracy of the information you submit.