Avastin Distribution

Authorized Distributors and Specialty Pharmacies

Genentech has contracted with a network of authorized specialty distributors to service practices choosing to purchase Avastin through the buy and bill model. Customers can purchase Avastin 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 to distribute Avastin through secondary channels.

Avastin Access Solutions works with SPs to help patients receive their medicines. SPs can dispense Genentech medicines to your office. The SPs can also provide coverage and reimbursement support.

Distributor Telephone Fax Web Orders
AmerisourceBergen Drug Corporation 844-222-2273 816-464-4140 www.amerisourcebergen.com/abc/
Cardinal Health Specialty Distribution 800-926-3161
270-219-6000 (KY)
501-707-2800 (AR) 
N/A www.cardinal.com
Dakota Drug 866-210-5887 763-421-0661 www.dakdrug.com/ddos/
DMS Pharmaceutical 877-788-1100 847-518-1105 dmspharma.com/store.htm
McKesson Plasma and Biologics (MPB) 877-625-2566 888-752-7626 connect.mckesson.com

 

Distributor Telephone Fax Web Orders
ASD Healthcare (a Division of AmerisourceBergen Specialty Group) 800-746-6273 800-547-9413 www.asdhealthcare.com
BioSolutions Direct (a Division of AmerisourceBergen Specialty Group) 866-860-3565 888-899-0063 www.biosolutionsdirect.com
Cardinal Health Specialty Distribution 800-926-3161 888-345-4916 specialtyonline.cardinalhealth.com
McKesson Plasma and Biologics (MPB) 877-625-2566 888-752-7626 connect.mckesson.com
Morris & Dickson Specialty Distribution 800-710-6100 318-524-3096 www.mdspecialtydist.com
Distributor Telephone Fax Web Orders
ASD Healthcare 800-746-6273 800-547-9413 www.asdhealthcare.com
Besse Medical 800-543-2111 800-543-8695 www.besse.com
BioSolutions Direct 866-860-3565 888-899-0063 www.biosolutionsdirect.com
Cardinal Health Specialty Distribution 877-453-3972 888-345-4916 specialtyonline.cardinalhealth.com
CuraScript SD 877-599-7748 800-862-6208 www.curascriptsd.com
McKesson Specialty Health 800-482-6700
855-477-9700
(Non-Oncology Customers) 
800-289-9285 mscs.mckesson.com
Oncology Supply 800-633-7555 800-248-8205 www.oncologysupply.com

 

Distributor Telephone Fax Web Orders
ASD Healthcare 800-746-6273 800-547-9413 www.asdhealthcare.com
Besse Medical 800-543-2111 800-543-8695 www.besse.com
BioSolutions Direct 866-860-3565 888-899-0063 www.biosolutionsdirect.com
Cardinal Health Specialty Distribution 877-453-3972 888-345-4916 specialtyonline.cardinalhealth.com
CuraScript SD 877-599-7748 800-862-6208 www.curascriptsd.com
Humana Specialty Pharmacy
800-486-2668
877-405-7940
www.humanapharmacy.com/specialty
McKesson Specialty Health 800-482-6700
855-477-9700
(Non-Oncology Customers)
800-289-9285 mscs.mckesson.com

 

Distributor Telephone Fax Web Orders
Cardinal Health Puerto Rico 800-981-4699
787-625-4200
787-625-4398 N/A
Cesar Castillo 787-999-1616 787-720-1095 www.cesarcastillo.net

 

Genentech does not influence or advocate the use of any one specialty distributor or specialty pharmacy. We make no representation or guarantee of service or coverage of any item.

About Buy and Bill

With buy and bill, the practice purchases the medication in advance, then bills the patient’s health insurance plan for reimbursement. The practice is responsible for storing and handling the drug as well as collecting the patient’s co-pay for both the drug and its administration. With buy and bill, practices can maintain a stock of the drug, giving them the flexibility to treat patients when clinically appropriate.

About Specialty Pharmacies

Avastin Access Solutions works with specialty pharmacies (SPs) to help patients receive their medicines.

An SP may provide the following services:

  • Reimbursement resources
  • Clinical services to support patients throughout their treatment
  • The ability to manage the specialty handling and shipping needs linked with many specialty therapies

You can work with your preferred SP or contact Avastin Access Solutions to learn which SP the patient’s health insurance plan requires.

Genentech does not influence or advocate the use of any one specialty distributor or specialty pharmacy. We make no representation or guarantee of service or coverage of any item.

Spoilage Replacement Program

The Genentech Spoilage Replacement Program provides for replacement of infused, injected and self-administered products, which are prescribed and prepared for a labeled indication, yet not administered due to unforeseen patient clinical circumstances, subject to certain limitations and conditions set forth by Genentech.

Please contact Genentech Customer Service at (800) 551-2231 to submit a request for replacement of spoiled product or to obtain additional information about the Program.

To request replacement product:

  • Contact Genentech Customer Service at (800) 551-2231 to obtain the Genentech Spoilage Replacement Program Form
  • Complete the Genentech Spoilage Replacement Program Form and fax it back to Genentech Customer Service at (877) 329-6737 within 30 days of the spoilage event
  • The request may take up to 3 business days to review. If approved by Genentech, further instructions for returning product or completing a Certificate of Destruction will be provided
  • The spoiled product or completed Certificate of Destruction must be received by Genentech within 60 days of approval of the spoilage request
    • Replacement product generally ships within 11 business days following receipt of the spoiled product or completed Certificate of Destruction

Important guidelines:

  • Each instance of spoilage replacement requires completion of the Spoilage Replacement Program Form. Replacement is on a case-by-case basis at the sole discretion of Genentech; please retain all original product packaging for returns processing
  • Genentech does not ship replacement product if the spoiled product has been used for an off-label indication
  • Genentech does not ship replacement product if ANY portion of the product has been administered
  • Genentech will only ship replacement product to licensed facilities
  • All spoilage replacement requests are subject to review by Genentech; returned product is subject to analysis
  • Replacement is not available if any amount has been billed to a patient or an insurance claim has been remitted to a payer
  • Requests are subject to certain limitations and conditions. Genentech has the right to modify or discontinue the Spoilage Replacement Program at any time without notice

 

PAN=Patient Authorization and Notice of Request for Transmission of Health Information to Genentech Access Solutions and Genentech® Access to Care Foundation.

SMN=Statement of Medical Necessity.

Important Safety Information & Indication

Indication

[MCRC]

Avastin, in combination with intravenous 5fluorouracil-based chemotherapy, is indicated for the first or secondline treatment of patients with metastatic colorectal cancer.

Avastin, in combination with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy, is indicated for the secondline treatment of patients with metastatic colorectal cancer who have progressed on a first-line Avastin-containing regimen.

Limitation of Use: Avastin is not indicated for adjuvant treatment of colon cancer.

[NSCLC]

Avastin, in combination with carboplatin and paclitaxel, is indicated for the firstline treatment of patients with unresectable, locally advanced, recurrent or metastatic non–squamous non–small cell lung cancer.

[mrCC]

Avastin, in combination with interferon alfa, is indicated for the treatment of metastatic renal cell carcinoma.

[rGBM]

Avastin is indicated for the treatment of recurrent glioblastoma in adults.

[CC]

Avastin, in combination with paclitaxel and cisplatin or paclitaxel and topotecan, is indicated for the treatment of patients with persistent, recurrent, or metastatic cervical cancer.

[OC]

Avastin, in combination with carboplatin and paclitaxel, followed by Avastin as a single agent, is indicated for the treatment of patients with stage III or IV epithelial ovarian, fallopian tube, or primary peritoneal cancer following initial surgical resection.

Avastin, in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan, is indicated for the treatment of patients with platinum-resistant recurrent epithelial ovarian, fallopian tube or primary peritoneal cancer who received no more than 2 prior chemotherapy regimens.

Avastin, in combination with carboplatin and paclitaxel, or with carboplatin and gemcitabine, followed by Avastin as a single agent, is indicated for the treatment of patients with platinum-sensitive recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer.

Important Safety Information

Boxed WARNINGS

  • Gastrointestinal (GI) perforation
    • Serious and sometimes fatal GI perforation occurs at a higher incidence in Avastin-treated patients compared to patients treated with chemotherapy
    • The incidence of GI perforation ranged from 0.3% to 3% across clinical studies
    • Discontinue Avastin in patients with GI perforation
  • Surgery and wound healing complications
    • The incidence of wound healing and surgical complications, including serious and fatal complications, is increased in Avastin-treated patients
    • Withhold Avastin for at least 28 days prior to elective surgery. Do not administer Avastin for at least 28 days after surgery and until the wound is fully healed 
    • Discontinue in patients with wound healing complications requiring medical intervention
  • Hemorrhage
    • Severe or fatal hemorrhage, including hemoptysis, GI bleeding, hematemesis, central nervous system hemorrhage, epistaxis, and vaginal bleeding, occurred up to 5-fold more frequently in patients receiving Avastin. In clinical studies, the incidence of grade ≥3 hemorrhagic events among patients receiving Avastin ranged from 0.4% to 7% 
    • Do not administer Avastin to patients with serious hemorrhage or a recent history of  hemoptysis (≥1/2 tsp of red blood) 
    • Discontinue Avastin in patients who develop grade 3-4 hemorrhage

Additional serious adverse events

  • Additional serious and sometimes fatal adverse events with increased incidence in the Avastin-treated arm vs chemotherapy arm included:
    • Non-GI fistulae (<1% to 1.8%, highest in patients with cervical cancer) 
    • Arterial thromboembolic events (grade ≥3, 5%, highest in patients with GBM)
    • Renal injury and proteinuria 
      • Grade 3–4 proteinuria ranged from 0.7% to 7% in clinical studies
      • Nephrotic syndrome (<1%)
  • Additional serious adverse events with increased incidence in the Avastin-treated arm vs chemotherapy arm included:
    • Venous thromboembolism (grade ≥3, 11% seen in GOG-0240)
    • Hypertension (grade 3–4, 5%–18%)
    • Posterior reversible encephalopathy syndrome (PRES) (<0.5%)
    • Congestive heart failure (CHF) (1%)
  • Infusion reactions with the first dose of Avastin occurred in <3% of patients, and severe reactions occurred in 0.2% of patients
  • Avoid use in patients with ovarian cancer who have evidence of recto-sigmoid involvement by pelvic examination or bowel involvement on CT scan or clinical symptoms of bowel obstruction 
  • Inform females of reproductive potential of the risk of ovarian failure prior to initiating treatment with Avastin

Pregnancy warning

  • Based on the mechanism of action and animal studies, Avastin may cause fetal harm
  • Advise female patients that Avastin may cause fetal harm, and to inform their healthcare provider of a known or suspected pregnancy 
  • Advise females of reproductive potential to use effective contraception during treatment with Avastin and for 6 months after the last dose of Avastin
  • Advise nursing women that breastfeeding is not recommended during treatment with Avastin and for 6 months following their last dose of treatment
  • Avastin may impair fertility

Most common adverse events

  • Across studies, the most common adverse reactions observed in Avastin patients at a rate >10% were:
    • Epistaxis
    • Proteinuria
    • Lacrimation disorder
    • Headache
    • Taste alteration
    • Back pain
    • Hypertension
    • Dry skin
    • Exfoliative dermatitis
    • Rhinitis
    • Rectal hemorrhage
  • Across all studies, Avastin was discontinued in 8% to 22% of patients because of adverse reactions