Referrals to Independent Co-pay Assistance Foundations

An independent co-pay assistance foundation is a charitable organization providing financial assistance to patients with specific disease states. GAZYVA Access Solutions offers referrals to independent co-pay assistance foundations for eligible patients who are commercially or publicly insured, including those covered by Medicare and Medicaid.

Listing of Independent Co-pay Assistance Foundations

Select from the available disease states below for a list of foundations. This information is updated regularly.

The Leukemia & Lymphoma Society
Co-pay Assistance Program
PO Box 12268
Newport News, VA 23612
877-557-2672 (877-LLS-COPAY)
www.lls.org/copay

The Leukemia & Lymphoma Society
Co-Pay Assistance Program
PO Box 12268
Newport News, VA 23612
(877) 557-2672
www.lls.org/copay

Genentech does not influence or control the operations or eligibility criteria of any independent co-pay assistance foundation and cannot guarantee co-pay assistance after a referral from GAZYVA Access Solutions. This information is provided as a resource to patients. Please note that this list is not indicative of Genentech's endorsement or financial support of any particular disease area and/or foundation, nor is it exhaustive. There may be other foundations to support the patient’s disease state.

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.