Referrals to the Genentech BioOncology Co-pay Card
Co-pay card programs provide direct financial assistance to patients to help with their co-pays, co-insurance or other out-of-pocket costs. If eligible commercially insured patients need assistance with their out-of-pocket costs, Herceptin Access Solutions can refer them to the Genentech BioOncology Co-pay Card.
Patients who qualify can receive up to $25,000 in assistance per 12-month period. They pay $5 per drug co-pay or co-insurance until the annual limit is reached.
To get started, call (855) MYCOPAY (855-692-6729) or visit CopayAssistanceNow.com.
The Genentech BioOncology Co-pay Card is available only for
commercially insured patients. Patients using Medicare, Medicaid or
any other government-funded program to pay for their medications are
not eligible. It requires a valid, on-label prescription and cannot
be combined with any other rebate/coupon, free trial or similar
offer for the specified prescription. It is available only for a
patient (or their guardian) who is 18 years or older. It is not
valid for medications the patient receives for free or that are
eligible to be reimbursed by private insurance plans or other health
care or pharmaceutical assistance programs that reimburse the
patient in whole or in part for the medication. It is valid only for
Genentech products in the United States and Puerto Rico. The
Genentech BioOncology Co-pay Card is not health insurance or a
benefit plan. Please see full terms and conditions at CopayAssistanceNow.com.
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
Breast Adjuvant indications Herceptin is indicated for adjuvant treatment of HER2-overexpressing node-positive or node-negative (ER/PR-negative or with one high-risk feature*) breast cancer:
- As part of a treatment regimen containing doxorubicin, cyclophosphamide, and either paclitaxel or docetaxel
- With docetaxel and carboplatin
- As a single agent following multi-modality anthracycline-based therapy
* High-risk is defined as ER/PR positive with one of the following features: tumor size >2 cm, age
Breast Metastatic indications
Herceptin is indicated:
- In combination with paclitaxel for the first line treatment of HER2-overexpressing metastatic breast cancer
- As a single agent for treatment of HER2-overexpressing breast cancer in patients who have received one or more chemotherapy regimens for metastatic disease
Herceptin is indicated in combination with cisplatin and capecitabine or 5-fluorouracil, for the treatment of patients with HER2 overexpressing metastatic gastric or gastroesophageal junction adenocarcinoma, who have not received prior treatment for metastatic disease.
Important Safety Information and BOXED WARNINGS
Boxed WARNINGS and Additional Important Safety Information
- Herceptin administration can result in sub-clinical and clinical cardiac failure. The incidence and severity was highest in patients receiving Herceptin with anthracycline-containing chemotherapy regimens. In a pivotal adjuvant trial, one patient who developed CHF died of cardiomyopathy
- Evaluate left ventricular function in all patients prior to and during treatment with Herceptin. Discontinue Herceptin treatment in patients receiving adjuvant therapy and withhold Herceptin in patients with metastatic disease for clinically significant decrease in left ventricular function
- Herceptin administration can result in serious and fatal infusion reactions and pulmonary toxicity. Symptoms usually occur during or within 24 hours of Herceptin administration. Interrupt Herceptin infusion for dyspnea or clinically significant hypotension. Monitor patients until symptoms completely resolve. Discontinue Herceptin for anaphylaxis, angioedema, interstitial pneumonitis, or acute respiratory distress syndrome
- Exposure to Herceptin during pregnancy can result in oligohydramnios and oligohydramnios sequence manifesting as pulmonary hypoplasia, skeletal abnormalities, and neonatal death. Advise patients of these risks and the need for effective contraception
- Exacerbation of chemotherapy-induced neutropenia has also occurred
- Detection of HER2 protein overexpression is necessary for selection of patients appropriate for Herceptin therapy
- The most common adverse reactions associated with Herceptin in breast cancer were fever, nausea, vomiting, infusion reactions, diarrhea, infections, increased cough, headache, fatigue, dyspnea, rash, neutropenia, anemia, and myalgia
- The most common adverse reactions associated with Herceptin in metastatic gastric cancer were neutropenia, diarrhea, fatigue, anemia, stomatitis, weight loss, upper respiratory tract infections, fever, thrombocytopenia, mucosal inflammation, nasopharyngitis, and dysgeusia
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.
Please see additional select Important Safety Information throughout, and the accompanying full Prescribing Information, including Boxed WARNINGS.