The OCREVUS Co-pay Program

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, your OCREVUS Patient Navigator can help them enroll in the OCREVUS Co-pay Program. Your Patient Navigator can also provide information about the patient's status in the program.

To get started, call (844) OCREVUS (844-627-3887) or visit OCREVUSCopay.com/HCP.

The OCREVUS Co-pay Program is available only for commercially insured patients. Patients using Medicare, Medicaid, Medigap, Veteran's Affairs (VA), Department of Defense (DoD), TriCare or any other government-funded program to pay for their medications are not eligible. Patients who start utilizing their government coverage during their enrollment period will no longer be eligible for the program. 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 US Territories. The OCREVUS Co-pay Program is not health insurance or a benefit plan. Please see full terms and conditions at OCREVUSCopay.com/HCP.

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

Indications

OCREVUS is indicated for the treatment of adult patients with relapsing or primary progressive forms of multiple sclerosis.

Contraindications

OCREVUS is contraindicated in patients with active hepatitis B virus infection and in patients with a history of life-threatening infusion reaction to OCREVUS.

Warnings and Precautions

Infusion Reactions:

Management recommendations for infusion reactions depend on the type and severity of the reaction. Permanently discontinue OCREVUS if a life-threatening or disabling infusion reaction occurs.

Infections:

Delay OCREVUS administration in patients with an active infection until the infection is resolved. Vaccination with live-attenuated or live vaccines is not recommended during treatment with OCREVUS and after discontinuation, until B-cell repletion.

Malignancies:

An increased risk of malignancy, including breast cancer, may exist with OCREVUS.

Most Common Adverse Reactions

RMS: The most common adverse reactions in RMS trials (incidence ≥10% and >REBIF): upper respiratory tract infections and infusion reactions.

PPMS: The most common adverse reactions (≥10% and >placebo): upper respiratory tract infections, infusion reactions, skin infections, and lower respiratory tract infections.

For additional safety information, please see the full Prescribing Information and Medication Guide.