Referrals to 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, OCREVUS Access Solutions can refer them to the OCREVUS Co-pay Program.

For drug assistance, eligible patients pay $5 per co-pay, up to $20,000 per 12-month period. For infusion assistance, eligible patients pay $5 per co-pay, up to a $500 daily limit, per 12-month period.

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 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 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.