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. POLIVY 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.
Diffuse Large B-cell Lymphoma
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 POLIVY
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.
Important Safety Information & Indication
Indication Statement
POLIVY in combination with bendamustine and a rituximab product is indicated for the treatment of adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), not otherwise specified, after at least 2 prior therapies.
Accelerated approval was granted for this indication based on complete response rate. Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial.
Warnings and Precautions
Peripheral Neuropathy: Monitor patients for peripheral neuropathy and modify or discontinue dose accordingly.
Infusion-Related Reactions: Premedicate with an antihistamine and an antipyretic. Monitor patients closely during infusions. Interrupt or discontinue infusion if reactions occur.
Myelosuppression: Monitor complete blood counts. Manage using dose delays or reductions and growth factor support. Monitor for signs of infection.
Serious and Opportunistic Infections: Closely monitor patients for signs of bacterial, fungal, or viral infections.
Progressive Multifocal Leukoencephalopathy (PML): Monitor patients for new or worsening neurological, cognitive, or behavioral changes suggestive of PML.
Tumor Lysis Syndrome: Closely monitor patients with high tumor burden or rapidly proliferating tumors.
Hepatotoxicity: Monitor liver enzymes and bilirubin.
Embryo-Fetal Toxicity: Can cause fetal harm. Advise females of reproductive potential of the potential risk to a fetus and to use effective contraception during treatment and for 3 months after the last dose.
The Most Common Adverse Reactions
The most common adverse reactions (≥20%) included neutropenia, thrombocytopenia, anemia, peripheral neuropathy, fatigue, diarrhea, nausea, pyrexia, decreased appetite, abdominal pain, and pneumonia.
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 the full Prescribing Information for additional Important Safety Information.