Patients can submit the Patient Consent Form online using the eSubmit option. They do not have to use the mouse to create a digitally “written” signature.
ACTEMRA® (tocilizumab)
ALECENSA® (alectinib)
Avastin® (bevacizumab)
COTELLIC® (cobimetinib)
ENSPRYNG® (satralizumab-mwge)
Erivedge® (vismodegib)
Esbriet® (pirfenidone)
Evrysdi® (risdiplam)
GAVRETO® (pralsetinib)
GAZYVA® (obinutuzumab)
HEMLIBRA® (emicizumab-kxwh)
Herceptin® (trastuzumab)
Herceptin HYLECTA™ (trastuzumab and hyaluronidase-oysk)
KADCYLA® (ado-trastuzumab emtansine)
LUCENTIS® (ranibizumab injection)
LUNSUMIO™ (mosunetuzumab-axgb)
OCREVUS® (ocrelizumab)
PERJETA® (pertuzumab)
PHESGO™ (pertuzumab, trastuzumab, and hyaluronidase-zzxf)
POLIVY® (polatuzumab vedotin-piiq)
Pulmozyme® (dornase alfa) Inhalation Solution
Rituxan® (rituximab) for Rheumatoid Arthritis (RA)
RITUXAN® (rituximab) for Oncology
Rituxan® (rituximab) for Granulomatosis with Polyangiitis (GPA), Microscopic Polyangiitis (MPA) or Pemphigus Vulgaris (PV)
RITUXAN HYCELA® (rituximab/hyaluronidase human)
ROZLYTREK® (entrectinib)
SUSVIMO™ (ranibizumab injection)
TECENTRIQ® (atezolizumab)
VABYSMO® (faricimab-svoa)
VENCLEXTA® (venetoclax tablets)
XOLAIR® (omalizumab) for subcutaneous use
ZELBORAF® (vemurafenib)
Oncology
Ophthalmology
Rheumatology
ROZLYTREK Access Solutions
Committed to helping patients access the Genentech medicine they have been prescribed
Committed to helping patients access the Genentech medicine they have been prescribed
Coverage
Help understanding benefits and coverage, such as benefits investigations and prior authorization resources
Reimbursement
Sample coding information and resources for denials and appeals
Product Distribution
A list of authorized distributors and specialty pharmacies
To learn more about your patient’s treatment, visit ROZLYTREK.com.
For assistance, call (877) GENENTECH/(877) 436-3683
6 a.m.–5 p.m. PT, Monday through Friday
Patient Assistance Tool
Find the right assistance option for your patients