Referrals to the Genentech BioOncology® Co-pay Assistance Program

Co-pay 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 the out-of-pocket costs for ROZLYTREK and/or NTRK gene fusion diagnostic testing, Genentech BioOncology Access Solutions for ROZLYTREK can refer them to the Genentech BioOncology Co-pay Assistance Program.

To get started, call (855) MYCOPAY (855-692-6729) or visit CopayAssistanceNow.com.

This Genentech BioOncology Co-pay Assistance Program is valid ONLY for patients with commercial insurance who have a valid prescription for a Food and Drug Administration (FDA)-approved indication of a Genentech medication. Patients using Medicare, Medicaid, or any other federal or state government program to pay for their medications are not eligible.

Under the Program, the patient will pay a co-pay. After reaching the maximum Program benefit, the patient will be responsible for all out-of-pocket costs.

All participants are responsible for reporting the receipt of all Program benefits as required by any insurer or by law. No party may seek reimbursement for all or any part of the benefit received through this Program. This Program is void where prohibited by law. Genentech reserves the right to rescind, revoke, or amend the Program without notice at any time. Additional eligibility criteria apply. See full terms and conditions at CopayAssistanceNow.com.

Under the Program, the patient will pay a co-pay. After reaching the maximum per treatment or annual limit the patient will be responsible for all remaining pay Out-of-Pocket expenses. The amount of the Program benefit cannot exceed the patient’s Out-of-Pocket expenses for the cost of administrative fees associated with ROZLYTREK.

Patients using Medicare, Medicaid or any other federal or state government funded program to pay for their medications or associated Testing Reimbursement fees are not eligible. Patients who start utilizing their Government Program during their enrollment period will no longer be eligible for the Program. The Program is only valid in the United States and U.S. Territories. The Program is not valid for Massachusetts, Michigan, Minnesota, or Rhode Island residents. This program is not valid where prohibited by law. Participating patients, physician offices, and hospitals are responsible for reporting the receipt of all Program benefits as may be required, to any insurer, health plan, or other third party who pays for or reimburses any part of the testing fees using the Program. This program is not health insurance or a benefit plan. The patient or guardian must be 18 years or older to receive Program benefits.

This Program is void if the program benefit (eg, physical card, virtual card, etc) is reproduced and where prohibited by law. It is only valid for treatment with ROZLYTREK and only valid in the U.S. and U.S. Territories. Genentech, Inc. reserves the right to rescind, revoke, or amend the program without notice at any time. The patient, guardian, prescriber, hospital and any other person using or administering the Program agree not to seek reimbursement for all or any part of the benefit received by the patient through the offer of this program. Additional Terms and Conditions apply. Please visit ROZLYTREK.com for the full list of Terms and Conditions.