Referrals to the Genentech® Access to Care Foundation (GATCF)

GATCF provides free medicine to eligible patients who are uninsured, rendered uninsured by payer denial or underinsured. To qualify, patients must meet financial criteria.

Is My Patient Eligible?

  • Does your patient have health insurance?

  • Is your patient’s annual household adjusted gross income (AGI) less than $100,000?

  • Is your patient’s annual household adjusted gross income (AGI) less than $150,000?

  • Does your patient spend 5% or more of his or her annual household AGI on the out-of-pocket costs for his or her VENCLEXTA?

Your Patient Appears to Be Eligible for GATCF

To get started with GATCF, complete and submit the SMN and PAN to VENCLEXTA Access Solutions. Patients must complete Section 6 of the PAN to apply for GATCF.

Download the Forms

Your Patient Does Not Appear to Be Eligible for GATCF, but Other Options May Be Available

Several options are available to help eligible patients with the out-of-pocket costs of VENCLEXTA.

Call VENCLEXTA Access Solutions at (888) 249-4918 or use our Patient Assistance Tool to find out which option may be right for your patient.

Use the Patient Assistance Tool

To be eligible for free medicine from GATCF, insured patients must have exhausted all other forms of patient assistance (including support from independent co-pay assistance foundations) and meet financial criteria. Uninsured patients must meet different financial criteria.

Download this flash card to view a summary of GATCF eligibility and enrollment information.

How Do I Get My Patient Started?

To apply for GATCF, submit the completed SMN and PAN to VENCLEXTA Access Solutions. Patients must complete Section 6 of the PAN to apply for GATCF.

These forms can be downloaded from Forms and Documents.

If needed, additional GATCF-specific forms may also be requested. You can download them by selecting the button below.

Only the information requested on these forms is required. Providing additional documents or information will delay processing.

Once we receive your patient’s information, VENCLEXTA Access Solutions will contact the patient with further instructions. This may include verifying financial eligibility.

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

Indication

  • VENCLEXTA is indicated for the treatment of patients with chronic lymphocytic leukemia (CLL) with 17p deletion, as detected by an FDA-approved test, who have received at least one prior therapy
  • This indication is approved under accelerated approval based on overall response rate. Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial

Important Safety Information

Contraindication

  • Concomitant use of VENCLEXTA with strong CYP3A inhibitors at initiation and during ramp-up phase is contraindicated

Tumor Lysis Syndrome

  • Tumor lysis syndrome (TLS), including fatal events and renal failure requiring dialysis, has occurred in previously treated CLL patients with high tumor burden treated with VENCLEXTA
  • VENCLEXTA poses a risk for TLS in the initial 5-week ramp-up phase. Changes in blood chemistries consistent with TLS that require prompt management can occur as early as 6 to 8 hours following the first dose of VENCLEXTA and at each dose increase
  • Patients should be assessed for TLS risk, including evaluation of tumor burden and comorbidities, and should receive appropriate prophylaxis for TLS, including hydration and antihyperuricemics. Reduced renal function (CrCl<80mL/min) further increases the risk. Monitor blood chemistries and manage abnormalities promptly. Interrupt dosing if needed. Employ more intensive measures (IV hydration, frequent monitoring, hospitalization) as overall risk increases.
  • Concomitant use of VENCLEXTA with strong or moderate CYP3A inhibitors and P-gp inhibitors may increase the risk of TLS at initiation and during the ramp-up phase, and may require dose adjustment due to increases in VENCLEXTA exposure

Neutropenia

  • Grade 3 or 4 neutropenia occurred in 41% (98/240) of patients treated with VENCLEXTA. Monitor complete blood counts throughout treatment. Interrupt dosing or reduce dose for severe neutropenia

Immunization

  • Do not administer live attenuated vaccines prior to, during, or after treatment with VENCLEXTA until B-cell recovery

Embryo-Fetal Toxicity

  • VENCLEXTA may cause embryo-fetal harm when administered to a pregnant woman. Advise females of reproductive potential to avoid pregnancy during treatment

Adverse Reactions

  • Serious adverse reactions were reported in 43.8% of patients. The most frequent serious adverse reactions (≥2%) were pneumonia, febrile neutropenia, pyrexia, autoimmune hemolytic anemia, anemia, and TLS
  • The most common adverse reactions (≥20%) of any grade were neutropenia, diarrhea, nausea, anemia, upper respiratory tract infection, thrombocytopenia, and fatigue

Drug Interactions

For patients who have completed the ramp-up phase and are on a steady daily dose of VENCLEXTA, reduce the dose by at least 75% when used concomitantly with strong CYP3A inhibitors.

  • Avoid concomitant use of moderate CYP3A inhibitors or P-gp inhibitors. If an inhibitor must be used, reduce the VENCLEXTA dose by at least 50%
  • Patients should avoid grapefruit products, Seville oranges, and starfruit during treatment as they contain inhibitors of CYP3A
  • Avoid concomitant use of strong or moderate CYP3A inducers
  • Avoid concomitant use of narrow therapeutic index P-gp substrates. If these substrates must be used, they should be taken at least 6 hours before VENCLEXTA
  • Monitor international normalized ratio (INR) closely in patients receiving warfarin