Committed to Helping You Get Your Genentech Medicine
Knowing what to expect can make all the difference. We can help walk you through each step of getting your Genentech medicine and assist you along the way.
Frequently Asked Questions
About Genentech Rheumatology Access Solutions
What is Genentech Rheumatology Access Solutions?
Genentech Rheumatology Access Solutions is a resource for people who
take a Genentech medicine. We connect you to the medicine you
I Am Concerned About Paying for ACTEMRA
My co-pays for ACTEMRA are too high. How can you help me?
There may be options to help you get the Genentech medicine your doctor has prescribed. Genentech Rheumatology Access Solutions can refer you to patient assistance options.
Getting My Medicine
I have been prescribed ACTEMRA Subcutaneous (SC). Can I pick it up from my local pharmacy?
You can’t get your Genentech medicine from your local pharmacy. Instead, it will come to you from a specialty pharmacy.
Your specialty pharmacy is different from your regular mail-order pharmacy. It handles drugs like ACTEMRA.
When we check your coverage, we also refer you to a specialty pharmacy your health insurance plan will cover.
How long will it take to get my medicine?
You might not be able to get your Genentech medicine right away. First, your doctor’s office or specialty pharmacy will have to check to make sure your health insurance plan covers your medicine. This is called a “benefits investigation.” They also might have to send some more information before your plan covers your medicine. This is called a “prior authorization.”
Enrolling in Genentech Rheumatology Access Solutions
How do I enroll in Genentech Rheumatology Access Solutions?
- You fill out a form called the PAN.
- Your doctor fills out a form called the SMN. You do not have to fill out anything on this form.
- Your doctor sends both of these forms to Genentech Rheumatology Access Solutions.
There are 2 ways to fill out the PAN form:
- You can fill out the form online
- You can download and print it to fill out a paper copy
Why do I need to sign the PAN form?
The PAN form lets us discuss your health information with your doctor
and your health insurance plan. We can’t work with you without a
I submitted the PAN online or gave the signed PAN to my doctor. Is there anything else I need to do to enroll?
You do not need to do anything else, but your doctor does. He or she needs to submit a form called the Statement of Medical Necessity, or SMN. The SMN tells us your doctor wants to treat you with ACTEMRA. Make sure your doctor has sent us the SMN so you get help from us.
You do not need to fill out anything on the SMN form.
My Health Plan Denied Coverage for ACTEMRA
My health insurance plan will not cover ACTEMRA. What do I do?
If your health insurance plan will not cover your Genentech medicine, you and your doctor’s office can file an appeal. Contact your doctor to find out if filing an appeal is right for you.
We have resources to help you and your doctor file an appeal.
Does Genentech Rheumatology Access Solutions send the appeal to my health insurance plan?
We have resources to help you and your doctor file an appeal. You or
your doctor’s office has to file the appeal directly with your health
How long does an appeal take?
This depends on your health insurance plan. You should ask your plan directly about its process. Sometimes the appeals process is quick. However, it can also take several months if you have to appeal several times.
My Insurance Might Change
I am enrolled in Genentech Rheumatology Access Solutions and my health insurance plan has changed. What do I do next?
If your insurance changes while you’re taking your Genentech
medicine, call us. We can help you understand your new coverage.
I no longer have a health insurance plan. What should I do?
GATCF helps people who don't have health insurance. It also helps
people who have health insurance but have trouble paying for their
Genentech medicine. If you qualify for GATCF, you could receive your
medicine for free.
It is your and your doctor's responsibility to complete and submit
all required paperwork to your health insurance plan. Genentech
cannot guarantee your plan will cover any treatments.
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
What it Treats
ACTEMRA® (tocilizumab) is a prescription medicine used to treat:
- Adults with moderately to severely active rheumatoid arthritis, or RA. ACTEMRA is used after at least one other medicine called a Disease Modifying Anti-Rheumatic Drug (DMARD) has been used and did not work well.
- Adults with giant cell arteritis (GCA).
- People with active polyarticular juvenile idiopathic arthritis (PJIA) age 2 years and above.
- People with active systemic juvenile idiopathic arthritis (SJIA) age 2 years and above.
- People who experience severe or life-threatening CRS following chimeric antigen receptor T cell treatment age 2 years and above.
ACTEMRA is not approved for subcutaneous use in people with SJIA or CRS.
It is not known if ACTEMRA is safe and effective in children with PJIA or SJIA under 2 years of age, in children with CRS under 2 years of age, or in children with conditions other than PJIA, SJIA or CRS.
Important Safety Information
ACTEMRA can cause serious side effects. ACTEMRA changes the way a patient’s immune system works. This can make a patient more likely to get infections or make any current infection worse. Some patients have serious infections while taking ACTEMRA, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some patients taking ACTEMRA have died from these infections.
ACTEMRA can cause other serious side effects. These include:
- Stomach tears
- Changes in blood test results, including low neutrophil (white blood cells) and platelet (platelets help the blood to clot) counts, and increases in certain liver function test levels and blood cholesterol levels
- An increased risk of certain cancers by changing the way a patient’s immune system works
- Hepatitis b infection in people who carry the virus in their blood
- Serious allergic reactions, including death. These may happen with ACTEMRA infusions or injections, even if they did not occur with an earlier infusion or injection. If a patient has had hives, a rash, or experienced flushing after injecting, the patient should tell their doctor or nurse before their next injection
- Nervous system problems
ACTEMRA affects the immune system and may increase a patient’s risk of certain cancers.
Most common side effects in patients treated with ACTEMRA:
Patients must tell their doctor if they have these or any other side effect that bothers them or does not go away:
- Upper respiratory tract infections (like common cold and sinus infections)
- Increased blood pressure (also called hypertension)
- Injection site reactions (for subcutaneous use only)
ACTEMRA & pregnancy:
Patients must tell their doctor if they are planning to become pregnant, are pregnant, plan to breast-feed, or are breast-feeding. The patient and their doctor should decide if the patient will take ACTEMRA or breast-feed. Patients should not do both. If a patient is pregnant and taking ACTEMRA, they must join the pregnancy registry. To learn more, patients should call 1-877-311-8972 or talk to their doctor to register.
Patients must tell their doctor right away if they are experiencing any side effects.
Report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. Call Genentech at 1-888-835-2555.
Please see the full Prescribing Information, including BOXED WARNING and Medication Guide, for additional Important Safety Information.