What Options Are There?
There may be options to help you afford your Genentech medicine, no
matter what type of health insurance you have.
If you need help with your co-pay for your Genentech medicine, Esbriet Access Solutions can refer you to an independent co-pay assistance foundation.
An independent co-pay assistance foundation is a charitable
organization that gives financial assistance for medicines.
Call Esbriet Access Solutions at (844) 372-7438 for a referral.
If you would like to contact a foundation directly, you can use the information below:
Idiopathic Pulmonary Fibrosis (IPF)
Independent co-pay assistance foundations have their own rules for
eligibility. We cannot guarantee a foundation will help you. We only
can refer you to a foundation that supports your disease state. This
information is provided as a resource for you. We do not endorse or
show financial preference for any particular foundation. The
foundations in this list are not the only ones that might be able to
The Genentech Access to Care Foundation, or GATCF, can help you receive your Genentech medicine free of charge, if you qualify.
GATCF helps people who are:
- Uninsured—People who do not have insurance
- Rendered uninsured—People whose health insurance does not cover their Genentech medicine
- Underinsured—People who have health insurance (including commercial or government insurance plans), but pay more than a certain amount for their medicines each year
Other eligibility criteria must be met to qualify for free medicine from GATCF. You might qualify if you meet the requirements below.
Do you have health insurance?
Is your yearly household income less than $100,000?
Is your yearly household income less than $150,000?
Do you spend 5% or more of your yearly household income on the out-of-pocket costs for your Genentech medicine?
You Might Qualify for Free Medicine From GATCF
To apply for GATCF, you’ll need to complete the PAN form and your doctor’s office will need to complete the SMN form.
Be sure to fill out Sections 5 and 6 on the PAN form.
Other Options May Be Available
You do not appear to qualify for free medicine from GATCF. However, other patient assistance options may be available to help you.
You can also call Esbriet Access Solutions at (844) 372-7438 and speak with one of our Specialists.
You’ll have to fill out Sections 5 and 6 of the PAN form to apply for
If you have health insurance, you must have already tried other
types of patient assistance to qualify for free Genentech medicine
from GATCF. This includes the Esbriet Co-pay Program and support
from independent co-pay assistance foundations. You must also meet
financial criteria. If you do not have insurance, you must meet
different financial criteria.
Esbriet Access Solutions can refer you to the Esbriet Co-pay Program. It can help you with the out-of-pocket costs of your Genentech medicine, if you’re eligible.
The Esbriet Co-pay Program helps patients with commercial health
insurance. This might be a plan you get through your employer or one
you purchased through a Health Insurance Marketplace like
HealthCare.gov. To qualify, you must also meet other criteria.
In order to be eligible for the Esbriet Co-pay Program, the patient
must have commercial insurance, must not have Medicare, Medicaid or
other government insurance, and must meet other eligibility
criteria. They also must agree to the rules set forth in the terms
and conditions for the program. Please visit EsbrietCopay.com for the full list of terms and conditions.
How to Work With Esbriet Access Solutions
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
Esbriet is a prescription medicine used to treat people with a lung disease called idiopathic pulmonary fibrosis (IPF).
It is not known if Esbriet is safe and effective in children.
Select Important Safety Information
Before you take Esbriet, tell your doctor about all of your medical conditions, including if you:
- have liver problems.
- have kidney problems.
- are a smoker.
- are pregnant or plan to become pregnant. It is not known if Esbriet will harm your unborn baby.
- are breastfeeding or plan to breastfeed. It is not known if Esbriet passes into your breast milk.
You and your doctor should decide if you will take Esbriet or breastfeed.
Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
What should I avoid while taking Esbriet?
- Sunlight. Esbriet can make your skin sensitive to the sun and the light from sunlamps and tanning beds. You could get a severe sunburn. Use sunscreen (SPF 50) and wear a hat and clothes that cover your skin if you have to be in sunlight. Talk to your doctor if you get sunburn or a rash.
- Taking Esbriet with other medicines that can make your skin sensitive to the sun, the light from sunlamps and tanning beds.
- Smoking. Smoking may affect how well Esbriet works.
What are the possible side effects of Esbriet?
Esbriet may cause serious side effects, including:
- liver problems. Call your doctor right away if you have unexplained symptoms such as yellowing of your skin or the white part of your eyes (jaundice), dark or brown (tea-colored) urine, pain on the upper right side of your stomach area (abdomen), bleeding or bruising more easily than normal, or feeling tired. Your doctor will do blood tests to check how your liver is working during your treatment with Esbriet.
- sensitivity to sunlight (photosensitivity) and rash. See “What should I avoid while taking Esbriet?”
- stomach problems. Esbriet may cause stomach problems such as nausea, vomiting, diarrhea, indigestion, heartburn, and stomach pain. Tell your doctor right away if your stomach problems get worse or do not go away. Your doctor may need to change your dose of Esbriet.
The most common side effects of Esbriet include feeling tired, insomnia, upper respiratory tract infections, sinusitis, headache, dizziness, decreased weight and decreased or loss of appetite.
These are not all the possible side effects of Esbriet.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at 1-888-835-2555.
Please see full Prescribing Information, including Patient Information, for additional important safety information at esbriet.com.