What Options Are There?
Whether you have insurance or not, you might feel concerned about the cost of your treatment. If you are eligible, there is an option to help you pay for your PEGASYS.
You might qualify if you meet the requirements below.
To apply for this program, you must be enrolled in PEGASYS Access Solutions.
To enroll in PEGASYS Access Solutions, you must complete a form called the Patient Authorization and Notice of Release of Information, or PAN. This form is located under Forms and Documents.
We also need a form from your doctor. This is called a Statement of Medical Necessity, or SMN.
If you think you might qualify for GATCF, be sure to complete Sections 5 and 6 when you fill out the PAN.
†Including Genentech brand-specific co-pay cards and support from independent co-pay assistance foundations.
What Can I Expect?
Here is what you can expect as we work with you, your doctor and/or your health insurance plan, if you have one.