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, Pulmozyme 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 Pulmozyme Access Solutions at (800) 690-3023 for a referral.
If you would like to contact a foundation directly, you can use the information below:
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 Pulmozyme Access Solutions at (800) 690-3023 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 Pulmozyme Co-pay Card 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.
Pulmozyme Access Solutions can refer you to the Pulmozyme Co-pay Card Program. It can help you with the out-of-pocket costs of your Genentech medicine, if you’re eligible.
The Pulmozyme 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 Pulmozyme Co-pay Card 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 PulmozymeCopayCard.com for the full list of
terms and conditions.
How to Work With Pulmozyme 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
Pulmozyme® (dornase alfa) is indicated for daily administration along with standard therapies for the management of cystic fibrosis (CF) patients to improve pulmonary function.
In CF patients with an FVC ≥40% of predicted, daily administration of Pulmozyme has also been shown to reduce the risk of respiratory tract infections requiring injectable antibiotics.
Important Safety Information
Pulmozyme should not be used in patients who are allergic to any of its ingredients.
Patients may experience the following when using Pulmozyme: change in or loss of their voice, discomfort in the throat, rash, chest pain, red watery eyes, runny nose, lowering of lung function, fever, indigestion and shortness of breath. There have been no reports of severe allergic reactions caused by the administration of Pulmozyme. Mild to moderate hives and mild skin rash have been observed and have been short-lived.
You are encouraged to report side effects to Genentech and the FDA. 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.
For further information, please see the Pulmozyme full Prescribing Information.
The safety and effectiveness of Pulmozyme have been established in patients 5 years of age and older. While clinical trial data are limited in patients younger than 5 years of age, the use of PULMOZYME should be considered for pediatric CF patients who may experience potential benefit in lung function or who may be at risk of respiratory tract infection.
The safety of Pulmozyme given by daily inhalation for 2 weeks has been studied using 98 CF patients with 65 of them aged 3 months to ™ reusable nebulizer (which uses a face mask instead of a mouthpiece) was used in patients who were unable to show that they could breathe in or out using their mouth throughout the entire treatment period. Overall, the kind of side effects observed in children was similar to those seen in larger trials in older patients.