What Options Are There?

There may be options to help you afford RITUXAN, no matter what type of health insurance you have.

Referrals to Independent Co-pay Assistance Foundations

If you need help with your co-pay for RITUXAN, RITUXAN 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 RITUXAN Access Solutions at (888) 249-4918 for a referral.

If you would like to contact a foundation directly, you can use the information below:

Patient Access Network Foundation (PANF)
P.O. Box 221858
Charlotte, NC 28222-1858
Toll Free: 1-866-316-PANF (7263)
www.panfoundation.org

No funds are available at this time.

Please call Genentech Access Solutions at (866) 4ACCESS /
(866) 422-2377. We may be able to help.

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 help you.

Referrals to the Genentech® Access to Care Foundation

The Genentech Access to Care Foundation, or GATCF, can help you receive RITUXAN 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 RITUXAN
  • Underinsured—People who have health insurance (including commercial or government insurance plans), but pay more than a certain amount for RITUXAN 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 RITUXAN?

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.

Download the SMN and PAN

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.

Find Out Which Option May Be Right for You

You can also call RITUXAN Access Solutions at (888) 249-4918 and speak with one of our Specialists.

You’ll have to fill out Sections 5 and 6 of the PAN form to apply for GATCF.

If you have health insurance, you must have already tried other types of patient assistance to qualify for free medicine from GATCF. This includes the Genentech BioOncology Co-pay Card 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.

Referrals to the Genentech BioOncology Co-pay Card

RITUXAN Access Solutions can refer you to the Genentech BioOncology Co-pay Card. It can help you with the out-of-pocket costs of RITUXAN, if you’re eligible.

The Genentech BioOncology Co-pay Card 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 Genentech BioOncology Co-pay Card, 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 CopayAssistanceNow.com for the full list of terms and conditions.

How to Work With RITUXAN Access Solutions

Step 1

Enroll in RITUXAN Access Solutions.

How do I enroll?

Step 2

We work with you, your doctor’s office, your health insurance plan and your specialty pharmacy. We might contact you for more information.

What will we find out?

Step 3

We refer you to patient assistance options.

What options are there?

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

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What it Treats

RITUXAN® (Rituximab) is indicated for the treatment of:

  • Low-grade or follicular CD20-positive non-Hodgkin’s lymphoma as a single-agent therapy in patients whose disease recurred or did not respond to initial treatment
  • Follicular CD20-positive non-Hodgkin’s lymphoma as an initial treatment with chemotherapy, and in patients whose initial treatment was successful, as a single- agent follow-up therapy
  • Low-grade CD20-positive non-Hodgkin’s lymphoma as a single-agent follow-up therapy for patients who did not progress on initial treatment with CVP chemotherapy
  • CD20-positive diffuse large B-cell non-Hodgkin’s lymphoma as an initial treatment in combination with CHOP chemotherapy
  • CD20-positive chronic lymphocytic leukemia in combination with FC chemotherapy as an initial treatment or as a treatment after disease has recurred

People with serious infections should not receive RITUXAN.

It is not known if RITUXAN is safe or effective in children.

Important Safety Information

What is the most important information I should know about RITUXAN?

Tell your doctor right away about any side effect you experience. RITUXAN can cause serious side effects that can lead to death, including:

  • Infusion Reactions: may occur during or within 24 hours of your infusion. Your doctor should give you medicines before your treatment. Symptoms can include hives, rash, itching, facial or oral swelling, sudden cough, shortness of breath, difficulty breathing, weakness, dizziness, feeling faint, racing heart, or chest pain
  • Severe Skin and Mouth Reactions: symptoms can include painful sores, ulcers, or blisters on your skin, lips or mouth; peeling skin; rash; or pustules
  • Hepatitis B Virus (HBV) Reactivation: may cause serious liver problems including liver failure and death. If you have had hepatitis B or are a carrier of HBV, receiving RITUXAN could cause the virus to become an active infection again. You should not receive RITUXAN if you have active HBV liver disease. Your doctor will do blood tests to check for HBV infection prior to treatment and will monitor you during and for several months following your treatment
  • Progressive Multifocal Leukoencephalopathy (PML): a rare, serious brain infection that can lead to severe disability and death and for which there is no known prevention, treatment, or cure. Symptoms can include difficulty thinking, loss of balance, changes in speech or walking, weakness on one side of your body, or blurred or lost vision

What are the additional possible serious side effects of RITUXAN?

Tell your doctor right away about any side effect you experience. RITUXAN can cause serious side effects that can lead to death, including:

  • Tumor Lysis Syndrome (TLS): may cause kidney failure and the need for dialysis treatment, abnormal heart rhythm, and can lead to death. Your doctor may give you medicines before your treatment to help prevent TLS
  • Serious Infections: can happen during and after treatment and can lead to death.
    These infections may be bacterial, fungal, or viral. Symptoms can include fever; cold or flu symptoms; earache or headache; pain during urination; white patches in the mouth or throat; cuts or scrapes that are red, warm, swollen, or painful
  • Heart Problems: symptoms can include chest pain and irregular heartbeats that may require treatment. Your doctor may need to stop your treatment
  • Kidney Problems: your doctor should do blood tests to check how well your kidneys are working
  • Stomach and Serious Bowel Problems: can include blockage or tears in the bowel that can lead to death. Stomach area pain during treatment can be a symptom
  • Low Blood Cell Counts: your blood cell counts may be monitored during treatment

The most common side effects of RITUXAN are infusion reactions, chills, infections, body aches, tiredness, and low white blood cells.

Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. It is not known if RITUXAN may harm your unborn baby or pass into your breast milk. Women should use birth control while using RITUXAN and for 12 months after treatment.

Tell your doctor about any side effect that bothers you or that does not go away. These are not all of the possible side effects of RITUXAN. For more information, ask your doctor or pharmacist.

You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835- 2555.

Please see the RITUXAN full Prescribing Information, including the Medication Guide, for additional Important Safety Information.