Receive additional information

Register Now

Unsubscribe

Manage Your Communications


 

QUICKLinks

Avastin Co-Pay Card

The Avastin Co-Pay Card Program is designed to reduce monthly co-payments for eligible patients who have been prescribed Avastin. This program makes it easy for you to get patients started on Avastin.

Genentech Co-Pay Card

How does the program work?

  • Your practice gives eligible patients a brochure with an enclosed Avastin CoPay Card at the time the diagnosis is made and therapy is chosen

  • Enroll your patients over the phone with Avastin Access Solutions prior to their treatment. Before calling, be sure patients have completed the Patient Authorization and Notice of Release Information and Patient Enrollment forms.

  • Your practice will receive confirmation of successful patient enrollment. The patient's co-pay amount will be reduced accordingly.

Who is eligible?

Eligible Not Eligible
  • Covered by commercial insurance (non-governmental)
    AND
  • Co-pay for Avastin over $100
    AND
  • Annual household income of $100,000 or less
    AND
  • Age 18 years or older
  • Participating in Medicare D, Medicaid, Medigap, VA, DoD, and Tricare (or any other federal or statefunded benefit programs)
    OR
  • Uninsured
    OR
  • Currently residing or receiving services in Massachusetts
    OR
  • Currently participating in Genentech Access to Care Foundation

How much does the program cover if my patient is eligible?

Patient Responsibility
The first $100 per month of his or her Avastin copay plus 20% of the remaining amount and any additional amount not covered by the program

Program pays
Up to 80% of monthly Avastin co-pay once patient pays first $100 per month

Program limit
Up to $4000 in Avastin co-pay support, which must be used within 1 year after the patient activates his/her card

How do I explain to patients how this program works?

Eligibility
Be sure to highlight the need for commercial insurance with a copay of over $100.

Program limits
Program pays up to 80% of monthly co-pay up to $4000 per year. Patient must pay first $100 per month, plus amount not covered by program.

Getting started
Activate the card with your patient by calling Avastin Access Solutions, where a specialist will assist you in initiating the enrollment process.

Where do I get Avastin Co-Pay Cards?

Please speak with your Avastin Sales Representative.

What about my Avastin patients who are not eligible for this program?

We develop medicines for serious or lifethreatening medical conditions and we believe they should be accessible to the patients who need them. At Avastin Access Solutions, we are here to help find a way for you to get Avastin to your patients, regardless of their ability to pay for it. If your patients have difficulty paying their copay for Avastin, an Access Solutions specialist can refer them to an independent, nonprofit organization for financial assistance. Call us at 1 (888) 249-4918 weekdays, 6 am to 5 pm PST or visit our Web site at www.AvastinAccessSolutions.com for more information.

Avastin Access Solutions - Treatment made possible

  • AVASTIN® is a registered trademark and the Access Solutions logo and the Access Solutions Treatment made possible logo are trademarks of Genentech, Inc.