NCCN Research & Business Resources
NCCN Virtual Reimbursement Resource Room
The oncology reimbursement landscape continues to present ever-evolving challenges for clinicians. Recently, the Centers for Medicare and Medicaid Services (CMS) issued its 2010 physician fee schedule, which includes cuts to reimbursement for oncology services. As a response to these ongoing challenges, NCCN is introducing a new resource, the NCCN Virtual Reimbursement Resource Room.
Clinicians: Select a cancer or supportive care indication below to learn about reimbursement help and services available to you to help your practice mitigate reimbursement challenges.
Acute Myeloid Leukemia (AML)
- Arsenic Trioxide (Trisenox®) --- Cephalon Oncology Reimbursement Expertise (CORE)
- Clofarabine (Clolar®): 800-RX-CLOLAR (800.792.5652) --- Genzyme
- Fludarabine (Fludara®): 888-4-FLUDARA (888.435.8327) --- Genzyme
Antiemesis
Bladder Cancer
Bone Cancer
Breast Cancer
- Epirubicin (Ellence®) --- Pfizer First Resource®
- Exemestane (Aromasin®) --- Pfizer First Resource®
- Ixabepilone (Ixempra®) --- Bristol-Myers Squibb Oncology: DESTINATION ACCESS™
- Letrozole (Femara®) --- Patient Assistance NOW Oncology (PANO) (Novartis Oncology)
- Paclitaxel, albumin-bound (Abraxane®) --- Celgene Patient Support®
Cancer- and Chemotherapy-Induced Anemia
Cervical Cancer
Central Nervous System Cancers
Chronic Myelogenous Leukemia (CML)
- Dasatinib (Sprycel®) --- Bristol-Myers Squibb Oncology: DESTINATION ACCESS™
- Imatinib (Gleevec®) --- Patient Assistance NOW Oncology (PANO) (Novartis Oncology)
- Nilotinib (Tasigna®) --- Patient Assistance NOW Oncology (PANO) (Novartis Oncology)
Colon Cancer
- Cetuximab (Erbitux®) --- Bristol-Myers Squibb Oncology: DESTINATION ACCESS™
- Irinotecan (Camptosar®) --- Pfizer First Resource®
- Panitumumab (Vectibix®) --- Amgen Assist™
Esophageal Cancer
Gastric Cancer
Head and Neck Cancers
- Cetuximab (Erbitux®) --- Bristol-Myers Squibb Oncology: DESTINATION ACCESS™
Hematopoietic Stem Cell Mobilization
- Plerixafor (Mozobil®): 877-4-MOZOBIL (877.466.9624) --- Genzyme
Hepatobiliary Cancers
- Sorafenib tosylate (Nexavar®) --- REACH (Resource for Expert Assistance and Care Helpline) (Bayer HealthCare Pharmaceuticals)
Hodgkin's Lymphoma
Kidney Cancer
- Everolimus (Afinitor®) --- Patient Assistance NOW Oncology (PANO) (Novartis Oncology)
- Sorafenib tosylate (Nexavar®) --- REACH (Resource for Expert Assistance and Care Helpline) (Bayer HealthCare Pharmaceuticals)
- Sunitinib (Sutent®) --- Pfizer First Resource®
Melanoma
- Ipilimumab (YERVOY™) --- Bristol-Myers Squibb Oncology: DESTINATION ACCESS™
- Temozolomide (Temodar®) --- Merck Oncology
Multiple Myeloma
- Bendamustine (Treanda®) --- Cephalon Oncology Reimbursement Expertise (CORE)
- Fludarabine (Fludara®): 888-4-FLUDARA (888.435.8327) --- Genzyme
- Lenalidomide (Revlimid®) --- Celgene Patient Support®
- Thalidomide (Thalomid®) --- Celgene Patient Support®
Myelodysplastic Syndromes
Neuroendocrine Tumors
- Everolimus (Afinitor®) --- Patient Assistance NOW Oncology (PANO) (Novartis Oncology)
- Sunitinib (Sutent®) --- Pfizer First Resource®
- Temozolomide (Temodar®) --- Merck Oncology
Non-Hodgkin's Lymphomas
- Alemtuzumab (Campath®): 877-4-CAMPATH (877.422.6728) --- Genzyme
- Bendamustine (Treanda®) --- Cephalon Oncology Reimbursement Expertise (CORE)
- Fludarabine (Fludara®): 888-4-FLUDARA (888.435.8327) --- Genzyme
- Imatinib (Gleevec®) --- Patient Assistance NOW Oncology (PANO) (Novartis Oncology)
- Romidepsin for injection (Istodax®) --- Celgene Patient Support®
- Temozolomide (Temodar®) --- Merck Oncology
- Vorinostat (Zolinza®) --- Merck Oncology
Non-Melanoma Cancers
- Epirubicin (Ellence®) --- Pfizer First Resource®
- Imatinib (Gleevec®) --- Patient Assistance NOW Oncology (PANO) (Novartis Oncology)
Non-Small Cell Lung Cancer
- Cetuximab (Erbitux®) --- Bristol-Myers Squibb Oncology: DESTINATION ACCESS™
- Irinotecan (Camptosar®) --- Pfizer First Resource®
Occult Primary
Ovarian Cancer
- Irinotecan (Camptosar®) --- Pfizer First Resource®
Pancreatic Adenocarcinoma
Prevention and Treatment of Cancer-Related Infections
- Filgrastim (Neupogen®) --- Amgen Assist™
- Pegfilgrastim (Neulasta®) --- Amgen Assist™
- Sargramostim (Leukine®): 888-4-RX-LEUKINE (888.479.5385) --- Genzyme
Prostate Cancer
Rectal Cancer
- Cetuximab (Erbitux®) --- Bristol-Myers Squibb Oncology: DESTINATION ACCESS™
- Irinotecan (Camptosar®) --- Pfizer First Resource®
- Panitumumab (Vectibix®) --- Amgen Assist™
Small Cell Lung Cancer
- Irinotecan (Camptosar®) --- Pfizer First Resource®
Soft Tissue Sarcoma
- Cetuximab (Erbitux®) --- Bristol-Myers Squibb Oncology: DESTINATION ACCESS™
- Dasatinib (Sprycel®) --- Bristol-Myers Squibb Oncology: DESTINATION ACCESS™
- Epirubicin (Ellence®) --- Pfizer First Resource®
- Imatinib (Gleevec®) --- Patient Assistance NOW Oncology (PANO) (Novartis Oncology)
- Nilotinib (Tasigna®) --- Patient Assistance NOW Oncology (PANO) (Novartis Oncology)
- Sunitinib (Sutent®) --- Pfizer Oncology FirstRESOURCE®
- Temozolomide (Temodar®) --- Merck Oncology
Testicular Cancer
Thyroid Carcinoma
- Sunitinib (Sutent®) --- Pfizer Oncology FirstRESOURCE®
Tumor Lysis Syndrome
Uterine Neoplasms
- Epirubicin (Ellence®) --- Pfizer First Resource®
- Exemestane (Aromasin®) --- Pfizer First Resource®
- Ixabepilone (Ixempra®) --- Bristol-Myers Squibb Oncology: DESTINATION ACCESS™
Venous Thromboembolic Disease
Or select the Reimbursement Program in which you are interested
- Allos Support for Assisting Patients (ASAP) read more...
Monday–Friday, 9:00am – 6:00pm, ET
1-877-ASAP102 (877-272-7102) – phone
1-877-801-0777 – fax
www.getASAPinfo.com
Allos Therapeutics, Inc. proudly sponsors the Allos Support for Assisting Patients (ASAP) program, a reimbursement support and patient assistance program designed to help patients and healthcare professionals gain appropriate access to FOLOTYN® (pralatrexate injection). The ASAP program provides the following services:
- Verification of Patient-Specific Insurance Benefits
- Pre-Submission Claims Review and Support
- Prior Authorization Assistance
- Coding and Billing Guidance
- Payer Research
- Denied and Underpaid Claims Assistance
- Patient Assistance Program for Qualified Patients
Allos Therapeutics, Inc. does not guarantee coverage and/or reimbursement for FOLOTYN. Coverage, coding, and reimbursement policies vary significantly by payer, patient, and setting of care. Actual coverage and reimbursement decisions are made by individual payers following the receipt of claims. Allos strongly recommends verifying coverage, coding, and reimbursement guidelines on a payer and patient-specific basis.
- Amgen Assist™ read more...
New enhanced online services
There is a place you can go for user-friendly online tools and reimbursement forms…
Where your coverage questions can be answered…
Where you can talk to a reimbursement specialist directly…
Introducing Amgen Assist™, our new reimbursement assistance and patient support program for Amgen products.
Use Amgen Assist™ for help with:
- Insurance verification
- Prior authorization
- Patient assistance program information
- Billing and claims processing support
Online or by phone
Amgen Assist™ Online
A single destination for online tools and forms. Visit www.amgenassistonline.com to set up your personalized account.
Once you register, you can visit your homepage anytime to:
- Fill out, submit, and track forms online
- Manage your profile
- View status and results of requests
- View account history and current activity
You can also find information for specific programs:
- Request coverage and reimbursement information
- Get co-pay support information
- Apply for assistance for uninsured patients
Amgen Assist™ by phone
When our online eService is not an option, providers, administrators, social workers, and patients can contact Amgen Assist™ to request insurance verifications regarding Amgen products. In addition to this service, our Amgen Assist™ hotline 1-888-4ASSIST (1-888-427-7478) has reimbursement specialists with regional expertise.
- Hours of operation are Monday through Friday from 9 AM to 8 PM ET
- After-hours calls are returned within 1 business day
- Bristol-Myers Squibb Oncology: DESTINATION ACCESS™read more...
The Bristol-Myers Squibb Oncology: DESTINATION ACCESS™ Reimbursement Support and Patient Assistance Program is a comprehensive resource for Reimbursement Support Services and Patient Assistance that offers access services for patients including:
- Benefit Investigation
- Appeals Assistance
- Alternative coverage search
- Prior Authorization Assistance
- Patient Assistance
To learn more about the Destination Access Program, please visit the Destination Access web site, or call the toll-free number to speak with a reimbursement counselor.
Phone 1-800-861-0048
Monday - Friday 8am to 8pm ET
www.destinationaccess.com
- Celgene Patient Support® read more...
- www.celgenepatientsupport.com
Celgene Patient Support® provides a dedicated, central point of contact for patients and healthcare professionals who use Celgene products. Celgene Patient Support® is a free service that helps patients and healthcare professionals navigate the challenges of reimbursement, providing information about co-pay assistance, and answering questions about obtaining Celgene products.
- Cephalon Oncology Reimbursement Expertise (CORE) read more...
Cephalon Oncology is committed to enhancing the lives of cancer patients through the discovery, development and commercialization of innovative medicines, providing therapeutic solutions enhancing the quality and length of life. Cephalon Oncology has an extensive portfolio of products in hematology, solid tumors and supportive care. For information visit www.CephalonOncologyCore.com
CORE (Cephalon Oncology Reimbursement Expertise)
CORE (Cephalon Oncology Reimbursement Expertise) offers reimbursement support for the Cephalon Oncology products. Some of the options include benefit verification, prior authorization support and customer service through the claims and appeals process. CORE also provides templates for letters of medical necessity and support for the Cephalon patient assistance program.
For more information or an introductory consult please call 1-888-587-3263 or visit www.CephalonOncologyCore.com
- Dendreon ON Call read more...
Dendreon Is Committed to Serving Our Customers. Dendreon ON Call is committed to support throughout the course of therapy.
Dendreon ON Call is a multifaceted support program devoted to health care professionals, patients receiving PROVENGE, and their families.
Dendreon ON Call is staffed by a well-trained, dedicated team of specialists who provide:
- Assistance with product ordering, scheduling, and tracking
- Reminders to patients about upcoming leukapheresis appointments
- Insurance verification and investigation of available benefits
- Referrals to and assistance with enrollment in patient assistance programs
For more information about PROVENGE, please contact Dendreon ON Call at 1-877-336-3736 or visit www.provenge.com/hcp/contact-us.aspx
- Genzyme read more...
Genzyme is one of the world's foremost biotechnology companies. Founded in 1981, Genzyme has grown from a small start-up in Boston to a diversified enterprise with over 12,000 global employees. Genzyme's focus on meeting major unmet medical needs has translated into products and services that provide significant positive impact on the lives of people with serious diseases.
Genzyme Transplant & Oncology's product development expertise, robust research programs, and strong global infrastructure provide a solid base for developing and commercializing novel treatments for cancer patients. Genzyme currently has several promising oncology therapies in clinical trials, including marketed treatments for chronic lymphocytic leukemia, pediatric acute lymphocytic leukemia, stem cell transplantation and acute myelogenous leukemia. Marketed products include Campath® (alemtuzumab), Leukine® (sargramostim), Fludara® (fludarabine), Clolar® (clofarabine), Mozobil® (plerixafor injection), and Thymoglobulin® (anti-thymocyte globulin (rabbit)).
Genzyme offers complimentary reimbursement support services to help healthcare providers and patients with reimbursement questions or concerns. Reimbursement consultants can be reached at the following support lines Monday through Friday from 9 AM to 7 PM ET.
- Campath Direct - (877) 4-CAMPATH (877-422-6728)
- Fludara Direct - (888) 4-FLUDARA (888-435-8327)
- Leukine Direct - (888) 4-RX-LEUKINE (888-479-5385)
- Mozobil Direct - (877) 4-MOZOBIL (877-466-9624)
- Clolar Direct - (800) RX-CLOLAR (800-792-5652)
Genzyme Genetics understands that a multi-disciplinary approach is required to evaluate specific types of cancer to help guide treatment decisions. With experienced pathologists, cytogeneticists and molecular geneticists, and an extensive network of laboratories, Genzyme employs the most relevant technologies to provide the answers clinicians need. For hematologic and solid tumor malignancies, Genzyme provides a comprehensive Antibody Library, and a FISH Probe Library, and, every case is reviewed by experienced pathologists/clinical cytogeneticists.
- Genzyme Genetics Managed Care Information Line - (888-202-1675)
- Genzyme Genetics Oncology/Pathology Client Services - (800-447-5816)
- Genzyme Genetics Reproductive Health Client Services - (800-848-4436
For more information, please visit www.genzyme.com
- Merck Oncology read more...
Today's Merck is working to help the world be well. Through our medicines, vaccines, biologic therapies, and consumer and animal products, we work with customers and operate in more than 140 countries to deliver innovative health solutions. Merck. Be Well. For more information, visit www.merck.com
- OncoADVOCATE™ (OncoMed, The Oncology Pharmacy) read more...
www.OncoMed.net
OncoADVOCATE is OncoMed's, The Oncology Pharmacy dedicated program that supports patients who have financial hardships and need assistance. Our devoted and compassionate team of Reimbursement Advocates work one on one with the patients and caregivers to find funding, process the paperwork and gain access to the drug therapy they need. Our Reimbursement Advocates research and scour thru the myriad of Patient Financial Assistance, Indigent and Charitable Foundation Programs available to ensure maximum benefits are obtained. They act as a liaison between the patient, healthcare professional and the financial assistance program and manage the entire process from referral to conformations in coordination with everyone that is involved. Because of this program, we are able to relieve the physicians practice personnel from the time and staff consuming administrative tasks and follow up associated with investigating and sourcing financial assistance programs. The OncoADVOCATE program is an essential part of our comprehensive services provided to our patients and physician practices to support access and continuation of therapy.
- Patient Assistance NOW Oncology (PANO) (Novartis Oncology) read more...
Novartis Oncology shares your commitment to helping patients living with cancer receive the medicines they need. Patient Assistance NOW Oncology offers quick and easy access to information about the broad array of reimbursement support programs available to your patients.
You can get information about our Patient Assistance NOW Oncology support programs in two ways:
- Call 1-800-282-7630 to speak to one of our knowledgeable staff dedicated to making access to our programs as simple and convenient as possible; or
- Visit our website at www.OncologyAccessNow.com
Support for patients includes:
- Insurance verification
- Coding/billing questions
- Medicare education
- Assistance with denials/appeals
- Therapy-specific support programs for out-of-pocket costs
- Alternative funding searches and referrals for Federal or State assistance programs
- Referrals to Independent Charitable Foundations for assistance with co-pay costs
- Patients pre-qualified via phone screening for the Patient Assistance Program (PAP) will be sent a 30-day supply of their needed medication while completing the application
- Pfizer First Resource® read more...
- REACH (Resource for Expert Assistance and Care Helpline) (Bayer HealthCare Pharmaceuticals) read more...
The REACH program assists patients in getting started with Nexavar® (sorafenib) tablets. Nexavar is distributed through designated specialty pharmacy providers (SPPs); it is not available through retail pharmacies. A REACH program counselor will identify an SPP that will fill the Nexavar prescription and send it directly to the patient’s home. A REACH program counselor will also call patients to provide help in understanding insurance coverage and the Medicare Part D drug benefit and aid in finding other sources of payment for Nexavar, Enrollment forms are available via REACH at 1.866.NEXAVAR (1.866.639.2827), Monday through Friday—9 am to 8 pm EST, or at www.NEXAVAR.com. The Reimbursement Support Line team has experience with all payer types, including Medicare. Questions answered by the team typically can be classified into one of the following groups:
- Benefit verification
- Coding assistance and billing instruction
- Claims review
- Claims-appeal assistance
- Prior-authorization assistance
- Patient assistance
The On-call Team closely monitors the reimbursement environments for latest changes in Medicare, Medicaid, and private payer reimbursement and coverage polices. In addition, Bayer HealthCare Pharmaceuticals offers a patient assistance program that provides treatment to uninsured patients who meet the program requirements.
- ZytigaOne™ Support 1-855-ZYTIGA-1 read more...
ZytigaOne™ offers single-source reimbursement information for eligible patients on ZYTIGA®.
Call for benefits investigation, care coordination and other services.
Monday – Friday 8am-8pm ET
1-855-ZYTIGA-1 (1-855-998-4421)
Additional Clinician Resources:
Patient Advocacy:
Drug Shortages:
Industry: Provide needed information on reimbursement programs and service available
For information on participating in the NCCN Reimbursement Resource Room or other support opportunities, please contact C. Lyn Fitzgerald at 215.690.0226 or fitzgerald@nccn.org.
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