The oncology reimbursement landscape continues to present ever-evolving challenges for clinicians and others that work with patients with cancer. As a response to these ongoing challenges, help is available through the NCCN Virtual Reimbursement Resource Room.
Select a cancer or supportive care indication or select a reimbursement program below to learn about reimbursement help and services available to you to help your practice mitigate reimbursement challenges.
Download the NCCN Virtual Reimbursement Resource Room Guide
Download the NCCN Reimbursement Resource App for Smartphones and Tablets
Acute Promyelocytic Leukemia (APL)
Basal Cell Carcinoma
Chronic Lymphocytic Leukemia
Chronic Myelogenous Leukemia (CML)
Gastrointestinal Stromal Tumor (GIST)
Head and Neck Cancers
Mantle Cell Lymphoma
Metastatic Colorectal Cancer
Mycosis Fungoides/Sezary Syndrome
Non-Small Cell Lung Cancer
Peripheral T-Cell Lymphoma
Prevention and Treatment of Cancer-Related Infections
Soft Tissue Sarcoma
Abiraterone acetate (ZYTIGA®) --- ZytigaOne™ Support – http://www.zytigahcp.com/zytigaone-support#zytigaone-support and http://www.janssenprescriptionassistance.com/zytiga
Ado-trastuzumab emtansine (Kadcyla) --- Genentech Access Solutions
Arsenic Trioxide (Trisenox®) --- Teva Oncology: CORE (Comprehensive Oncology Reimbursement Expertise)
Azacitidine for injection (Vidaza®) --- Celgene Patient Support®
Bendamustine (Treanda®) --- Teva Oncology: CORE (Comprehensive Oncology Reimbursement Expertise)
Bevacizumab (Avastin®) --- Genentech Access Solutions
Bortezomib (Velcade®) --- Millennium Pharmaceuticals, Inc.
Brentuximab Vedotin (ADCETRIS®) --- Seattle Genetics - SeaGen Secure
Capecitabine (Xeloda®) --- Genentech Access Solutions
Carfilzomib (Kyprolis™) --- Onyx Pharmaceuticals
Cetuximab (Erbitux®) --- Bristol-Myers Squibb Oncology Reimbursement Services
Dasatinib (Sprycel®) --- Bristol-Myers Squibb Oncology Reimbursement Services
Enzalutamide capsules (XTANDI) --- XTANDI Access ServicesSM
Erlotinib (Tarceva) --- Genentech Access Solutions
Everolimus (Afinitor®) --- Patient Assistance NOW Oncology (PANO) (Novartis Oncology)
Imatinib (Gleevec®) --- Patient Assistance NOW Oncology (PANO) (Novartis Oncology)
Ipilimumab (Yervoy™) --- Bristol-Myers Squibb Oncology Reimbursement Services
Ixabepilone (Ixempra®) --- Bristol-Myers Squibb Oncology Reimbursement Services
Lenalidomide (Revlimid®) --- Celgene Patient Support®
Letrozole (Femara®) --- Patient Assistance NOW Oncology (PANO) (Novartis Oncology)
Nilotinib (Tasigna®) --- Patient Assistance NOW Oncology (PANO) (Novartis Oncology)
Omacetaxine Mepesuccinate (Synribo®) --- Teva Oncology: CORE (Comprehensive Oncology Reimbursement Expertise)
Paclitaxel, albumin-bound (Abraxane®) --- Celgene Patient Support®
Pemetrexed for injection (Alimta®) --- Lilly PatientOne: Reimbursement & Patient Assistance Programs
Pertuzumab (Perjeta) --- Genentech Access Solutions
Regorafenib (Stivarga®) --- REACH (Resource for Expert Assistance and Care Helpline) (Bayer HealthCare Pharmaceuticals)
Rituximab (Rituxan) --- Genentech Access Solutions
Romidepsin for injection (Istodax®) --- Celgene Patient Support®
Ruxolitinib (tablets) (Jakafi®) --- IncyteCARES (Incyte Corporation)
Sorafenib tosylate (Nexavar®) --- REACH (Resource for Expert Assistance and Care Helpline) (Bayer HealthCare Pharmaceuticals)
Tbo-filgrastim (Granix™) --- Teva Oncology: CORE (Comprehensive Oncology Reimbursement Expertise)
Thalidomide (Thalomid®) --- Celgene Patient Support®
Trastuzumab (Herceptin®) --- Genentech Access Solutions
Vemurafenib (Zelboraf) --- Genentech Access Solutions
Vismodegib (Erivedge®) --- Genentech Access Solutions
Zoledronic acid (Zometa®) --- Patient Assistance NOW Oncology (PANO) (Novartis Oncology)
- Your Patients - Your Practice - Your Choice
XTANDI Access ServicesSM is designed as a single point of contact to help patients and their loved ones understand their coverage and reimbursement options for XTANDI (enzalutamide) capsules. Astellas is firmly committed to ensuring our patients have access to XTANDI, regardless of their financial status. We are here to answer questions about your insurance coverage and options for filling your prescription in order to get you started on therapy as quickly as possible.
Flexible and integrated resources for patient access and support:
XTANDI Patient Savings Program℠
Quick Start+℠ for XTANDI
To enable rapid initiation of treatment, the Quick Start+™ program for XTANDI provides a one-time, 14-day gratis fill supply of XTANDI that requires a physician prescription. Quick Start+ is intended for new patients who have not received a coverage decision from their payer (for example, a benefit verification or prior authorization is pending) in time to start therapy in 10 business days. Quick Start+™ offers several benefits:
Astellas Access Program℠
Astellas is committed to supporting and maintaining access to medications for patients who are treated with an Astellas product.
The Astellas Access Program℠ for XTANDI is designed for patients who have no health insurance. This program provides free XTANDI to patients who qualify for enrollment based on insurance and household income status. Eligibility is determined on a patient-specific basis. XTANDI Access Services℠ can quickly determine whether a patient is eligible for enrollment.
If you need assistance with the Astellas eService site, XTANDI Access Services℠ or have any questions on coding, coverage, and reimbursement for Astellas products, please contact us between the hours of 9:00 AM and 8:00 PM ET Monday through Friday.
XTANDI Access Services℠
Monday – Friday, 9:00 AM – 8:00 PM ET
Phone: 1.855.8XTANDI (1.855.898.2634)
Astellas Access Services℠
P.O. Box 13185
La Jolla, CA 92039
For Full Prescribing Information please see www.Astellas.com or contact Astellas Medical Communication at 1.800.961.0018.
XTANDI and Astellas are trademarks of Astellas Pharma Inc.
XTANDI Access Services℠ is a component of Astellas Access Services℠.
VeriStrat® is a serum protein test that is predictive of significant differential overall survival treatment benefit between erlotinib and single-agent chemotherapy for patients with advanced NSCLC who are EGFR wild-type or whose EGFR mutation status is unknown. The test is used in patients who have progressed after or are ineligible for platinum-based doublet chemotherapy.
If you have any questions at all regarding coverage and payment, please contact the VeriStrat Support Hotline at 1.866.432.5930.
Bristol-Myers Squibb Oncology is committed to helping appropriate patients get access to our medications by providing reimbursement support services for healthcare professionals.
Bristol-Myers Squibb Oncology: Access Support is a comprehensive resource for Reimbursement Support Services and Patient Assistance that offers access services for patients including:
To learn more about BMS Access Support, please visit our web site or call the toll-free number to speak with a reimbursement counselor.
Monday – Friday, 8:00 AM to 8:00 PM ET
BTG is a specialist healthcare company targeting critical care, cancer, and other disorders. Specialty pharmaceuticals approved for use in the US include CroFab® Crotalidae Polyvalent Immune Fab (Ovine), DigiFab® Digoxin Immune Fab (Ovine), and Voraxaze® (glucarpidase).
Company and product website addresses:
Founded in 1944, CancerCare® is dedicated to helping people affected by cancer. A national, nonprofit 501C3 organization, CancerCare provides free, professional support services to individuals, families, caregivers and the bereaved in order to help them cope with, and manage, the emotional and practical challenges of cancer.
CancerCare services include counseling, support groups, educational publications, workshops, financial assistance and co-pay assistance. All psychosocial services are provided by professional oncology social workers. All services are offered completely free of charge.
CancerCare serves all 50 states. To learn more, please visit www.cancercare.org. Patients and families can call 1-800-813-HOPE (4673).
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.
1.800.931.8691 or www.CelgenePatientSupport.com
We Focus on Access So You Can Focus on Health
If you are concerned about paying for your Genentech medicine, we are here to help. Whether you have health care coverage or not, we can help you by:
Visit Genentech-Access.com to learn more about these programs and how to get started. To speak live with one of our Specialists, call (866) 4ACCESS/(866) 422-2377.
IncyteCARES (Connecting to Access, Reimbursement, Education and Support) was established by Incyte to assist providers, patients, and caregivers through a single point of contact with reimbursement assistance, patient access, and distribution coordination for Jakafi® (ruxolitinib).
IncyteCARES assists healthcare professionals and eligible patients with product access through a suite of services, including:
You can contact IncyteCARES, between 8 AM – 8 PM ET, by calling 1-855-4-JAKAFI (855-452-5234) or visit www.IncyteCARES.com for more information.
Reliable, individualized support. Resources that may help your patients.
The Lilly PatientOne program may address financial and coverage issues for qualified uninsured, underinsured, and insured patients who are prescribed a Lilly Oncology product. Services offered by this program include:
Patient Assistance Program
Reimbursement Assistance for Eligible Lilly Oncology Products for an Approved Diagnosis
Denied Claim Appeals Assistance
For more information call 1-866-4PatOne (1-866-472-8663) Monday-Friday, 9 AM-7 PM EST or visit www.lillypatientone.com.
Onyx 360 sets a new standard of personalized treatment support for patients, caregivers, and practices. You and your patients will have access to a dedicated Oncology Nurse Advocate and a wide range of services and support, including:
Talk to Your Patients About Onyx 360 Today.
To learn more about these services, please call 1.855.ONYX.360 (1.855.669.9360).
Patient Access Network (PAN) Foundation (866.316.7263)
PAN is an independent non-profit organization that provides assistance to underinsured patients for their out-of-pocket expenses for life-saving medications. PAN supports patients through nearly 60 oncology, chronic, and rare disease funds that cover conditions such as multiple myeloma, metastatic breast cancer, and lung cancer (non-small cell). Since 2004, PAN has provided nearly $400 million in assistance for out-of-pocket expenses through more than 200,000 patient grants. Patients and their advocates can apply for assistance by calling 866.316.7263 or start the application process online at www.PANFoundation.org.
Helping to make access to the therapies you need easier
Novartis Oncology is committed 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 support and reimbursement programs available.
You can get information about our Patient Assistance NOW Oncology support programs in 2 ways:
The REACH program assists patients with their coverage options for Nexavar® (sorafenib) tablets and Stivarga (regorafenib) tablets. Nexavar and Stivarga are distributed through designated specialty pharmacy providers (SPPs); it is not available through retail pharmacies. A REACH program counselor will work with Payers and patients to identify an SPP that will fill the Nexavar or Stivarga 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 or Stivarga. Enrollment forms are available via REACH at (866.639.2827), Monday through Friday from 9:00 AM to 8:00 PM EST, or at www.nexavar-us.com or www.stivarga-us.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:
The On-call Team closely monitors the reimbursement environment 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 assistance to uninsured patients who meet the program requirements.
SeaGen Secure™ is a comprehensive assistance program for patients who have been prescribed ADCETRIS™ (brentuximab vedotin) and for the healthcare providers caring for them. Services offered by the program include:
Teva Oncology: CORE (Comprehensive Oncology Reimbursement Expertise) offers reimbursement support for branded Teva Oncology products. Some of the options include benefit verification, prior authorization support and customer service through the claims and appeals process. CORE also provides referrals to the Teva Cares patient assistance program.
For more information or an introductory consult please call 1-888-587-3263 or visit www.TevaCore.com
Janssen Biotech, Inc., the marketer of ZYTIGA® (abiraterone acetate), has developed ZytigaOne™ Support to help make access to ZYTIGA® simple, convenient, and easy. ZytigaOne™ Support provides focused attention and personalized support to help you and your patients with access to ZYTIGA®.
Support For You
Support For Your Patients
Click here for more information about how to enroll patients in ZytigaOne™ Support or call your personally assigned ZytigaOne™ Support Site Coordinator today.
Contact ZytigaOne™ Support
Monday – Friday, 8:00 AM – 8:00 PM ET
Before prescribing ZYTIGA® (abiraterone acetate), please see full Prescribing Information including Dosage and Administration, Warnings and Precautions available at http://www.ZYTIGAHCP.com
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 Jennifer Tredwell at 215.690.0274 or firstname.lastname@example.org.
NCCN Member Institutions|
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