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 Reimbursement Resource App for Smartphones and Tablets
Download the NCCN Virtual Reimbursement Resource Room Guide
Now available for Apple and Android smartphones and tablets! As a response to these ongoing challenges, help is available through the NCCN Reimbursement Resource App; users are able to search for available resources and payment assistance programs.
Information on resources available are listed under three different tabs entitled: Search by Cancer Type or Supportive Care Indication, Search by Drug Name (brand or generic), and Search by Reimbursement or Assistance Program.
A printer-friendly 23 page resource to empower patients with cancer and their caregivers as you help them navigate the challenging reimbursement landscape.
Acute Promyelocytic Leukemia (APL)
Anaplastic Large Cell Carcinoma
Basal Cell Carcinoma
Bone Cancer
Bone Metastases
Breast Cancer
Chemotherapy-Induced Nausea and Vomiting (CINV)
Castrate Resistant Prostate Cancer
Chronic Lymphocytic Leukemia
Chronic Myelogenous Leukemia (CML)
Colon Cancer
Gastric Cancer
Gastroesophageal Junction Cancer
Gastrointestinal Stromal Tumor (GIST)
Glioblastoma
Hepatobiliary Cancers
Hodgkin's Lymphoma
Kidney Cancer
Mantle Cell Lymphoma
Melanoma
Metastatic Breast Cancer
Metastatic Colorectal Cancer
Multiple Myeloma
Mycosis Fungoides/Sezary Syndrome
Myelodysplastic Syndromes
Myelofibrosis
Neuroendocrine Tumors
Neuroendocrine Tumors of Pancreatic Origin
Neutropenia
Non-Hodgkin's Lymphomas
Non-Melanoma Cancers
Non-Small Cell Lung Cancer
Pancreatic Adenocarcinoma
Peripheral T-Cell Lymphoma
Philadelphia Chromosome-negative Acute Lymphoblastic Leukemia
Prevention and Treatment of Cancer-Related Infections
Prostate Cancer
Rectal Cancer
Renal Cell Carcinoma
Soft Tissue Sarcoma
Thyroid Cancer
Waldenström's Macroglobulinemia
Abiraterone acetate (ZYTIGA®) --- ZytigaOne® Support
Ado-trastuzumab emtansine (Kadcyla) --- Genentech Access Solutions
Afatinib (GILOTRIF®) --- Boehringer Ingelheim Solutions Plus™
Arsenic Trioxide (Trisenox®) --- Teva Oncology: CORE (Comprehensive Oncology Reimbursement Expertise)
bortezomib (Velcade®) --- Takeda Oncology- Velcade Reimbursement Assistance Program (VRAP)
Azacitidine for injection (Vidaza®) --- Celgene Patient Support®
Bendamustine (Treanda®) --- Teva Oncology: CORE (Comprehensive Oncology Reimbursement Expertise)
Bevacizumab (Avastin®) --- Genentech Access Solutions
Capecitabine (Xeloda®) --- Genentech Access Solutions
Enzalutamide capsules (XTANDI) --- XTANDI Support SolutionsSM
Eribulin mesylate (HALAVEN®) --- Eisai Assistance Program (EAP)
Erlotinib (Tarceva) --- Genentech Access Solutions
Everolimus (Afinitor®) --- Patient Assistance NOW Oncology (PANO) (Novartis Oncology)
filgrastim-sndz (ZARXIO®) --- Sandoz One Source™
Ibrutinib (IMBRUVICA®) --- YOU&i™ Support Program
Imatinib (Gleevec®) --- Patient Assistance NOW Oncology (PANO) (Novartis Oncology)
ixazomib (NINLARO®) --- Takeda Oncology- NINLARO 1Point™
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)
ONIVYDE® (irinotecan liposome injection) --- PROVYDE™ (ONIVYDE Access Services)
Paclitaxel protein-bound particles for injectable suspension (albumin-bound) (Abraxane®) --- Celgene Patient Support®
Pemetrexed for injection (Alimta®) --- Lilly PatientOne: Reimbursement & Patient Assistance Programs
Pertuzumab (Perjeta) --- Genentech Access Solutions
Pomalidomide (Pomalyst®) --- Celgene Patient Support®
Rituximab (Rituxan) --- Genentech Access Solutions
Rolapitant (VARUBI®) --- TOGETHER with TESARO™
Romidepsin for injection (Istodax®) --- Celgene Patient Support®
Ruxolitinib (tablets) (Jakafi®) --- IncyteCARES (Incyte Corporation)
Tbo-filgrastim (Granix™) --- Teva Oncology: CORE (Comprehensive Oncology Reimbursement Expertise)
Thalidomide (Thalomid®) --- Celgene Patient Support®
TheraSphere® (TheraSphere®) --- BTG International Inc.: Reimbursement Services
Trastuzumab (Herceptin®) --- Genentech Access Solutions
(trifluridine and tipiracil) tablets (Lonsurf®) --- Taiho Oncology Patient Support
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 Support Solutions℠ 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 Support Solutions℠ can quickly determine whether a patient is eligible for enrollment.
If you need assistance with the Astellas eService site, XTANDI Support Solutions℠ 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.
Contact Us XTANDI Support Solutions℠ Monday – Friday, 9:00 AM – 8:00 PM ET Phone: 1.855.8XTANDI (1.855.898.2634) Fax: 1.855.982.6341
Mailing Address 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 Support Solutions℠ is a component of Astellas Access Services℠.
www.Astellas.com
Making patient support our priority by providing a broad range of access, reimbursement and clinical support solutions for patients who are prescribed GILOTRIF® (afatinib) tablets
Call Solutions Plus at 1-877-814-3915 from 8AM to 8PM EST or online at www.bisolutionsplus.com
BTG is a specialist healthcare company focused on three business areas: Interventional Medicine, Specialty Pharmaceuticals and Licensing.
BTG's Interventional Medicines include Interventional Oncology products used to treat patients with liver tumors and Interventional Vascular products used to treat patients with severe blood clots and patients with varicose veins in the great saphenous vein system of the leg.
BTG's Specialty Pharmaceutical products include antidotes to treat snake envenomation and toxicity associated with medicines used for heart conditions and cancer.
Company and product website addresses: www.btgplc.com www.therasphere.com www.voraxaze.com
www.celgenepatientsupport.com
A single source for access support Celgene Patient Support® provides patients support with accessing their prescribed Celgene oncology medications. No matter what type of insurance patients have, a Celgene Patient Support® Specialist is here to help. Patients will speak to the same Specialist every time they call. A Specialist can provide a range of services when one of our medications is prescribed.
*Patients must meet specified financial and insurance eligibility criteria to qualify for assistance.
There are 4 simple ways to enroll your patient in Celgene Patient Support®:
Eisai's commitment to innovative solutions in disease prevention, treatment and care for the health and well-being of people worldwide is embodied in our human health care (hhc) mission: we give first thoughts to patients and their families by helping to facilitate access to necessary medicines.
With this in mind, the Eisai Assistance Program (EAP) provides dedicated reimbursement and access support for patients and healthcare professionals to reduce barriers to patient access to medicines.
Specifically, EAP offers the following services:
To learn more about the Eisai Assistance Program, please visit our website or call our toll‐free number.
Phone: 1.866.61.EISAI (1.866.613.4724) (Monday-Friday, 8 AM to 8 PM, ET)
www.eisaireimbursement.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.
Genoptix collaborates with healthcare providers on complex oncology cases to provide definitive diagnoses to help improve patient outcomes. We partner with most major insurance companies, as well as Medicare. If Genoptix is not contracted with an insurance carrier, we will consult with the healthcare or insurance provider to determine a course of action.
Results from a regional retrospective study show economic benefits associated with the COMPASS hematopathologist-directed, centralized diagnostic workflow. Genoptix patients demonstrated improved transfusion independence and fewer office visits, lab tests, diagnoses, and transfusions, saving considerable time and resources. Source: Engel-Nitz NM, et al.
For any reimbursement questions, call Genoptix at 800-755-0802 or visit Genoptix.com
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.
The Lilly PatientOne program is committed to helping eligible patients access support programs for Lilly Oncology products they are prescribed. It aims to address both financial and coverage issues for qualified uninsured, underinsured, and insured patients who are prescribed a Lilly Oncology product. PatientOne strives to offer resources, ranging from benefits investigations to financial assistance and appeals information, that provide reliable and individualized treatment support for eligible patients.
Services offered by this program include:
Insurance expertise
Patient Assistance Program
Financial assistance
Reimbursement assistance for eligible Lilly Oncology products for an approved diagnosis
Denied claim appeals
For more information call 1-866-4PatOne (1-866-472-8663) Monday–Friday, 9AM–7PM ET or visit www.lillypatientone.com.
Patient Access Network (PAN) Foundation (866.316.7263) The Patient Access Network Foundation is an independent, nationwide 501(c)(3) organization dedicated to providing help and hope to underinsured patients who are unable to afford the out-of-pocket expenses for their prescribed medications. Since 2004, PAN has provided over $1 billion in financial assistance to more than 500,000 people living with chronic or critical illnesses, across nearly 60 disease-specific programs. For applications and eligibility questions, call 866-316-PANF (7263). To learn more, visit 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:
www.OncologyAccessNow.com
PROVYDE™ (ONIVYDE Access Services) offers an array of services to help healthcare providers and their patients access ONIVYDE® (irinotecan liposome injection).
PROVYDE can help by offering:
Contact Us PROVYDE™ (ONIVYDE Access Services) Monday – Friday, 8AM – 8PM ET Phone: 1.844.ONIVYDE (1.844.664.8933) Fax: 1.844-269-3039 www.onivyde.com
*Patients must meet specified financial and insurance eligibility criteria to qualify for assistance. Merrimack reserves the right to make eligibility determinations and to modify or discontinue the program at any time.
†Functionally uninsured patients are those who may be enrolled in a health plan but do not have coverage for ONIVYDE.
Sandoz One Source™ : Patient Support Services
Sandoz One Source is a comprehensive program designed to help simplify and support patient access. Sandoz One Source offers a variety of customized services for patients prescribed filgrastim-sndz (ZARXIO®) including:
Phone: 1.844.726.3691 (1.844.SANDOZ1) - Monday – Friday, 9:00 AM – 8:00 PM ET
Fax: 1.844.726.3695
Address:
P.O. Box 220188Charlotte, NC 28222-0188
Online: http://www.SandozOneSource.com
* Maximum benefit of $10,000 annually. Prescription must be for an approved indication. This program is not health insurance. This program is for insured patients only; cash-paying or uninsured patients are not eligible. Patients are not eligible if prescriptions are paid, in whole or in part, by any state or federally funded programs, including but not limited to Medicare (including Part D, even in the coverage gap) or Medicaid, Medigap, VA, DOD, or TriCare, or private indemnity, or HMO insurance plans that reimburse the patient for the entire cost of their prescription drugs, or where prohibited by law. Patients can participate for a maximum of 12 months up to age 65. Co-Pay Program may not be combined with any other rebate, coupon, or offer. Sandoz reserves the right to rescind, revoke, or amend this offer without further notice. ZARXIO and Sandoz One Source are trademarks Novartis AG.
©2016 Sandoz Inc., a Novartis company, 100 College Road West, Princeton, NJ 08540 All Rights Reserved S-ZRX-1329695 03/2016
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
We know getting patients access to LONSURF® (trifluridine and tipiracil) is a critical step in their treatment. We strive to make this process as simple as possible.
Access and reimbursement support
Specialty pharmacy (SP) prescription coordination
Co-pay support
Alternate funding support
Personalized nurse support for treatment plan adherence upon request
We will quickly investigate each patient's LONSURF coverage, and help them get access to the LONSURF treatment they have been prescribed.
Call 1-844-TAIHO-4U (1-844-824-4648) or for more information visit www.TaihoPatientSupport.com
NINLARO 1Point is designed to assist patients with coverage, access, and staying on therapy
NINLARO 1Point is a comprehensive support program that offers an array of access and coverage services for NINLARO® (ixazomib) patients and their healthcare providers.
Our dedicated case management team can deliver personalized services that help NINLARO patients and providers navigate coverage requirements for NINLARO, streamline product access, and connect to helpful resources.
Service Include:
Contact us by phone
To get more information on access, coverage, and available support and services, call a NINLARO 1Point case manager.
Contact us by fax
To submit a request for insurance benefit verification, RapidStart enrollment, prescriptions for specialty pharmacy, or Patient Assistance Program enrollment.
Enroll today
Reimbursement services and more for your office and your patients
VRAP provides you and your patients with a full suite of services and resources designed to make access to therapy as easy as possible.
For your office: Filing claims
Our dedicated case managers help you and your practice get started
For your office: Managing claims
A dedicated case manager helps your office manage claims
For your patient: Treatment and Personal Support
Our dedicated case managers help assist your patients
For questions regarding the Takeda Oncology- Velcade Reimbursement Assistance Program (VRAP), please call (866) 835-2233, option 2.
https://www.velcade-hcp.com/reimbursement/vrap.aspx
TOGETHER with TESARO™ is a patient resource program dedicated to supporting people bravely fighting cancer. The program offers solutions for medication access and affordability throughout each patient's journey. TESARO's expert case management team facilitates a seamless process to ensure TESARO patients get the individualized support needed.
For more information about TOGETHER with TESARO, call 1-844-2TESARO (1-844-283-7276), or visit www.TOGETHERwithTESARO.com
Personalized assistance for IMBRUVICA® (ibrutinib) patients to help them:
Access Support We can help patients learn about access to IMBRUVICA® through:
Affordability Support Regardless of insurance type, we can help your patients understand their options
Nurse Call Support & Resources Your patients can talk to YOU&i™ nurses who can answer questions and provide information about IMBRUVICA® and their disease
Enrolling in the YOU&i™ Support Program is easy
Contact YOU&i™ Support 1.877.877.3536 Monday – Friday, 8:00 AM – 8:00 PM ET
Before prescribing IMBRUVICA® (ibrutinib), please see the full Prescribing Information available at www.IMBRUVICA.com.
ZytigaOne® Support
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 Case Coordinator today.
Contact ZytigaOne® Support 1-855-ZYTIGA-1 (998-4421) 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 tredwell@nccn.org.
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