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ANCO acknowledges the assistance of Lash Group Healthcare Consultants for their help in compiling this information. For general assistance information, also visit:
American Society of Clinical Oncology (ASCO)
www.asco.org/asco/downloads/PhRMA_Brochure.pdf
CancerCare Co-Payment Assistance Foundation
www.cancercarecopay.org
Chronic Disease Fund
www.cdfund.org
HealthWell Foundation
www.healthwellfoundation.org
National Organization for Rare Disorders
www.rarediseases.org
NeedyMeds
www.needymeds.com
Partnership for Prescription Assistance
www.helpingpatients.org
Patient Access Network Foundation
www.patientaccessnetwork.org
Patient Advocate Foundation
www.copays.org
Patient Services Incorporated
www.uneedpsi.org
ANCO Corporate Member
Drug Reimbursement & Patient Assistance Programs
(click on the Corporate Member Name to view a summary and links
to their Drug Reimbursement & Patient Assisitance Programs)
Abraxis BioScience • Agendia • Alexion Pharmaceuticals • Allos Therapeutics • AMGEN
AstraZeneca • Bayer Healthcare Pharmaceuticals/Onyx Pharmaceuticals • biogenIDEC
bioTheranostics • Bristol-Myers Squibb Oncology • Celgene • Centocor Ortho Biotech
Cephalon Oncology • Eisai • Genentech BioOnoclogy • Genomic Health • Genzyme Oncology
Lash Group HealthCare Consultants • Lilly Oncology • Merck • Millennium • Novartis Oncology
Oncology Supply/International Oncology Network
Onmark, a McKesson Specialty Care Solutions Company • OSI Pharmaceuticals
Pathwork Diagnostics • Pfizer Oncology • Response Genetics • Sanofi Aventis Oncology
Spectrum Pharmaceuticals
US Oncology Physician Services (Oncology Pharmaceutical Services) • Vidacare
Abraxis BioScience
ARC of Support
(800) 564-0216;
Abraxane
The ARC of Support is a comprehensive program that provides a broad range of services (i.e., medical information, reimbursement and patient assistance, drug safety, product quality) for healthcare professionals caring for patients undergoing treatment with Abraxane.
Abraxis Patient Access Program (APAP)
(800) 564-0216, option 3;
8:00AM-8:00PM Eastern Time
Abraxane
APAP consists of two components—one for insured patients that have been treated with Abraxane where claims have been denied by their insurers, and the other for uninsured patients that receive treatment with Abraxane. More information can be obtained at www.abraxane.com.
Second Payer+ Coinsurance Program
(800) 562-0216; option 3
Abraxane
Second Payer + is an extension of APAP assisting patients who have coverage for Abraxane through their primary private insurance, but need assistance with their Abraxane coinsurance.
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AMGEN
AMGEN Assist
www.amgenassist.com;
(800) 272-9376;
9:00AM-8:00PM Eastern Time
Aranesp, Epogen, Neulasta, Neupogen, Nplate, Sensipar, Vectibix
AMGEN Assist gives healthcare professionals and patients a single destination for user-friendly online tools and forms and makes it easier to find the appropriate program for each patient’s unique needs. Use AMGEN Assist for insurance verification, prior authorization, patient assistance program information, and billing and claims processing support
The Safety Net Foundation
(888) 762-6436;
FAX (877) 549-7239;
9:00AM-8:00PM Eastern Time
A nonprofit foundation supported by AMGEN that provides qualified uninsured patients with AMGEN medicines at no cost.
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Allos Therapeutics
Allos Support for Assisting Patients (ASAP) Program
(877) ASAP102 (272-7102);
FAX (877) 801-0777;
9:00AM-8:00PM Eastern Time
Folotyn
ASAP (Allos Support for Assisting Patients) is a program designed to provide you with the tools to help make reimbursement easy to undertand and more manageable. Services include benefit investigations, pre-authorizations, pre-determinations, appeals, drug replacement, alternative sources of coverage, and finding co-pay assistance. Visit www.getasapinfo.com for more information and to access the interactive map that provides available reimbursement information by state, specific to Medicare, Medicaid, and commercial payers.
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AstraZeneca
AstraZeneca Cancer Support Network (AZ CSN)
(866) 922-9276;
FAX (866) 279-0709;
8:00AM-6:00PM Eastern Time
Arimidex, Casodex, Faslodex, Zoladex
AZ CSN is a comprehensive service platform for physicians and patients designed to meet informational needs, provide access to product, and address coverage issues. Specially trained Registered Nurses, Pharmacists, and Reimbursement Specialists are available to personally address customer needs including a gateway to the AZ & Me Prescription Savings Program. More information can be obtained by visiting www.azcsn.net.
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Bayer Healthcare Pharmaceuticals/Onyx Pharmaceuticals
REACH Program for Nexavar and NexConnect
(866) NEXAVAR (639-2827);
FAX (866) 639-5181;
9:00AM-8:00PM Eastern Time
Nexavar
A REACH Program counselor can provide reimbursement support and patient services, including insurance information, finding/providing patient assistance, and referring the patient to a specialty pharmacy.
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biogenIDEC
RESULTS
(800) 386-9997;
FAX (800) 513-8095;
9:00AM-6:00PM Eastern Time
Zevalin
RESULTS (REimbursement SUpport Line Trained Specialists) provides access to Zevalin for patients who meet the program’s eligibility criteria and reimbursement counseling to patients and their healthcare providers.
Single Point of Contact (SPOC)
(888) 249-4918;
FAX (888) 249-4919;
9:00AM-5:00PM Pacific Time
Rituxan
SPOC investigates benefits for new patients and those changing insurance or facing open enrollment; assists with coverage paperwork (e.g., prior authorization, medical reviews); helps with appeals and coverage denials; searches for alternative coverage for patients whose insurers do not provide adequate coverage; answers reimbursement questions; consults on coding and billing issues; tracks insurance claims; and, provides information on uninsured patient programs.
Zevalin Concierge Program
(866) 298-8433;
FAX (877) 264-8483;
8:30AM-8:00PM Eastern Time
Zevalin
The Program verifies insurance benefits and addresses reimbursement concerns; obtains patient assistance details and provides follow-up; assists with scheduling; coordinates financial assistance when needed; tracks claims from submission to payment; provides access to medical information and assists with technical product information; and, serves as a point of contact for each physician and staff member involved in treatment.
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Bristol-Myers Squibb Oncology
Destination Access
(800) 861-0048;
FAX (888) 776-2370;
8:00AM-8:00PM Eastern Time
(Reimbursement specialists available live Monday through Friday)
All Bristol-Myers Squibb Oncology products
Destination Access provides prior authorization assistance, appeals assistance, benefits investigation, general reimbursement guidance, and patient assistance.
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Celgene
Innohep Support Services
(866) 742-7646
Innohep
Innohep Support Services provides reimbursement and patient assistance support.
Patient Support Coordinator (PSC) Program
(800) 931-8691;
FAX (800) 822-2496;
www.celgenepsc.com;
patientsupport@celgene.com
5:00AM-4:00PM Pacific Time
The Celgene Patient Support Coordinator (PSC) Program was created to help patients and healthcare providers navigate the challenges of reimbursement, provide information about co-pay assistance, and answer general questions about Celgene products and their distribution. The PSC is a dedicated central point of contact who assists providers and patients who rely on Celgene products. The RevAssist/STEPS telephone number is (888) 423-5436.
Vidaza Support Services
(866) 742-7646;
FAX (866) 369-4333;
8:00AM-8:00PM Eastern Time
Vidaza
Vidaza Support Services provides reimbursement and patient assistance support.
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Centocor Ortho Biotech
DOXIL Line
(800) 609-1083;
FAX (800) 987-5572;
www.DOXILine.com;
8:00AM-8:00PM Eastern Time
Doxil
DOXILine provides access to reimbursement information and support—patient assistance program to patients without insurance coverage (based on financial need); access to insurance guidelines for private, federal, and state plans; verification of insurance coverage; and, coding and billing assistance.
Procrit Line
(800) 553-3851;
FAX (800) 987-5572;
www.procritline.com;
8:00AM-8:00PM Eastern Time
Leustatin, Procrit
ProcritLine provides easy access to reimbursement information and support—patient assistance program to patients without insurance coverage (based on financial need), coding and billing assistance, verification of insurance coverage, and assistance with appeals.
Cephalon Oncology
CORE (Cephalon Oncology Reimbursement Expertise)
(888) 587-3263;
FAX (866) 676-4073;
www.cephalononcologycore.com
9:00AM-8:00PM Eastern Time
Treanda, Trisenox
CORE services are designed to help patients and healthcare providers navigate the reimbursement landscape with resources aimed at clarifying issues and assisting with the claims process. Specific assistance includes benefit verification and coverage determination, policy benefits and limitations, personalized support through the claims process, and appeals support. In addition, Cephalon Oncology offers a Patient Assistance Program to provide FDA-approved products free of charge for patients who qualify.
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Eisai
Eisai Reimbursement Assistance Program
(866) 613-4724;
FAX (866) 573-4724;
Fragmin FAX (866) 272-8805;
www.eisaireimbursement.com
8:00AM-8:00PM Eastern Time
Aloxi, Dacogen, Fragmin, Gliadel, Hexalen, Ontak, Panretin, and Targretin
The Eisai Reimbursement Assistance Program provides patient assistance and reimbursement support for Aloxi, Dacogen, Fragmin, Gliadel, Hexalen, Ontak, Panretin, and Targretin. A customer service representative will assist with Eisai product information, patient assistance programs for uninsured and ingident patients, reimbursement questions, prior authorizations, insurance verifications, referral to co-pay assistance programs, billing/coding questions, appeal assistance, and referral to disease-state assistance programs.
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Genentech BioOncology
Genentech Access Solutions
(888) 249-4918;
www.genentechaccesssolutions.com;
Avastin, Herceptin, Rituxan, Tarceva
Genentech Access Solutions provides one-stop access to a broad array of reimbursement information, and support and services for patients so that they can focus on treatment. In addition to providing information about co-pay assistance through independent public charities, Genentech Access Solutions can also help with common reimbursement challenges, insurance appeals and coverage denials, and referrals to the Genentech Access to Care Foundation. For coverage and reimbursement services, visit www.genentechaccesssolutions.com/
docs/av/ASEEnrollment.pdf; for patient assistance, visit www.genentechaccesssolutions.com/
docs/av/GATCFEnrollment.pdf.
Avastin Patient Assistance Program
(888) 249-4918;
FAX (888) 249-4919;
6:00AM-5:00PM Pacific Time
The Avastin Patient Assistance Program is designed to limit the overall annual cost of Avastin for eligible patients receiving treatment for FDA-approved indications. Participation in the Program provides a voluntary opportunity for physicians and eligible patients who reach an annual charge of 10,000mg to receive free Avastin from Genentech for the remainder of the 12-month period. The Program is open to all patients receiving Avastin (regardless of insurance coverage) with a household adjusted gross income of up to $100,000. Patients must be receiving Avastin for an FDA-approved indication.
Oncoline
(800) 443-6676;
8:30AM-5:00PM Eastern Time
Kytril, Roferon-A, Vesanoid, Xeloda
Oncoline offers a range of reimbursement and literature search services, including third-party payer reimbursement information, coverage and benefits verification, billing codes and claims procedures, assistance with appeals, clinical literature searches, and enrollment information for Roche’s Medical Needs Program.
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Genomic Health
Genomic Access Program (GAP)
(866) ONCOTYPE (662-6897);
Oncotype Dx
Genomic Health has established the Genomic Access Program (GAP) to provide financial and administrative support to patients ordering the Oncotype DX assay. The GAP program was established to assist qualified patients gain access to Oncotype DX and to help patients and physicians with the entire reimbursement process. GAP is made up of dedicated professionals who advocate on a patient’s behalf by working with physicians’ offices and insurance companies to facilitate access to Oncotype DX. In addition, GAP provides various comprehensive financial assistance programs for patients with financial hardship, uninsured patients, and underinsured patients based on eligibility. While GAP directly supports the patient, it also works with physicians’ offices to provide individualized assistance and support with every claim. GAP services are available at physician or patient request, do not require pre-registration, and can be accessed at any time before, during, or after you have ordered the Oncotype DX assay. Genomic Health is prepared to bill insurance plans directly on behalf of insured patients whose physician orders an Oncotype DX assay. Through GAP, the patient’s physician can request a Benefits Investigation to confirm whether the patient’s insurance plan is active and obtain available benefits information specific for Oncotype DX. Some insurers require a prior authorization before processing the patient’s specimen; the GAP team can also help facilitate this process. In the event that a payer denies an Oncotype DX claim, GAP representatives will identify the reasons and advocate on the patient’s behalf. For additional information, visit www.OncotypeDX.com.
Lilly Oncology
Lilly Patient One
(866) 4PatOne;
FAX (866) 472-8663
Alimta, Gemzar
Lilly Oncology’s Patient One program provides reliable and individualized treatment support that addresses financial, access, and claim issues for patients who are candidates for Lilly’s oncology products. More information is available at www.lillypatientone.com/index.jsp.
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Millennium
Velcade Reimbursement Assistance Program
(866) VELCADE;
www.velcade.com/hcp2/default.aspx
9:00AM-7:00PM Eastern Time
Velcade
Millennium has developed this reimbursement resource website as a tool to help physicians understand the healthcare insurance environment for Velcade. While payers generally reimburse for Velcade, it is the details that dictate coverage for each individual patient’s healthcare. This website provides general guidance regarding steps to support appropriate reimbursement and patient access to Velcade treatment.
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Novartis Oncology
Patient Assistance and Reimbursement Programs
Reimbursement Hotline
(800) 282-7630;
Patient Assistance Programs
(866) 884-5906
Novartis is committed to providing access to its medicines for those most in need. Through a variety of resources, including the Novartis Oncology Patient Assistance Program, the Novartis Oncology Reimbursement Hotline, and our support of independent Charitable Copay foundations, Novartis has made a firm commitment to enable patients in need to access medicines. Visit www.novartisoncology.us for complete patient assistance, reimbursement, and clinical trial information.
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Oncology Supply/ION
(888) 536-7697
OS/ION offers a unique value to pharmaceutical companies, service providers, and physician practices. Access provided by OS/ION empowers health care providers and industry companies to improve the efficiency, effectiveness, and quality of health care delivery to patients while enabling them to satisfy their respective missions. The collective portfolio of services and solutions from OS/ION include OS/ION Coding Workshops, monthly Web/teleconference workshops specifically for OS/ION members, which address pertinent topics such as basic coding rules and standards, and evaluation and management documentation requirements; OS/ION Medical Advisory Panel (MAP), comprising industry thought leaders with collective expertise in disease states, community-based practice, and business administration with an ongoing mission to deliver quality pharmaceutical products to patients as well as creative practice solutions to physicians; OS/ION Protocol Analyzer, a preloaded software program, complete with standard drug pricing from Oncology Supply and CMS’s most recent reimbursement data, which is available online at www.iononline.com, and calculates the overall cost of delivering chemotherapy in the practice; the OS/ION Pharmacy & Dispensing Program, with two distinct drug dispensing models that can be used to distribute medication for payment under the pharmacy benefits portion of a patient’s insurance and enables close analysis of each practice’s prescription-writing habits to determine which model is most suitable for use; OS/ION Practice Reimbursement Series, a series of reimbursement webinars that are designed to help network members stay abreast of breaking issues related to reimbursement and how it impacts them; OS/ION Vital Reimbursement Resources, a feature on the OS/ION Web site through which members are directed to an array of reimbursement material including CMS and Medicare enrollment forms, and timely news updates pertaining to reimbursement and legislation are posted in this section; and the overall OS/ION GPO Function, whereby the country’s largest diversified services organization for the community-based practitioner is designed to contract directly with pharmaceutical and biotech companies to support their products within the organization’s membership.
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Onmark, a McKesson Specialty Care Solutions Company
(866) 686-8340
Onmark, McKesson Specialty Care Solution’s group purchasing organization (GPO), represents more than 2,800 member clinics, and over 4,600 physicians nationwide. Onmark helps its members save money, increase efficiency, stay informed, and deliver high-quality care by offering a wide variety of services, including:
• Robust Contract Portfolio offering significant savings on the most widely-used chemotherapy, biologic, and supportive care agents.
• Cutting-edge Educational Programs covering clinical, practice management, and legislative topics.
• Innovative Business and Clinical Solutions designed to help practices standardize and improve patient care through every step of the treatment process.
• Integrated Quality (IQ) Program that helps Lynx Mobile users succeed with quality initiatives and earn money paid as account credit to be use for technology.
• Regimen Profiler, a web-based tool that helps practices and patients understand financial and clinical information for many disease treatment regimens.
• Clinical Trial Network, providing national clinical trial opportunities in Phase II and Phase III clinical trials of investigational cancer treatments.
McKesson Specialty Care Solutions, a business unit of McKesson Corporation, empowers physicians in the community treatment setting to focus on patient care by providing distribution, technology, clinical, and educational solutions that improve profitability, maximize practice efficiencies, and reduce administrative burden, including:
• Best-in-class distribution services to ensure patients receive their drugs on time.
• The Lynx technology platform that helps thousands of clinics provide efficient, high-quality patient care and continually evolves to help practices succeed in the changing world of healthcare.
• Onmark, its Group Purchasing Organization (GPO) that offers significant savings through its leading contract portfolio, as well as online business and clinical tools for the entire staff.
• Its expert clinical team that is dedicated to creating relevant clinical tools and educational programs designed to help practices deliver high-quality patient care.
OSI Pharmaceuticals
(866) 435-2524;
Gelclair
(866) 374-8906;
Novantrone
(888) 249-4918;
Tarceva
These hotlines provide medical information and patient assistance.
Pfizer Oncology
FirstRESOURCE
(877) 744-5675;
FAX (800) 708-3430;
9:00AM-8:00PM Eastern Time
Aromasin, Camptosar, Ellence, Emcyt, Idamycin, Sutent, Zinecard
FirstRESOURCE provides insurance benefit verification, prior authorization, payer cover policy, appeals assistance, alternative sources of coverage, and patient support program information.
Sutent Patient Call Center
(877) 5SUTENT;
8:00AM-7:00PM Central Time
Sutent
The Sutent Patient Call Center is staffed by trained oncology certified nurse consultants who can give general information about Sutent treatment and potential side effects.
Torisel Reimbursement Support Program
(866) 993-8466;
FAX (866) 993-8411;
9:00AM-6:00PM Eastern Time
Toricel
The reimbursement services provided by the Torisel Reimbursment Support Program are designed to ease the administrative burden providers face when working with their patients’ insurers. Services include research into patient-specific coverage for Torisel; identification of Torisel coverage policy for Federal, State, and private payers; research to identify alternatives for patients with inadequate or no coverage, including assessment of the patient’s eligibility to participate in the Torisel Patient Assistance Program; comprehensive prior authorization support; coding and claims filing assistance; claims tracking assistance to routinely monitor status of Torisel claims; and, claims denial appeal assistance. One call connects you to your dedicated Regional Reimbursement Counselor (RCC) who is ready to handle your reimbursement questions about Torisel.
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Sanofi Aventis Oncology
Eligard Reimbursement Hotline
(877) 354-4273;
FAX (866) 354-4273;
9:00AM-8:00PM Eastern Time
Eligard
The Hotline provides patient assistance and reimbursement support.
Hyalgan Reimbursement Hotline
(800) 7HYALGAN
FAX (866) 354-4273;
9:00AM-8:00PM Eastern Time
Hyalgan
The Hotline provides patient assistance and reimbursement support.
PACT+ Program
(800) 996-6626;
FAX (800) 996-6627;
www.pactplusonline.com;
www.oncology.sanofi-aventis.us/docs/pdf/US.XON.09.04.008.pdf;
9:00AM-8:00PM Eastern Time
Anzemet, Elitek, Eloxatin, Nilandron, Taxotere
The PACT+ Program is a comprehensive program that includes both reimbursement and patient assistance services to help take the challenge out of gaining access to medication for patients in need. Visit www.oncology.sanofi-aventis.us/docs/pdf/US.DOC.08.10.011.pdf to download the PACT+ Program Application.
The goal of the Patient Assistance Program (PAP) is to provide medication free of charge to patients who have no insurance and who meet the program eligibility requirements. To qualify for patient assistance, patients must meet financial criteria, meet legal residency status, and be under the care of a healthcare provider licensed and authorized to prescribe, dispense, and administer medicines.
The goal of the Drug Replacement Program is to assist patients who have insurance coverage, but who were denied product coverage on appeal. To qualify for drug replacement, patients must meet financial criteria, meet legal residency status, and be under the care of a healthcare provider licensed and authorized to prescribe, dispense, and administer medicines. Effective September 4th, 2009, online drug replacement forms (via the PACT+ Portal) no longer require FAXing or scanning.
The goal of the Reimbursement Assistance Program is to help patients with no insurance or patients who have insurance but have been denied coverage for a Sanofi-Aventis medication. PACT+ Reimbursement Assistance offers benefit verification and authorization, claims management, appeals assistance, and coding and billing guidance. Visit www.oncology.sanofi-aventis.us/docs/pdf/US.DOC.08.10.063.pdf to download a Quick Guide to the ICD-9-CM: Codes for Common Cancer Sites.
PACT+ will also work with patients to help find alternative services and resources that may help them, such as referrals to co-pay assistance, referrals to other drug assistance programs, prescription savings programs, home care services, nutritional supplements, medical supplies and devices, utilities, cosmetic aids (e.g., wigs, scarves, makeup), clothing, transportation, support groups, patient advocacy support, groceries and food banks, cancer advocacy groups, and hospice. Visit www.oncology.sanofi-aventis.us/docs/pdf/US.DOC.08.12.005.pdf to download the PACT+ Reimbursement and Patient Assistance Brochure.
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