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genentech actemra patient assistance form

by Ricardo Johnston Published 2 years ago Updated 1 year ago
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How do I contact Genentech for more information about Actemra® supply?

For more, please visit our COVID-19 response page, or call 1-877-436-3683. See the latest update on Actemra® (tocilizumab) supply here. Genentech Patient Foundation

How can I get help paying for my Genentech medicine?

Uninsured patients and insured patients without coverage for their medicine must meet a different set of income requirements. ACTEMRA Access Solutions can refer eligible patients to the ACTEMRA Co-pay Card Program for help with the out-of-pocket costs associated with their Genentech medicine.*

How do I enroll in the Genentech patient Foundation?

Two forms are needed to enroll in the Genentech Patient Foundation: Prescriber Foundation Form (to be completed by the health care provider). Patient Consent Form (to be completed by the patient). For more information, visit GenentechPatientFoundation.com.

Does Actemra access solutions offer co-pay assistance?

For eligible patients with commercial or public health insurance, ACTEMRA Access Solutions offers referrals to independent co-pay assistance foundations.*

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What is ACTEMRA Access Solutions?

For eligible patients with commercial or public health insurance, ACTEMRA Access Solutions offers referrals to independent co-pay assistance foundations.†

Who provides Genentech medicine?

The Genentech Patient Foundation provides free Genentech medicine to people who don't have insurance coverage or who have financial concerns and to people who meet certain income criteria.*

Does ACTEMRA have a copay card?

ACTEMRA Access Solutions can refer eligible patients to the ACTEMRA Co-pay Card Program for help with the out-of-pocket costs associated with their Genentech medicine.*

Does Genentech support evrysdi?

Please Note: At this time, Genentech supports Evrysdi, Nutropin, Cellcept, Valcyte, and Fuzeon through a separate process.

Do you need to complete a patient consent form?

Both forms are required. No action can be taken until a completed Patient Consent Form and Prescriber Service Form have been received.

How to contact ACTEMRA?

Call ACTEMRA Access Solutions at (866) 681-3261 for a referral. These foundations may be able to help you. Please check their websites for up-to-date information.

What is ACTEMRA access?

If you need help with the co-pay for your Genentech medicine, ACTEMRA Access Solutions can refer you to an independent co-pay assistance foundation. An independent co-pay assistance foundation is a charitable organization that gives financial assistance for medicines. Call ACTEMRA Access Solutions at (866) 681-3261 for a referral.

What is ACTEMRA Access Solutions number?

At this time, no independent co-pay assistance foundations have been identified. Please call ACTEMRA Access Solutions at (866) 681-3261 for assistance.

What is ACTEMRA copay card?

The ACTEMRA Co-pay Card Program helps patients with commercial health insurance. This might be a plan you get through your employer or one you purchased through a Health Insurance Marketplace like HealthCare.gov. To qualify, you must also meet other criteria.

What to do if you don't have insurance for Genentech?

If you do not have insurance, or if your insurance does not cover your Genentech medicine, you must meet a different set of income requirements.

Who gives Genentech medicine?

The Genentech Patient Foundation gives free Genentech medicine to people who don't have insurance coverage or who have financial concerns and meet certain eligibility criteria.

Does ACTEMRA have copay assistance?

If you have public insurance or commercial insurance, ACTEMRA Access Solutions can refer you to an independent co-pay assistance foundation that might help pay for your Genentech medicine.

How to contact Genentech about Actemra?

Medicine Information Support. Ask about possible side effects and any other medical questions related to your prescribed Genentech medicine. Call us at (800) 821-8590, Monday-Friday, 5am-5pm PT. Chat with us using our live chat feature, Monday-Friday, 5am-5pm PT.

How to report side effects of Genentech?

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects to Genentech at 1-888-835-2555. Please see full Prescribing Information and the Medication Guide, including Serious Side Effects, for more Important Safety Information.

What is the phone number for Genentech?

Genentech Patient Resource Center. Our center dedicated to getting patients and caregivers to the right resources. Call us at (877) 436-3683 or (877) GENENTECH, Monday-Friday, 6am-5pm PT. Genentech Access Solutions. This service offers coverage support, patient assistance, and other useful information.

How old do you have to be to get PJIA?

To treat people with active polyarticular juvenile idiopathic arthritis (PJIA) 2 years of age and older

Can ACTEMRA cause multiple sclerosis?

While rare, Multiple Sclerosis has been diagnosed in people who take ACTEMRA.

Does actuma increase cancer risk?

ACTEMRA may increase your risk of certain cancers by changing the way your immune system works .

Can you get actherma if your neutrophils are low?

Changes in Blood Test Results. Your healthcare provider should do blood tests before and after you start receiving ACTEMRA. You should not receive ACTEMRA if your neutrophil and platelet counts are too low or your liver function test levels are too high.

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