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ocrevus patient assistance form

by Mr. Marquis Bins I Published 2 years ago Updated 1 year ago
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How do I obtain patient support services from Ocrevus?

OCREVUS Start Form Patient By completing this form you can: Instructions for Patients Page 1 of 4 To obtain assistance, please follow these steps: 1. Read the Patient Authorization Informationdescribing Genentech patient support services on pages 2 and 3. 2.

What is the Ocrevus co-pay program?

If eligible commercially insured patients need assistance with their out-of-pocket drug and/or infusion costs, your OCREVUS Patient Navigator can help them enroll in the OCREVUS Co-pay Program.* *Eligibility criteria apply.

What is the Ocrevus patient navigator referral program?

For eligible patients with commercial or public health insurance, your OCREVUS Patient Navigator offers referrals to independent co-pay assistance foundations.† *Eligibility criteria apply.

How can Ocrevus help uninsured or underinsured patients?

Uninsured patients and insured patients without coverage for their medicine must meet a different set of income requirements. Your Patient Navigator can help eligible commercially insured patients enroll in the OCREVUS Co-pay Program for help with their out-of-pocket drug costs, infusion costs or both.*

What is PML in MS?

When should ocrevus be discontinued?

Is ocrelizumab in human milk?

Does Ocrevus cause breast cancer?

Can you use ocrevus after immunosuppressive therapy?

Does Ocrevus work for hepatitis B?

Can a herpes infection occur with ocrevus?

See 2 more

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Does Ocrevus have copay assistance?

OCREVUS Co-pay Program Genentech co-pay programs provide financial assistance to eligible commercially insured patients to help with their co-pays, co-insurance, or other out-of-pocket (OOP) costs. Patients who qualify can receive up to $21,000 in assistance per 12-month period.

How do I use my Ocrevus copay card?

The OCREVUS Co-pay Program verifies the patient's information and notifies your practice when the card is loaded with the proper amount. Collect the patient's $5 co-pay for drug costs and/or $5 co-pay for infusion costs, then collect the rest of the patient's out-of-pocket costs for drug and/or infusion using the card.

Is Ocrevus covered by Medicare?

If you have Medicare Part B and supplemental insurance, most or all of your OCREVUS costs will be covered by the plan. If you have Medicare Advantage, plan designs and out-of-pocket expenses may vary depending on your other healthcare expenses and whether you have hit your out-of-pocket maximum.

What company makes Ocrevus?

Genentech: Ocrevus® (ocrelizumab)

Does OCREVUS cause headaches?

Infusion side effects can occur during or up to 24 hours after an Ocrevus infusion. This may also be called an infusion reaction. Examples of infusion side effects that Ocrevus can cause include: headache.

How good is OCREVUS?

Ocrevus is a highly effective (category 2.0) DMD; in clinical trials people taking Ocrevus had about 50% fewer relapses than people taking Rebif . During the clinical trials, Ocrevus appeared to reduce disability progression and significantly reduce the number of lesions seen on MRI scans compared to Rebif.

Does Ocrevus improve walking?

People treated with Ocrevus had a 49% reduction in the risk of needing a walking aid compared to those that received interferon beta-1a over 6 years of study (4.3% vs. 7.2%*; p=0.0042).

Is Ocrevus like chemotherapy?

No, Ocrevus is not chemotherapy. It belongs to a class of drugs called monoclonal antibodies. Ocrevus works by decreasing the activity of your immune system and stopping it from attacking your body.

Is there a generic for Ocrevus?

Ocrevus, whose generic name is ocrelizumab, also is approved to treat patients who have relapsing-remitting MS.

How many years can you stay on Ocrevus?

Ocrevus continuers maintained a low ARR of 0.03 after 7.5 years of Ocrevus treatment. After eight years, outcomes continue to favor early and ongoing treatment with Ocrevus to slow disability progression in people with PPMS.

What is the most effective multiple sclerosis treatment?

Interferon beta medications. These drugs are among the most commonly prescribed medications to treat MS . They are injected under the skin or into muscle and can reduce the frequency and severity of relapses. Side effects of interferons may include flu-like symptoms and injection-site reactions.

Does Ocrevus affect the liver?

Ocrelizumab has not been associated with serum enzyme elevations during therapy nor with instances of idiosyncratic liver injury, but has been linked to cases of reactivation of hepatitis B in susceptible patients.

What is the J code for Ocrevus?

Drug: HCPCSCODEDESCRIPTIONJ2350Injection, ocrelizumab, 1 mg

What is Ocrevus infusion used for?

What is OCREVUS? OCREVUS is a prescription medicine used to treat: Relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults. Primary progressive MS, in adults.

What does Kesimpta do for MS?

Kesimpta® is a monoclonal antibody that binds to a docking site (CD20) on some immune B cells and depletes them. B cells are among immune cells that have been implicated in causing nervous system damage in MS.

Can Tysabri cause thrombocytopenia?

Cases of thrombocytopenia, including immune thrombocytopenic purpura (ITP), have been reported with the use of TYSABRI in the postmarketing setting. Symptoms of thrombocytopenia may include easy bruising, abnormal bleeding, and petechiae.

What is the OCREVUS Start Form?

The OCREVUS Start Form is required for enrollment in OCREVUS Access Solutions. To use Quick Enroll for the OCREVUS Start Form, select E-Submit.

How to download multiple files at once?

Download Selected. To download multiple files at once, select the checkbox next to each file you would like to download from the list above then click Download Selected. Documents will be downloaded as a .zip file.

What is the most important information I should know about OCREVUS?from ocrevuscopay.com

Infusion reactions: Infusion reactions are a common side effect of OCREVUS, which can be serious and may require you to be hospitalized. You will be monitored during your infusion and for at least 1 hour after each infusion of OCREVUS for signs and symptoms of an infusion reaction.

What is the management recommendation for infusion reactions?from ocrevuscopay.com

Management recommendations for infusion reactions depend on the type and severity of the reaction. Permanently discontinue OCREVUS if a life-threatening or disabling infusion reaction occurs.

What is ocrevus used for?from ocrevuscopay.com

What is OCREVUS? OCREVUS is a prescription medicine used to treat: Relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults. Primary progressive MS, in adults. It is not known if OCREVUS is safe and effective in children.

What are the most common adverse reactions?from ocrevuscopay.com

Most Common Adverse ReactionsRMS: The most common adverse reactions (≥10% and >REBIF): upper respiratory tract infections and infusion reactions.

Does ocrevus cause cancer?from ocrevuscopay.com

OCREVUS may cause serious side effects, including: Risk of cancers (malignancies) including breast cancer. Follow your healthcare provider’s instructions about standard screening guidelines for breast cancer. These are not all the possible side effects of OCREVUS. Call your doctor for medical advice about side effects.

Does ocrevus cause skin infections?from ocrevuscopay.com

Infection: OCREVUS increases your risk of getting upper respiratory tract infections, lower respiratory tract infections, skin infections, and herpes infections. Infections are a common side effect, which can be serious. Tell your healthcare provider right away if you have an infection.

How to contact Ocrevus?from ocrevuscopay.com

For more information, go to www.OCREVUS.com or call 1-844-627-3887.

What is the most important information I should know about OCREVUS?

Infusion reactions: Infusion reactions are a common side effect of OCREVUS, which can be serious and may require you to be hospitalized. You will be monitored during your infusion and for at least 1 hour after each infusion of OCREVUS for signs and symptoms of an infusion reaction.

Does ocrevus cause cancer?

OCREVUS may cause serious side effects, including: Risk of cancers (malignancies) including breast cancer. Follow your healthcare provider’s instructions about standard screening guidelines for breast cancer. These are not all the possible side effects of OCREVUS. Call your doctor for medical advice about side effects.

Can you delay treatment with ocrevus?

Your healthcare provider should delay your treatment with OCREVUS until your infection is gone. Decreased immunoglobulins: OCREVUS may cause a decrease in some types of immunoglobulins. Your healthcare provider will do blood tests to check your blood immunoglobulin levels.

Does ocrevus cause skin infections?

Infection: OCREVUS increases your risk of getting upper respiratory tract infections, lower respiratory tract infections, skin infections, and herpes infections. Infections are a common side effect, which can be serious. Tell your healthcare provider right away if you have an infection.

Is ocrevus safe for children?

Primary progressive MS, in adults. It is not known if OCREVUS is safe and effective in children.

How to contact Ocrevus?

For more information, go to www.OCREVUS.com or call 1-844-627-3887.

What is Genentech Patient Foundation?from ocrevus-hcp.com

The Genentech Patient Foundation helps people affected by serious medical conditions get the Genentech medicine they have been prescribed. If patients don’t have insurance coverage or have financial concerns and meet eligibility criteria, they may be able to get free medicine from the Genentech Patient Foundation.

How long after ocrevus infusion do you have to be monitored?from ocrevus.com

You will be monitored during your infusion and for at least 1 hour after each infusion of OCREVUS for signs and symptoms of an infusion reaction. Tell your healthcare provider or nurse if you get any of these symptoms: These infusion reactions can happen for up to 24 hours after your infusion.

What is Genentech copay?from ocrevus-hcp.com

Genentech co-pay programs provide financial assistance to eligible commercially insured patients to help with their co-pays, co-insurance, or other out-of-pocket (OOP) costs.

What to do if you have a baby and you have ocrevus?from ocrevus.com

If you have a baby and you received OCREVUS during your pregnancy, it is important to tell your baby’s healthcare provider about receiving OCREVUS so they can decide when your baby should be vaccinated. are pregnant, think that you might be pregnant, or plan to become pregnant.

How long after birth control can you use ocrevus?from ocrevus.com

It is not known if OCREVUS will harm your unborn baby. You should use birth control (contraception) during treatment with OCREVUS and for 6 months after your last infusion of OCREVUS. Talk with your healthcare provider about what birth control method is right for you during this time. Pregnancy Registry.

What is PML in MS?from ocrevus-hcp.com

PML is an opportunistic viral infection of the brain caused by the John Cunningham (JC) virus that typically only occurs in patients who are immunocompromised, and that usually leads to death or severe disability. Although no cases of PML were identified in OCREVUS clinical trials, JC virus infection resulting in PML has been observed in patients treated with other anti-CD20 antibodies and other MS therapies and has been associated with some risk factors (e.g., immunocompromised patients, polytherapy with immunosuppressants). At the first sign or symptom suggestive of PML, withhold OCREVUS and perform an appropriate diagnostic evaluation. MRI findings may be apparent before clinical signs or symptoms. Typical symptoms associated with PML are diverse, progress over days to weeks, and include progressive weakness on one side of the body or clumsiness of limbs, disturbance of vision, and changes in thinking, memory, and orientation leading to confusion and personality changes (per USPI).

What is PML in the brain?from ocrevus.com

PML is a rare brain infection that usually leads to death or severe disability. Tell your healthcare provider right away if you have any new or worsening neurologic signs or symptoms. These may include problems with thinking, balance, eyesight, weakness on 1 side of your body, strength, or using your arms or legs.

How long after ocrevus infusion do you have to be monitored?

You will be monitored during your infusion and for at least 1 hour after each infusion of OCREVUS for signs and symptoms of an infusion reaction. Tell your healthcare provider or nurse if you get any of these symptoms: itchy skin. rash. hives.

What to do if you have a baby and you have ocrevus?

If you have a baby and you received OCREVUS during your pregnancy, it is important to tell your baby’s healthcare provider about receiving OCREVUS so they can decide when your baby should be vaccinated. are pregnant, think that you might be pregnant, or plan to become pregnant.

What to tell your healthcare provider before taking Ocrevus?

Before receiving OCREVUS, tell your healthcare provider about all of your medical conditions, including if you: have ever taken, take, or plan to take medicines that affect your immune system, or other treatments for MS. have ever had hepatitis B or are a carrier of the hepatitis B virus.

What is the registry for Ocrevus?

Pregnancy Registry. There is a pregnancy registry for women who take OCREVUS during pregnancy. If you become pregnant while receiving OCREVUS, tell your healthcare provider right away. Talk to your healthcare provider about registering with the OCREVUS Pregnancy Registry. The purpose of this registry is to collect information about your health and your baby’s health. Your healthcare provider can enroll you in this registry by calling 1-833-872-4370 or visiting www.ocrevuspregnancyregistry.com.

What is PML in the brain?

PML is a rare brain infection that usually leads to death or severe disability. Tell your healthcare provider right away if you have any new or worsening neurologic signs or symptoms. These may include problems with thinking, balance, eyesight, weakness on 1 side of your body, strength, or using your arms or legs.

How do you know if you have herpes?

Signs of more serious herpes infection include : changes in vision, eye redness or eye pain, severe or persistent headache, stiff neck, and confusion. Signs of infection can happen during treatment or after you have received your last dose of OCREVUS. Tell your healthcare provider right away if you have an infection .

How long before you start treatment for hepatitis B?

have had a recent vaccination or are scheduled to receive any vaccinations. You should receive any required ‘live’ or ‘live-attenuated’ vaccines at least 4 weeks before you start treatment with OCREVUS.

What is Genentech copay?from ocrevus-hcp.com

Genentech co-pay programs provide financial assistance to eligible commercially insured patients to help with their co-pays, co-insurance, or other out-of-pocket (OOP) costs.

How long after ocrevus infusion do you have to be monitored?from ocrevus.com

You will be monitored during your infusion and for at least 1 hour after each infusion of OCREVUS for signs and symptoms of an infusion reaction. Tell your healthcare provider or nurse if you get any of these symptoms: These infusion reactions can happen for up to 24 hours after your infusion.

What is access solutions?from ocrevus-hcp.com

Access Solutions is committed to helping your patients access the Genentech medicines they need, providing assistance to your patients after OCREVUS is prescribed. For more information, download the Patient Navigator Roadmap or reach out to a Patient Navigator by calling 1-844-627-3887.

What to do if you have a baby and you have ocrevus?from ocrevus.com

If you have a baby and you received OCREVUS during your pregnancy, it is important to tell your baby’s healthcare provider about receiving OCREVUS so they can decide when your baby should be vaccinated. are pregnant, think that you might be pregnant, or plan to become pregnant.

How long after birth control can you use ocrevus?from ocrevus.com

It is not known if OCREVUS will harm your unborn baby. You should use birth control (contraception) during treatment with OCREVUS and for 6 months after your last infusion of OCREVUS. Talk with your healthcare provider about what birth control method is right for you during this time. Pregnancy Registry.

What is PML in MS?from ocrevus-hcp.com

PML is an opportunistic viral infection of the brain caused by the John Cunningham (JC) virus that typically only occurs in patients who are immunocompromised, and that usually leads to death or severe disability. Although no cases of PML were identified in OCREVUS clinical trials, JC virus infection resulting in PML has been observed in patients treated with other anti-CD20 antibodies and other MS therapies and has been associated with some risk factors (e.g., immunocompromised patients, polytherapy with immunosuppressants). At the first sign or symptom suggestive of PML, withhold OCREVUS and perform an appropriate diagnostic evaluation. MRI findings may be apparent before clinical signs or symptoms. Typical symptoms associated with PML are diverse, progress over days to weeks, and include progressive weakness on one side of the body or clumsiness of limbs, disturbance of vision, and changes in thinking, memory, and orientation leading to confusion and personality changes (per USPI).

What does a patient navigator do?from genentech-access.com

Your Patient Navigator can refer you to patient assistance options to help you afford the medicine you need.

What is Genentech Patient Foundation?

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

What are the services offered by Genentech?

Education and patient support services: Optional programs offered by Genentech to help you start and stay on your medicine. Services may vary based on your medical condition and could include co-pay assistance, clinical support, marketing communication and general disease information.

What is a 1B?

1B: Patient consent to enroll in optionaldisease-specific education, support programs, market research and communication that may be considered marketing. I understand my PII may be needed for me to participate in these programs.

What is a patient consent form?

Patient Consent Form– to be filled out by patient

What is household income?

Household income: How much you and the members of your household make each year minus specific deductions. This is also frequently referred to as your Adjusted Gross Income or AGI. This information is needed to determine Genentech Patient Foundation eligibility.

When does Genentech start supporting you?

Genentech can start supporting you when PAGE 4of this form is submitted by you or your doctor’s office in one of the following ways:

What is copay assistance?

Co-pay assistance: Programs available to help eligible patients pay for their medicines.

How long after ocrevus infusion do you have to be monitored?

You will be monitored during your infusion and for at least 1 hour after each infusion of OCREVUS for signs and symptoms of an infusion reaction.

Does ocrevus cause skin infections?

Infection: OCREVUS increases your risk of getting upper respiratory tract infections, lower respiratory tract infections, skin infections, and herpes infections. Infections are a common side effect, which can be serious. Tell your healthcare provider right away if you have an infection.

How to contact Ocrevus?

For more information, go to www.OCREVUS.comor call 1-844-627-3887.

Is ocrevus safe for children?

Primary progressive MS, in adults. It is not known if OCREVUS is safe and effective in children.

Can you delay treatment with ocrevus?

Your healthcare provider should delay your treatment with OCREVUS until your infection is gone. Decreased immunoglobulins: OCREVUS may cause a decrease in some types of immunoglobulins. Your healthcare provider will do blood tests to check your blood immunoglobulin levels.

Who owns the OCREVUS logo?

OCREVUS®and its logo are registered trademarks of Genentech, Inc.

How does Ocrevus work?from gene.com

Although the exact way OCREVUS works is not known, it is thought to work in MS by decreasing certain B cells which have the CD20 protein on its surface.

What is access solutions?from ocrevus-hcp.com

Access Solutions is committed to helping your patients access the Genentech medicines they need, providing assistance to your patients after OCREVUS is prescribed. For more information, download the Patient Navigator Roadmap or reach out to a Patient Navigator by calling 1-844-627-3887.

What is pregnancy exposure registry?from ocrevus-hcp.com

There is a pregnancy exposure registry that monitors pregnancy and fetal/neonatal/infant outcomes in women exposed to OCREVUS during pregnancy. ...

What is the cause of MS?from gene.com

MS is a chronic neurological disease for which there is no cure, and over time will lead to some level of disability in most people. 3,4 The cause of MS is unknown. In people with MS, the immune system attacks the insulation around nerve cells in the brain, spinal cord and/or optic nerves, causing inflammation and potentially debilitating symptoms. 4 The majority of people living with MS either have a relapsing form or PPMS at the time of diagnosis. 5 Relapsing forms of MS are characterized by episodes of new or worsening symptoms (relapses) followed by periods of recovery. 6 PPMS is a highly disabling form of MS characterized by steadily worsening symptoms, usually without periods of improvement/remission. 6

What is a therapeutic area manager?from ocrevus-hcp.com

Therapeutic Area Managers (Clinical Specialists): provide education on the science, safety, and efficacy behind OCREVUS, and support for the OCREVUS Co-pay Program

How long after birth control do you need to use ocrevus?from gene.com

It is not known if OCREVUS will harm your unborn baby. You should use birth control (contraception) during treatment with OCREVUS and for 6 months after your last infusion of OCREVUS. Talk with your healthcare provider about what birth control method is right for you during this time.

How to contact Patient Navigator?from ocrevus-hcp.com

For more information, download the Patient Navigator Roadmap or reach out to a Patient Navigator by calling 1-844-627-3887. If you're ready to enroll your patients in Access Solutions, complete the Start Form once you've written a prescription for OCREVUS. Get the Start Form.

What is PML in MS?

PML is an opportunistic viral infection of the brain caused by the John Cunningham (JC) virus that typically only occurs in patients who are immunocompromised, and that usually leads to death or severe disability. Although no cases of PML were identified in OCREVUS clinical trials, JC virus infection resulting in PML has been observed in patients treated with other anti-CD20 antibodies and other MS therapies and has been associated with some risk factors (e.g., immunocompromised patients, polytherapy with immunosuppressants). At the first sign or symptom suggestive of PML, withhold OCREVUS and perform an appropriate diagnostic evaluation. MRI findings may be apparent before clinical signs or symptoms. Typical symptoms associated with PML are diverse, progress over days to weeks, and include progressive weakness on one side of the body or clumsiness of limbs, disturbance of vision, and changes in thinking, memory, and orientation leading to confusion and personality changes (per USPI).

When should ocrevus be discontinued?

If serious herpes infections occur, OCREVUS should be discontinued or withheld until the infection has resolved, and appropriate treatment should be administered.

Is ocrelizumab in human milk?

There are no data on the presence of ocrelizumab in human milk, the effects on the breastfed infant, or the effects of the drug on milk production . Ocrelizumab was excreted in the milk of ocrelizumab-treated monkeys. Human IgG is excreted in human milk, and the potential for absorption of ocrelizumab to lead to B-cell depletion in the infant is unknown. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for OCREVUS and any potential adverse effects on the breastfed infant from OCREVUS or from the underlying maternal condition.

Does Ocrevus cause breast cancer?

An increased risk of malignancy with OCREVUS may exist. In controlled trials, malignancies, including breast cancer, occurred more frequently in OCREVUS-treated patients. Breast cancer occurred in 6 of 781 females treated with OCREVUS and none of 668 females treated with REBIF or placebo. Patients should follow standard breast cancer screening guidelines.

Can you use ocrevus after immunosuppressive therapy?

When initiating OCREVUS after an immunosuppressive therapy or initiating an immunosuppressive therapy after OCREVUS, consider the potential for increased immunosuppressive effect. OCREVUS has not been studied in combination with other MS therapies.

Does Ocrevus work for hepatitis B?

Perform HBV screening in all patients before initiation of treatment with OCREVUS. Do not administer OCREVUS to patients with active HBV confirmed by positive results for HBsAg and anti-HB tests. For patients who are negative for surface antigen [HBsAg] and positive for HB core antibody [HBcAb+] or are carriers of HBV [HBsAg+], consult liver disease experts before starting and during treatment.

Can a herpes infection occur with ocrevus?

Serious cases of infections caused by herpes simplex virus and varicella zoster virus, including central nervous system infections (encephalitis and meningitis), intraocular infections, and disseminated skin and soft tissue infections, have been reported in the postmarketing setting in multiple sclerosis patients receiving OCREVUS. Serious herpes virus infections may occur at any time during treatment with OCREVUS. Some cases were life-threatening.

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