Answers to Your Questions

Am I eligible for the program?

You qualify for the BioOncology Co-Pay Card Program if you are covered by commercial insurance (non-governmental), your insurance co-pay is over $100, your annual household income is $100,000 or less, and you are age 18 years or older.

There are legal limits regarding who may participate in programs like this. You are not eligible if you are uninsured, covered by a government-funded healthcare program (eg, Medicare Part D, Medicaid Medigap, VA, DoD, or Tricare), currently residing in Massachusetts, or currently participating in the Genentech Access to Care Foundation.

How does the program work?

We have made it as easy as possible for you to get the support you need from the BioOncology Co-Pay Card Program. You can activate the card by answering some questions by phone or on the Internet. Then, present this card to your pharmacist along with your prescription. If eligible, your co-pay amount will be reduced accordingly.

How much co-payment support will I receive if I am eligible for the program?

You pay: The Herceptin Co-Pay, plus any additional amount not covered by the program.

Program pays: Contributes 80% of total copay after the first $100.

Example: $500 co-pay: patient pays first $100; program pays 80% of remaining $400 (total patient cost = $180)

Program limit: Up to $4,000 in Herceptin Co-Pay support, which must be used within 1 year after you activate you card.

BioOncology Co-Pay Card Program

Co-payment support that makes a real difference

Indication and Safety Information

We are committed to ensuring that all eligible patients have access to the therapies they need. That is why we created the BioOncology Co-Pay Card Program, a program that gives eligible patients help with their monthly insurance co-payments for Herceptin.

If eligible, this program can reduce your monthly co-pays for up to one year, up to $4,000.
For patients with commercial insurance and co-pays over $100 per month.
Quick and simple program qualification and activation.

Eligibility - Can I use this program?

Please respond to the following statements to see if you are eligible for the BioOncology Co-Pay Card Program.

What if I am not eligible for the program?

We develop medicines for serious or life-threatening medical conditions and we believe they should be accessible to the patients who need them. At Herceptin Access Solutions, we are here to help find a way for you to get Herceptin, regardless of your ability to pay for it. If you have difficulty paying for co-pay for Herceptin, an Access Solutions specialist can refer you to an independent, nonprofit organization for financial assistance. Call us at 1-888-249-4918 weekdays, 6AM to 5PM PST or visit our Web site at www.HerceptinAccessSolutions.com for more information.

Who is Herceptin for?

Herceptin is approved for the adjuvant treatment of HER2-overexpressing, node-positive or node-negative (ER/PR-negative or with one high-risk feature)^† breast cancer. Herceptin can be used several different ways:

As part of a treatment regimen including doxorubicin, cyclophosphamide, and either paclitaxel or docetaxel
With docetaxel and carboplatin
As a single agent following multi-modality anthracycline-based therapy

Herceptin in combination with paclitaxel is approved for the first-line treatment of HER2-overexpressing metastatic breast cancer. Herceptin as a single agent is approved for treatment of HER2-overexpressing breast cancer in patients who have received one or more chemotherapy regimens for metastatic disease.

† High-risk is defined as ER/PR positive with one of the following features: tumor size >2 cm, age <35 years, or tumor grade 2 or 3.

What important safety information should I know about Herceptin?

Herceptin treatment can result in heart problems, including those without symptoms (reduced heart function) and those with symptoms (congestive heart failure). The risk and seriousness of these heart problems were highest in people who received both Herceptin and a certain type of chemotherapy (anthracycline). Your doctor will stop or strongly consider stopping Herceptin if you have a significant drop in your heart function.

You should be monitored for decreased heart function before your first dose of Herceptin, and frequently during the time you are receiving Herceptin and after your last dose of Herceptin. If you must permanently or temporarily stop Herceptin due to heart problems, you should be monitored more frequently. In one study with Herceptin and certain types of chemotherapy, an inadequate blood supply to the heart occurred.

Some patients have had serious infusion reactions and lung problems; fatal infusion reactions have been reported. In most cases, these reactions occurred during or within 24 hours of receiving Herceptin. Your Herceptin infusion should be temporarily stopped if you have shortness of breath or very low blood pressure. Your doctor will monitor you until these symptoms go away. If you have a severe allergic reaction, swelling, lung problems, inflammation of the lung, or severe shortness of breath, your doctor may need to completely stop your Herceptin treatment.

Worsening of low white blood cell counts associated with chemotherapy has also occurred.

Herceptin can cause low amniotic fluid levels and harm to the fetus when taken by a pregnant woman.

The most common side effects associated with Herceptin were fever, nausea, vomiting, infusion reactions, diarrhea, infections, increased cough, headache, fatigue, shortness of breath, rash, low white and red blood cells, and muscle pain.

Because everyone is different, it is not possible to predict what side effects any one person will have. If you have questions or concerns about side effects, talk to your doctor.

Please see the Herceptin full Prescribing Information including Boxed WARNINGS and additional important safety information.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088, or Genentech at 1-888-835-2555

	Yes	No
I am covered by commercial insurance. To answer "yes," you must not be covered by a government-funded healthcare program (such as Medicare Part D, Medicaid Medigap, VA, DoD, and Tricare [or any other federal- or state-funded benefit programs]) or already receiving benefits from the Genentech Access to Care Foundation.
My insurance co-pay for Herceptin is over $100
My annual household income is $100,000 or less
I am age 18 years or older
I currently live in either Puerto Rico or the United States, but not in Massachusetts. Massachusetts state law does not allow programs like this.
You are eligible if you answered "Yes" to all of the above. Please speak with your Healthcare Provider for more information or apply through BioOncology Acess Solutions. Call us at 1-888-249-4918 weekdays, 6AM to 5PM PST.