BioOncology Co-Pay Card Program

Co-payment support for your patients taking Herceptin

The following frequently asked questions provide an overview of the BioOncology Co-Pay Card Program and how it can help your patients.

How does the program work?

Your practice gives eligible patients a brochure with an enclosed BioOncology Co-Pay Card at the time the prescription is written.
Eligible patients can then activate the card by phone or on the Internet before the prescription is filled.
The patient presents the activated card, along with their prescription, to the pharmacist and their co-pay amount will be reduced accordingly.

Who is eligible?

Eligible

Covered by commercial insurance (non-governmental) AND
Co-pay for Herceptin over $100 AND
Live in Puerto Rico or the United States AND
Annual household income of $100,000 or less AND
Age 18 years or older

Not Eligible

Participating in Medicare D, Medicaid Medigap, VA, DoD, and Tricare (or any other federal- or state-funded benefit programs) OR
Uninsured OR
Currently residing in Massachusetts OR
Currently participating in the Genentech Access to Care Foundation

How much does the program cover if my patient is eligible?

Patient responsiblity	The first $100 per month of their Herceptin co-pay, plus any additional amount not covered by the program.
Program pays	No monthly limit; program pays 80% of remaining copay after the first $100.
Program limit	Up to $4000 in Herceptin co-pay support, which must be used within 1 year after patient activates their card.

How do I explain to patients how this program works?

Eligibility	Be sure to highlight the need for commercial insurance with a co-pay of over $100.
Program limits	Program pays up to 80% of the remaining copay after the first $100, up to $4000 per year. Patients must pay first $100 per month, plus amount not covered by program.
Getting started	Patient activates card, then presents the card, along with their prescription, to the pharmacist.

Where do I get BioOncology Co-Pay Cards?

Please speak with your Herceptin Sales Representative.

What about my Herceptin patients who are not eligible for this 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 to your patients, regardless of their ability to pay for it. If your patients have difficulty paying their co-pay for Herceptin, an Access Solutions specialist can refer them to an independent, nonprofit organization for financial assistance. Call us at 1-888-249-4918 weekdays, 6 AM to 5 PM PST or visit our Web site at www.HerceptinAccessSolutions.com for more information.

Boxed WARNINGS and Additional Important Safety Information

Cardiotoxicity and Cardiac Monitoring
Herceptin administration can result in sub-clinical and clinical cardiac failure manifesting as congestive heart failure (CHF) and decreased left ventricular ejection fraction (LVEF).
- The incidence and severity of left ventricular cardiac dysfunction was highest in patients who received Herceptin concurrently with anthracycline-containing chemotherapy regimens.
- Discontinue Herceptin treatment in patients receiving adjuvant therapy and strongly consider discontinuation of Herceptin in patients with metastatic breast cancer who develop a clinically significant decrease in left ventricular function.
Patients should undergo monitoring for decreased left ventricular function before Herceptin treatment, and frequently during and after Herceptin treatment.
- More frequent monitoring should be employed if Herceptin is withheld in patients who develop significant left ventricular cardiac dysfunction.
In one adjuvant clinical trial, cardiac ischemia or infarction occurred in the Herceptin-containing regimens.

Infusion Reactions, Pulmonary Toxicity and Neutropenia
Serious infusion reactions and pulmonary toxicity have occurred; fatal infusion reactions have been reported.
- In most cases, symptoms occurred during or within 24 hours of administration of Herceptin. Herceptin infusion should be interrupted for patients experiencing dyspnea or clinically significant hypotension.
- Patients should be monitored until signs and symptoms completely resolve.
- Discontinue Herceptin for infusion reactions manifesting as anaphylaxis, angioedema, interstitial pneumonitis, or acute respiratory distress syndrome.
Exacerbation of chemotherapy-induced neutropenia has also occurred.

Pregnancy Category D

Herceptin can cause oligohydramnios and fetal harm when administered to a pregnant woman.

Most Common Adverse Events

The most common adverse reactions associated with Herceptin use were fever, nausea, vomiting, infusion reactions, diarrhea, infections, increased cough, headache, fatigue, dyspnea, rash, neutropenia, anemia, and myalgia.

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

References:
1. Sliwkowski MX, Lofgren JA, Lewis GD, Hotaling TE, Fendly BM, Fox JA. Nonclinical studies addressing the mechanism of action of trastuzumab (Herceptin). Semin Oncol. 1999;26(suppl 12):60-70.
2. Yakes FM, Chinratanalab W, Ritter CA, et al. Herceptin-induced inhibition of phosphatidylinositol-3 kinase and AktIs required for antibody-mediated effects on p27, cyclin D1, and antitumor action. Cancer Res.2002; 62(14):4132-4141.
3. Arnould L, Gelly M, Penault-Llorca F, et al. Trastuzumab-based treatment of HER2+ breast cancer: an antibody-dependent cellular cytotoxicity mechanism? Br J Cancer.2006;94(2):259-267.
4. Bianco AR. Targeting c-erbB2 and other receptors of the c-erb B family: rationale and clinical applications. JChemother. 2004; 16 Suppl 4:52-54.