Genentech Access Solutions is your resource for access and
reimbursement support services
Genentech Access Solutions provides effective access and reimbursement services to assist your patients and practice
At Genentech Access Solutions, we are dedicated to ensuring our
medications are accessible for the patients who need them. Once we
have received the completed and signed Statement of Medical Necessity
form and the Patient Authorization and Notice of Release of
Information (PAN) form,* your dedicated Genentech Access Solutions
- Complete an initial benefits investigation (BI), if requested
- Identify necessary prior authorizations (PAs)
- Provide you with resources for the appeals process, should it become necessary
- Refer patients to the appropriate patient
assistance option, if needed
*Only the information requested on these forms is required. Providing additional documents or information will delay processing.
Find patient assistance*
Our patient assistance options help eligible patients with
commercial insurance, public insurance or no insurance.
Is your patient insured?
Does your patient have commercial insurance?What does this mean?
Has your patient already been referred to the Genentech BioOncology Co-pay Card and is either ineligible or no longer receiving assistance?
Has your patient already been referred to an independent co-pay assistance foundation and is either ineligible or no longer receiving assistance?
Is the patient 18 years of age or older?
Your Patient Might Qualify for a Referral to the Genentech BioOncology Co-pay Card
If eligible commercially insured patients need assistance with their out-of-pocket costs, Erivedge Access Solutions can refer them to the Genentech BioOncology Co-pay Card.*
*In order to be eligible for the Genentech BioOncology Co-pay Card, the patient must have commercial insurance, must not have Medicare, Medicaid or other government insurance, and must meet other eligibility criteria. They also must agree to the rules set forth in the terms and conditions for the program. Please visit CopayAssistanceNow.com for the full list of terms and conditions.
Your Patient Might Qualify for a Referral to an Independent Co-pay Assistance Foundation
For eligible patients with commercial or public health insurance, Erivedge Access Solutions offers referrals to independent co-pay assistance foundations.*
*Genentech does not influence or control the operations or eligibility criteria of any independent co-pay assistance foundation and cannot guarantee co-pay assistance after a referral from Erivedge Access Solutions. The foundations to which we refer patients are not exhaustive or indicative of Genentech’s endorsement or financial support. There may be other foundations to support the patient's disease state.
Your Patient Might Qualify for a Referral to the Genentech® Access to Care Foundation (GATCF)
GATCF helps eligible patients who meet specific criteria receive their Genentech medicine free of charge.*
*To be eligible for free Genentech medicine from GATCF, insured patients must have exhausted all other forms of patient assistance (including the Genentech BioOncology Co-pay Card and support from independent co-pay assistance foundations) and meet financial criteria. Uninsured patients must meet different financial criteria.
*All assistance programs are subject to eligibility criteria.
Patient assistance programs*
If you are already aware of the appropriate assistance program for your patient, select the relevant option below:
Genentech offers the Genentech BioOncology Co-pay Card, which may help qualified patients with the costs associated with their Erivedge prescription.Learn more >
Referrals to Co-Pay Assistance Foundations
Access Solutions offers referrals to independent co-pay assistance
foundations† for eligible patients who are commercially
or publicly insured, including those covered by Medicare and
The Genentech® Access to Care Foundation (GATCF)
GATCF provides free medicine to eligible patients who are
uninsured, rendered uninsured by payer denial or underinsured. To
qualify, patients must meet specific criteria.‡
*All assistance programs are subject to eligibility criteria.
†Genentech does not influence or control the operations or eligibility criteria of any independent co-pay assistance foundation and cannot guarantee co-pay assistance after a referral from Genentech Access Solutions. The foundations to which we refer patients are not exhaustive or indicative of Genentech's endorsement or financial support. There may be other foundations to support the patient's disease state.
‡To be eligible for free medicine from GATCF, insured patients must have exhausted all other forms of patient assistance (including Genentech brand-specific co-pay cards and support from independent co-pay assistance foundations) and meet additional criteria.
Enroll in services
Erivedge Access Solutions enrollment forms
The Statement of Medical Necessity and Patient Authorization and Notice of Release of Information forms are required for enrollment in Erivedge Access Solutions.
To learn more about Erivedge Access Solutions or to enroll a patient, you can:
- Speak live to a Support Specialist at (888) 249-4918, 6 AM to 5 PM PT, Monday through Friday
- Visit ErivedgeAccessSolutions.com
Additional assistance for your patients
Co-pay card for privately insured patients*
Genentech offers the Genentech BioOncology Co-pay Card to help qualified patients with the out-of-pocket costs associated with their Erivedge prescription.
Some health plans might not accept a co-pay card. Patients should contact their insurance provider to find out if their plan allows the use of co-pay cards.
To verify your patients' eligibility or to enroll them in the Co-pay
Card Assistance Program, call
(855) MYCOPAY/(855) 692-6729, 6 AM to 5 PM PT, Monday through Friday or click Get Started.
*Not available for patients covered by federally funded health insurance. Patients who purchase health insurance through a state or federal exchange pursuant to the ACA can qualify to use the Co-pay Card.
The Erivedge Cares Program is a free program designed to support you throughout treatment by providing educational resources and other tools.
Two convenient ways for patients to enroll
The Erivedge Cares Program is for educational purposes only; it is not intended to provide medical advice or to be a substitute for the guidance you provide to your patients.
Encourage your patients to enroll in the Erivedge Cares Program today
Erivedge® (vismodegib) capsule is indicated for the treatment of adults with metastatic basal cell carcinoma, or with locally advanced basal cell carcinoma that has recurred following surgery or who are not candidates for surgery, and who are not candidates for radiation.
BOXED WARNING AND ADDITIONAL IMPORTANT SAFETY INFORMATION
- Erivedge can cause embryo-fetal death or severe birth defects when administered to a pregnant woman. Erivedge is embryotoxic, fetotoxic, and teratogenic in animals. Teratogenic effects included severe midline defects, missing digits, and other irreversible malformations
- Verify pregnancy status of females of reproductive potential within 7 days prior to initiating Erivedge therapy. Advise females of reproductive potential to use effective contraception during and after Erivedge therapy. Advise males of the potential risk of Erivedge exposure through semen and to use condoms with a pregnant partner or a female partner of reproductive potential. Advise pregnant women of the potential risks to a fetus
- Advise female patients and female partners of male patients to contact their healthcare provider with a known or suspected pregnancy. Report pregnancies to Genentech at (888) 835‑2555
- Advise females of reproductive potential to use effective contraception during therapy with Erivedge and for 24 months after the final dose
- Advise males of the potential risk to an embryo or fetus if a female partner of reproductive potential is exposed to Erivedge. Advise male patients to use condoms with a pregnant partner or a female partner of reproductive potential, even after a vasectomy, during therapy and for 3 months after the final dose of Erivedge
- Advise patients not to donate blood or blood products while receiving Erivedge and for 24 months after the final dose of Erivedge
- Vismodegib is present in semen. It is not known if the amount of vismodegib in semen can cause embryo-fetal harm. Advise male patients not to donate semen during and for 3 months after the final dose of Erivedge
Premature Fusion of the Epiphyses
- Premature fusion of the epiphyses has been reported in pediatric patients exposed to Erivedge. In some cases, fusion progressed after drug discontinuation
- The most common adverse reactions (≥10%) were muscle spasms, alopecia, dysgeusia, weight loss, fatigue, nausea, diarrhea, decreased appetite, constipation, arthralgias, vomiting, and ageusia
- Amenorrhea can occur in females of reproductive potential. Reversibility of amenorrhea is unknown. In clinical trials, a total of 3 of 10 pre-menopausal women developed amenorrhea while receiving Erivedge
- Treatment-emergent Grade 3 laboratory abnormalities observed in clinical trials were hyponatremia in 6 patients (4%), hypokalemia in 2 patients (1%), and azotemia in 3 patients (2%)
- Additionally, in a post-approval clinical trial conducted in 1232 patients with locally advanced or metastatic BCC treated with Erivedge, a subset of 29 patients had baseline values for CPK reported. Within the subset of patients, 38% had a shift from baseline, and one of the patients had a Grade 3 value. The prevalence of Grade 3/4 CPK elevation across the entire study population with any CPK measurement was 2.4% (11 out of 453 patients)
Use in Specific Populations
- No data are available regarding the presence of vismodegib in human milk, the effects of the drug on the breastfed infant, or the effects of the drug on milk production. Because of the potential for serious adverse reactions in breastfed infants from Erivedge, advise a nursing woman that breastfeeding is not recommended during therapy with Erivedge and for 24 months after the final dose