Access Programs for Peginterferon alfa-2a
Drug Company Assistance
The (GATCF) helps patients who are uninsured or have been denied coverage access peginterferon alfa-2a either for free or at reduced cost. To be eligible, a patient must either have been denied coverage or have no insurance, have an annual adjusted household income of less than $100,000, and meet certain medical criteria.
Applying for the GATCF requires a few steps. First, the healthcare provider must complete the statement of medical necessity form and the patient authorization and notice of release of information form. These forms can be submitted through the , or they can be faxed to 1-888-929-3334. After the forms are received, a representative will contact the patient to verify their financial circumstances. If you have questions, please call 1-888-249-4918, Monday through Friday from 6:00 AM to 5:00 PM PST.
Some patients with insurance may also qualify for the Genentech Copay Card. To check eligibility or enroll in the program, please call 1-888-202-9939.
Foundation Assistance
also offers co-pay assistance for patients needing peginterferon alfa-2a. Please read the , and then follow the prompts on the .
