Tarceva Co-Pay Card Program

Answers to your questions

Am I eligible for the program?

You qualify for the Tarceva Co-Pay Card Program if you are covered by commercial insurance (non-governmental), your insurance co-pay is over $200, 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 Tarceva 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 Tarceva Co-Pay, plus any additional amount not covered by the program.

Program pays: Up to $800 per month toward your Tarceva co-pay.

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

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 effective, safe, and accessible to the patients who need them. At Tarceva Access Solutions, we are here to help find a way for you to get Tarceva, regardless of your ability to pay for it. If you have difficulty paying for co-pay for Tarceva, 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.TarcevaAccessSolutions.com for more information.

Tarceva Indications and Use

NSCLC

Tarceva is prescribed as a single agent for patients with advanced-stage non-small cell lung cancer (NSCLC) who have received at least one previous chemotherapy regimen.

Pancreatic Cancer

Tarceva in combination with gemcitabine is prescribed for patients who have not received previous chemotherapy for locally advanced pancreatic cancer, pancreatic cancer that cannot be surgically removed, or pancreatic cancer that has spread to distant body organs.

Important Information to Know

In clinical studies, there were infrequent reports of serious lung injuries similar to Interstitial Lung Disease (ILD)-like events. Reports of ILD-like events have been serious and have included deaths in patients receiving Tarceva.

Liver and/or kidney problems (including deaths) have been reported in some patients taking Tarceva. Let your doctor know if you have a history of liver or kidney disease.

Patients receiving Tarceva plus gemcitabine were more likely to experience bleeding and clotting problems such as heart attack or stroke.

Tarceva may cause harm to an unborn baby or may cause possible risk of pregnancy loss. Women should avoid becoming pregnant and avoid breastfeeding while taking Tarceva.

You should call your doctor right away if you have these signs or symptoms: new or worsening skin rash; serious or ongoing diarrhea, nausea, loss of appetite, or vomiting; new or worsening shortness of breath or cough; fever; eye irritation.

If you smoke, you should stop smoking while taking Tarceva, as it may affect how well Tarceva works for you. If you continue to smoke, you should speak to your doctor before taking Tarceva.

Let your doctor know if you are taking other prescription or over-the-counter drugs or herbal supplements before you start taking Tarceva. While taking Tarceva, do not start taking any new drugs or herbal supplements before talking to your doctor.

Rash and diarrhea were the most common side effects associated with Tarceva in the non-small cell lung cancer clinical study.

Fatigue, rash, nausea, loss of appetite, and diarrhea were the most common side effects associated with Tarceva plus gemcitabine therapy in the pancreatic cancer clinical study.

Tarceva is not right for everyone. Ask your doctor if once-daily Tarceva is right for you.

Please see the Tarceva full prescribing information for complete safety information.

Terms & Conditions

Patients must present their card to the pharmacist along with their prescription to participate in this program. Use of the card does not obligate anyone to use or continue using any specific product or provider. If you have any questions regarding your eligibility or benefits or if you wish to discontinue your participation, call the Tarceva Co-Pay Card Program at 1-866-827-0612 (8:00AM - 8:00PM EST, Monday-Friday). You may receive additional program information about the Tarceva Co-Pay Card Program at 1-866-827-0612 (8:00AM - 8:00PM EST, Monday-Friday).

No person or entity may seek reimbursement from any third-party payer for any amount provided using the card program. Genentech USA, Inc., and OSI Pharmaceuticals, Inc., reserve the right to deny payment under the card to anyone deemed ineligible in accordance with the stated program criteria.

	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 Tarceva is over $200
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.