COMMITTED TO HELPING YOU FIND ASSISTANCE OPTIONS FOR ESBRIET
Find out what your insurance covers and where to get extra assistance
Genentech Access Solutions is a program that helps people who are taking Esbriet® (pirfenidone). Genentech Access Solutions can help you understand if your health insurance covers Esbriet, and refer you to patient assistance options if you are eligible.
Even with health insurance, you may still have concerns about treatment costs. If you are eligible, there may be options to help you pay for Esbriet.
or Call 1-844-My-Esbriet (1-844-693-7274) and press 2
For people with commercial health insurance
The Esbriet $5 Co-pay Program helps people with commercial health insurance*
You pay as little as $5 for a 30-day supply of Esbriet
The rest of your co-pay or co-insurance is covered, up to a $25,000 yearly limit
There are no income requirements for this program
To learn if you're eligible for the Esbriet $5 Co-pay Program:
Call 1-844-My-Esbriet (1-844-693-7274) and press 2
Visit EsbrietCopay.com
*This Esbriet $5 Co-pay Program is valid ONLY for patients with commercial insurance who have a valid prescription for a Food and Drug Administration
(FDA)-approved indication of a Genentech medication. Patients using Medicare, Medicaid or any other federal or state government program to pay for their medications are not eligible.
Under the program, the patient will pay a co-pay. After reaching the maximum program benefit, the patient will be responsible for all out-of-pocket expenses.
All participants are responsible for reporting the receipt of all program benefits as required by any insurer or by law. No party may seek reimbursement for all or any part of the benefit received through this Program. The program is only valid in the United States and U.S. Territories. This program is void where prohibited by law and shall follow state restrictions in relation to AB-rated generic equivalents (e.g., MA, CA) where applicable. The patient, guardian, prescriber, hospital and any other person using the program agree not to seek reimbursement for all or any part of the benefit received by the patient through the offer of this program. Genentech reserves the right to rescind, revoke or amend the program without notice at any time. Additional terms and conditions apply. Please visit EsbrietCopay.com for the full list of Terms and Conditions.
For people with public health insurance or commercial insurance
Independent co-pay assistance foundations help people with public or commercial health insurance†
Charitable organizations that provide financial assistance for medicines*
Usually provide assistance for a full year
You can apply to a foundation on your own, or if you are eligible, Genentech Access Solutions can refer you to one
Call 1-844-My-Esbriet (1-844-693-7274) and press 2
†Independent co-pay assistance foundations have their own rules for eligibility. We cannot guarantee a foundation will help you. We can only refer you to a foundation that supports your disease state. We do not endorse or show financial preference for any particular foundation. The foundations we refer you to are not the only ones that might be able to help you.
For people with Medicare Part D and a limited income
The Extra Help program from Medicare
The Extra Help program from Medicare helps people with Medicare Part D
and limited incomes†
Helps people with Medicare prescription drug plans who meet certain income and resource limits
If you qualify, your co-pay for brand name drugs, including Esbriet, could be $8.95 in 20201†
For more information or to apply for Extra Help, contact Social Security
†The Medicare Extra Help program is not a Genentech program. It is administered by the Social Security Administration. The co-pay amount for Medicare Extra Help changes each year.
Reference: 1. Medicare.gov. Save on drug costs. https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/save-on-drug-costs. Accessed January 9, 2019 to July 21, 2020.
For people with no health insurance or no coverage for Esbriet
The Genentech Patient Foundation helps people affected by serious medical conditions get the Esbriet they need‡
The Genentech Patient Foundation gives eligible patients their
Esbriet free of charge
One form is all you need to enroll in the Genentech Patient Foundation
To apply for the Genentech Patient Foundation, you must enroll in Esbriet Access Solutions. Learn more here:
Call 1-844-My-Esbriet (1-844-693-7274) and press 2
‡To be eligible for free Genentech medicine from the Genentech Patient Foundation, insured patients who have coverage for their medicine must have exhausted all other forms of patient assistance (including the Esbriet $5 Co-pay Program and support from independent co-pay assistance foundations) and must meet certain financial criteria. Uninsured patients and insured patients without coverage for their medicine must meet different financial criteria.
"My doctor and his staff helped me connect with Genentech Access Solutions. The people there went over my financial situation and we found an assistance program that I was eligible for. Now, everyone's financial situation is different, and this is just my experience."
Dave
Esbriet Ambassador
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QUESTIONS ABOUT ESBRIET
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Centers for Medicare & Medicaid Services. Advance notice of methodological changes for calendar year (CY) 2018 for Medicare Advantage (MA) capitation rates, Part C and Part D payment policies and 2018 call letter. https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Advance2018.pdf. Posted February 1, 2017. Accessed October 17, 2017.
Centers for Medicare & Medicaid Services. Advance notice of methodological changes for calendar year (CY) 2018 for Medicare Advantage (MA) capitation rates, Part C and Part D payment policies and 2018 call letter. https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Advance2018.pdf. Posted February 1, 2017. Accessed October 17, 2017.
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