COMMITTED TO HELPING YOU FIND ASSISTANCE OPTIONS FOR ESBRIET

Find out what your insurance covers and where to get extra assistance

Esbriet Access Solutions is a program that helps people who are taking Esbriet® (pirfenidone). Esbriet 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.

Some financial assistance options

REFERRALS TO INDEPENDENT CO-PAY ASSISTANCE FOUNDATIONS*

For people with public health insurance or commercial health insurance

THE EXTRA HELP PROGRAM FROM MEDICARE

For people with Medicare Part D and a limited income

THE ESBRIET $5 CO-PAY PROGRAM

For people with commercial health insurance

THE GENENTECH® ACCESS TO CARE FOUNDATION (GATCF)§

For people with no health insurance, or people with health insurance who have trouble paying for Esbriet

For people with public health insurance or commercial health insurance

Referrals to independent co-pay assistance foundations*

*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 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.

For people with commercial health insurance

The Esbriet $5 Co-pay Program

The Esbriet $5 Co-pay Program is available only for commercially insured patients. Patients using Medicare, Medicaid or any other government-funded program to pay for their medications are not eligible. It requires a valid, on-label prescription and cannot be combined with any other rebate/coupon, free trial or similar offer for the specified prescription. It is available only for a patient (or their guardian) who is 18 years or older. It is not valid for medications the patient receives for free or that are eligible to be reimbursed by private insurance plans or other health care or pharmaceutical assistance programs that reimburse the patient in whole or in part for the medication. It is valid only for Genentech products in the United States and Puerto Rico. The Esbriet $5 Co-pay Program is not health insurance or a benefit plan. Please see full terms and conditions at EsbrietCopay.com.

For people with no health insurance or no coverage for Esbriet

The Genentech® Access to Care Foundation (GATCF)§

§If you have health insurance, you must have already tried other types of patient assistance to qualify for free Genentech medicine from GATCF. This includes the Esbriet $5 Co-pay Program and support from independent co-pay assistance foundations. You must also meet financial criteria. If you do not have insurance, you must meet different financial criteria.