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*

Esbriet Co-Pay Assistance

For people with public health insurance or commercial health insurance





THE EXTRA HELP PROGRAM FROM MEDICARE
 

Esbriet and Medicare Part D

For people with
Medicare Part D and
a limited income




 


THE ESBRIET $5
CO-PAY PROGRAM‡§
 
 

Esbriet $5 Co-Pay Program

For people with commercial health insurance

With this program, you pay as little as $5 for Esbriet, up to a $25,000 yearly limit


THE GENENTECH PATIENT FOUNDATION||
 

Esbriet Financial Assistance

For people who don’t have insurance coverage or who have financial concerns




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.

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.

For people with commercial health insurance

The Esbriet $5 Co-pay Program§

§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 costs.

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. This Program is void where prohibited by law. Genentech reserves the right to rescind, revoke, or amend the Program without notice at any time. Additional eligibility criteria apply. See full terms and conditions at EsbrietCopay.com.

For people with no health insurance or no coverage for Esbriet

The Genentech Patient Foundation||

||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.