Financial Assistance with XOLAIR Co-Pay Card Program

Help your eligible patients with high co-pay concerns

Learn more:

Please see product and important safety information

Program Overview
The XOLAIR Co-Pay Card Program is set up to help XOLAIR patients who have expressed concerns about their co-payments. It is available through participating:

The XOLAIR caseworkers at the participating Specialty Pharmacies (SPs) are fully trained on the program.

The XOLAIR Co-Pay Card offers patients assistance with OOP costs, including co-insurance and co-payment coverage. Eligible patients may have access to up to $4,000 over a period of 12 consecutive months to assist with their co-payment.

Patients are responsible for 20% of their co-payment (eg, for a co-payment of $100, a patient would pay $20).

Participating patients in the program will receive notification approximately 2 months prior to when their co-pay card nears its exhaustion limit. Patients may re-enroll when their 12 consecutive enrollment months have elapsed.

Qualified Participants
The XOLAIR Co-Pay Card Program is available through:

  • Participating Specialty Pharmacies (SPs)
  • Alternate Injection Centers (AICs)
  • Hospital-based Outpatient Departments (HOPDs)
  • Healthcare Providers (HCPs)

Eligibility Requirements:

  • Patients must receive XOLAIR through a participating SP or HCP
  • Must be aged 12 years or older
  • Must not reside or receive treatment in Massachusetts
  • May not be a participant in charitable fund sources (ie, Genentech® Access to Care Foundation [GATCF])
  • May not be a participant in any state or federally funded healthcare programs such as Medicare, Medicaid, or Tricare

Union employees are eligible for the XOLAIR Co-Pay Card provided that the federal or state government does not pay for their insurance.

In addition, the XOLAIR Co-Pay Card Program is separate and may
not be combined with charitable fund sources, including Genentech® Access to Care Foundation. GATCF is a program for patients without insurance or for those patients whose insurance will not cover XOLAIR therapy.


If you or your patients/caregivers have any questions or concerns about the program, please call us at
1-877-411-8641.

Enrollment process
The enrollment process takes place during a single phone call between the SP or HCP and the patient/caregiver. See the information below for the SP process:

 
  SP process:    
       
 
  1. Patient contacted by participating SP upon XOLAIR approval.
  2. Patient expresses co-pay concern.
  3. SP describes Co-Pay Card Program and then logs onto secure website.
  4. Enrollment eligibility rules are verified online.
  5. Patient eligibility for XOLAIR Co-Pay Card Program established.
  6. SP inputs patient’s phone number to generate contact information.
  7. Card “TT0000008” assigned to patient.
    
       
 
  AIC, HOPD, and HCP Process:    
       
 
  1. The office must register patients for the XOLAIR Co-Pay Card by calling 1-877-411-8641.
  2. Access to a credit card terminal will be required.
  3. A help-desk representative will assist with inputting the card information.
  4. The office is then provided a merchant ID/account to begin the processing of debit cards.
  5. A card is then assigned to the patient.
    
       

For a list of participating specialty pharmacies, click here.

For more information on the XOLAIR Co-Pay Card Program, click here.

*Genentech Inc. and Novartis Pharmaceuticals Corporation have
the right to cancel this program at any time.

INDICATION
XOLAIR® (omalizumab) for subcutaneous use IS INDICATED FOR adults and adolescents (12 years of age and above) with moderate to severe persistent asthma who have a positive skin test or in vitro reactivity to a perennial aeroallergen and whose symptoms are inadequately controlled with inhaled corticosteroids.

XOLAIR has been shown to decrease the incidence of asthma exacerbations in these patients.

Important Limitations of Use
XOLAIR is not indicated for treatment of other allergic conditions
XOLAIR is not indicated for the relief of acute bronchospasm or status asthmaticus
XOLAIR is not indicated for use in pediatric patients less than 12 years of age

IMPORTANT SAFETY INFORMATION

WARNING: Anaphylaxis

Anaphylaxis presenting as bronchospasm, hypotension, syncope, urticaria, and/or angioedema of the throat or tongue, has been reported to occur after administration of XOLAIR. Anaphylaxis has occurred as early as after the first dose of XOLAIR, but also has occurred beyond 1 year after beginning regularly administered treatment. Because of the risk of anaphylaxis, observe patients closely for an appropriate period of time after XOLAIR administration. Healthcare providers administering XOLAIR should be prepared to manage anaphylaxis that can be life-threatening. Inform patients of the signs and symptoms of anaphylaxis and instruct them to seek immediate medical care should symptoms occur (see Warnings and Precautions: Anaphylaxis).

XOLAIR should only be administered in a healthcare setting by healthcare providers prepared to manage anaphylaxis that can be life-threatening.
XOLAIR should not be administered to patients who have experienced a severe hypersensitivity reaction to XOLAIR or any ingredient of XOLAIR (see Warnings and Precautions). XOLAIR should be discontinued in patients who experience a severe hypersensitivity reaction.
Malignant neoplasms were observed in 20 of 4127 (0.5%) XOLAIR-treated patients compared with 5 of 2236 (0.2%) control patients in clinical studies of asthma and other allergic disorders.
XOLAIR has not been shown to alleviate asthma exacerbations acutely. Do not use XOLAIR to treat acute bronchospasm or status asthmaticus.
A constellation of signs and symptoms including arthritis/arthralgia, rash (urticaria or other forms), fever and lymphadenopathy similar to serum sickness have been reported in postapproval use of XOLAIR in some patients. Physicians should stop XOLAIR if a patient develops this constellation of signs and symptoms.
Patients should be given and instructed to read the accompanying Medication Guide before starting treatment and before each subsequent treatment.
Do not abruptly discontinue corticosteroid use upon initiation of XOLAIR therapy. Decrease corticosteroids gradually under the direct supervision of a physician.
In patients >12 years of age, the most commonly observed adverse reactions (>1% more frequent in XOLAIR-treated patients) from 4 placebo-controlled asthma studies were arthralgia (8%), pain (general) (7%), leg pain (4%), fatigue (3%), dizziness (3%), fracture (2%), arm pain (2%), pruritus (2%), dermatitis (2%), and earache (2%).
The adverse events most frequently resulting in clinical intervention (eg, discontinuation of XOLAIR, or the need for concomitant medication to treat an adverse event), in either placebo-controlled or other controlled asthma studies, were injection site reaction (45%), viral infections (23%), upper respiratory tract infection (20%), sinusitis (16%), headache (15%), and pharyngitis (11%). These events were observed at similar rates in XOLAIR-treated patients and control patients.

 
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