Reimbursement & Support

Dedicated to Reimbursement Services and Patient Support

Nutropin GPS^™ (Growing Patient Support) offers you and your patients assistance throughout treatment from a dedicated case manager. Following the decision to prescribe growth hormone therapy, GPS services include device and injection training, insurance process management, a nurse hotline, and ongoing patient access and support programs. Call 1‐866‐NUTROPIN (1‐866‐688‐7674) to get started.

Your patients may be eligible for help with treatment costs

Key Features of the Nutropin Co-pay Card Program

• The Nutropin AQ^® NuSpin^® Co-pay Card Program provides support to eligible patients of up to $5,000 per 12-month enrollment cycle*
• Patients are not required to meet any income criteria to qualify for this benefit
• Eligible patients may pay as little as $10 monthly co-pay per prescription/refill
• The maximum co-pay assistance allowable to any patient under the program is $5,000 annually
• Patients are responsible for all out-of-pocket costs after $5,000
• Co-pay assistance is capped at $500 per month, however, patients may submit any unreimbursed out-of-pocket co-pay expenses, up to the $5,000 maximum, directly to Nutropin GPS at the end of the 12-month enrollment period

*Co-pay assistance is capped at $500 per month, however, outstanding co-pay expenses above the $500 monthly cap may be submitted (up to the $5,000 cap) directly to Nutropin GPS at the end of the 12-month enrollment period. Co-pay assistance may be renewable for eligible patients after 12 months.

Patients can enroll in the Co-pay Card Program online.

For more information, review the co-pay brochure.

By using the Nutropin GPS™ Copay Card Program, the patient acknowledges and confirms that, at the time of usage, (s)he is currently eligible and meets the criteria set forth in the terms and conditions described.

This Copay Card is valid ONLY for patients with commercial (private or non-governmental) insurance who are taking the medication for a Food and Drug Administration (FDA)-approved indication. Patients using Medicare, Medicaid, Medicap, Veteran’s Affairs (VA), Department of Defense (DoD), TriCare or any other government-funded program to pay for their medications are not eligible. Patients who start utilizing their government coverage during their enrollment period will no longer be eligible for the program.

This Copay Card Program is not health insurance or a benefit plan. Distribution or use of the Copay Card does not obligate use or continuing use of any specific product or provider. Patient or guardian is responsible for reporting the receipt of all Copay Card Program benefits or reimbursement received to any insurer, health plan, or other third party who pays for or reimburses any part of the prescription filled using the Copay Card Program, as may be required.

The Copay Card is not valid for medications the patient receives for free or that are eligible to be reimbursed by private insurance plans or other healthcare or pharmaceutical assistance programs (such as Genentech® Access to Care Foundation or any other charitable organization) that reimburse the patient in part or for the entire cost of his/her Genentech medication. Patient, guardian, pharmacist, prescriber, and any other person using the Copay Card agree not to seek reimbursement for all or any part of the benefit received by the recipient through this Copay Card Program.

The Copay Card may be accepted by participating pharmacies, physician offices, or hospitals. To qualify for the benefits of this Copay Card Program, the patient may be required to pay out-of-pocket expenses for each treatment. Once enrolled, this Copay Card Program will not honor claims with date of service or medication dispensing that precede program enrollment by more than 120 days. This Copay Card is only available with a valid prescription and cannot be combined with any other rebate, free trial, or similar offer for the specified prescription. Use of this Copay Card must be consistent with all relevant health insurance requirements and payer agreements. Participating patients, pharmacies, physician offices, and hospitals are obligated to inform third-party payers about the use of the Copay Card as provided for under the applicable insurance or as otherwise required by contract or law. The Copay Card may not be sold, purchased, traded, or offered for sale, purchase, or trade. The Copay Card is limited to 1 per person during this offer period and is not transferable. Program eligibility period is contingent upon patient’s ability to meet and maintain all requirements as set forth by the program. Genentech will periodically verify eligibility and will terminate patients without obligation to pay claims if change to status is detected. This program is not valid where prohibited by law, and shall follow state restrictions in relation to AB-rated generic equivalents where applicable (e.g. MA, CA).

The patient or their guardian must be 18 years or older to receive Copay Card Program assistance. This Copay Card Program is (1) void if the card is reproduced; (2) void where prohibited by law; (3) only valid in the United States and U.S. Territories; and (4) only valid for Genentech products. Healthcare providers may not advertise or otherwise use the program as a means of promoting their services or Genentech’s products to patients. Genentech reserves the right to rescind, revoke, or amend the program without notice at any time.

A program providing medicine for a limited time for eligible pediatric patients while their insurance coverage is being evaluated.

• Patients must meet medical criteria for initial and subsequent requests
• Product will be delivered to the patient’s home by a Genentech-designated pharmacy

Patient Access and Assistance Programs

Genentech is committed to helping your patients receive the treatment and medications they need. To this end, we provide a broad range of patient access and assistance programs, including:

Priority Review

Use Priority Review to check if Nutropin AQ is available on formulary. Check off "Priority Review" and complete the bolded fields on the Statement of Medical Necessity (SMN) to request this service.

If privately or publicly insured patients have difficulty paying for their Nutropin AQ co-pay, co-insurance, or other expenses, Nutropin GPS can refer them to a co-pay assistance foundation* that supports their disease state. For more information, contact Genentech at 1-866-688-7674.

*Genentech and Nutropin GPS™ do not influence or control the operations or eligibility criteria of any independent co-pay assistance foundation and cannot guarantee co-pay assistance after a referral from Nutropin GPS™. The foundations to which we refer patients are not exhaustive or indicative of Genentech’s or Nutropin GPS™ endorsement or financial support. There may be other foundations to support the patient's disease state.

GATCF helps eligible patients who meet specific criteria receive Nutropin free of charge.

GATCF provides free medicine to eligible patients who are uninsured, rendered uninsured by payer denial or underinsured. To qualify, patients must meet specific criteria.

Eligibility Criteria

To be eligible for free medicine from GATCF, insured patients must have exhausted all other forms of patient assistance (including Genentech brand-specific co-pay cards and support from independent co-pay assistance foundations) and meet additional criteria.

To get started with GATCF, complete and submit the Statement of Medical Necessity (SMN) and Patient Authorization and Notice of Release of Information (PAN) to Genentech Access Solutions.

Once we receive your patient’s information, Genentech Access Solutions will contact the patient with further instructions. This may include verifying financial eligibility.