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Helping People With Hemophilia A Get The Medicines They Need

Hemophilia A is a chronic bleeding disorder. People living with hemophilia A are at risk for internal bleeds that can be life-threatening and cause long-term damage, especially in the joints. Nearly one in three people with severe hemophilia A develop factor VIII inhibitors, which are antibodies that fight against the medicines that have been commonly used to help blood clot properly.

Hemophilia A is typically a lifelong disorder that creates unique health care needs. To ensure that people with hemophilia A and their families have affordable access to the care they need, hemophilia community organizations and companies that make hemophilia medicines — like Genentech — have developed a number of financial support programs.

Health Insurance Basics

When it comes to health insurance, people generally fall into one of three categories:

  • Commercially Insured: Many people have private health insurance provided by an organization other than the government, such as an employer. This can be insurance from a job, from a plan people buy themselves or from a health insurance marketplace.
  • Publicly Insured: Public health insurance is provided by the government, namely through Medicare, the program for people aged 65 and older, or Medicaid, the program offering insurance coverage to people meeting certain income requirements.
  • Uninsured or Underinsured: Some people may not have health insurance at all, or may be considered “underinsured” because their health insurance plan won’t cover some or all of the costs of a prescribed medicine.

The majority of people with hemophilia are covered under a commercial plan or a public plan like Medicare or Medicaid.

Helping People with Hemophilia Access Medicines

A number of organizations – including treatment centers, specialty pharmacies, and medicine manufacturers — offer access support for people with hemophilia.

These organizations may be able to help with:

  • Benefits investigations to determine coverage under your health plan
  • Finding patient assistance options, including programs that support patient co-payments or out-of-pocket costs

For people seeking support, national advocacy groups can also provide information on where to start:

  • National Hemophilia Foundation (NHF): Provides a health insurance toolkit that includes a glossary of healthcare-related terms, worksheets to help people choose the right insurance plan for their unique needs and other fact sheets and resources.
  • Hemophilia Federation of America (HFA): Provides information on available financial support programs, emergency funding assistance, reimbursement for medically necessary items not covered by insurance and resources for families affected by hemophilia.

These may not be the only advocacy resources available, and you can also check with your local advocacy chapter for more information. Find a local chapter on NHF’s website here and HFA’s website here.

Genentech Access Support

Genentech is committed to making sure our medicine for people with hemophilia A with and without factor VIII inhibitors gets to the people who need it. We offer a number of programs to help people afford and access our medicine, whether they have insurance or not.

Through our access programs, Genentech has provided*:

  • 1.7+ million people with support on access and reimbursement needs over the past 20+ years
  • 227,000 people who were fully insured, underinsured and uninsured with help in 2017 alone
  • 44,000 people who were uninsured or underinsured with free medicine

*each assistance option has its own eligibility criteria that must be met for people to receive assistance.

Genentech’s Access Solutions program is the starting point to help eligible people find options to pay for their medicine, including:

  • Benefits investigations to help you understand your insurance coverage
  • Learning about financial assistance available to you
  • Understanding how to get your medicine

For people who have been prescribed our medicine for hemophilia A with and without factor VIII inhibitors, we offer a range of access and reimbursement support options:

  • Commercial co-pay program support: At Genentech, we don’t want affordability to get in the way of patients accessing needed medicines. To provide financial assistance to people with commercial insurance, we offer a co-pay program to help cover out-of-pocket costs for our medicine.*
  • Starter program enrollment: Genentech offers a program to help people – including those covered by commercial and public insurance – initiate treatment (and in some cases, receive free medicine) after your doctor has prescribed it while awaiting an insurance coverage determination.
  • Genentech®Access to Care Foundation (GATCF)**: GATCF helps people who don’t have health insurance. It also helps people who have health insurance but have trouble paying for their Genentech medicine. If you qualify for GATCF, you could receive your medicine for free.

* The co-pay program is only for commercially insured patients. Patients using Medicare, Medicaid or other government funded programs to pay for their medications are not eligible.

**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 Genentech co-pay cards 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.

For more information about Genentech Access Solutions for people with hemophilia A with and without factor VIII inhibitors, please call (877) 233-3981 or visit Genentech-Access.com