No matter what type of health insurance your patients have, and even if they have none at all, there may be financial assistance options available. Take a look at the details of some potential programs below.
Use our financial assistance tool to see which programs may be right for your patient. If you would rather talk through some potential options, call us at 866-422-2377 (6AM-5PM PST, Monday through Friday).
If your patient has insurance coverage and needs help affording Pulmozyme, these programs may help:
Commercial insurance: An insurance plan you get from a private health insurance company. This can be insurance from your job, from a plan you bought yourself or from a Health Insurance Marketplace (for example, from HealthCare.gov). Medicare and Medicaid are not considered commercial insurance.
These foundations may be able to help. Please check their websites for up-to-date information.
Advise your patient that these organizations are independent of Genentech and may require the patient to provide personal or financial information directly to the organization to enroll in their respective programs. Genentech cannot share any information the patient has provided to us.
Independent co-pay assistance foundations have their own rules for eligibility. We have no involvement or influence in independent foundation decision-making or eligibility criteria and do not know if a foundation will be able to help your patient. We can only refer your patient to a foundation that supports their disease state. This information is provided as a resource for you. We do not endorse or show preference for any particular foundation. The foundations in this list may not be the only ones that might be able to help your patient.
The financial assistance tool can help your patient to find out if this option may be right for them. Get started.
If your patient has financial difficulty or does not have insurance coverage and needs help affording Pulmozyme, this program may help:
If you have any questions about the criteria, please contact a Foundation Specialist at 888-941-3331 (Mon.–Fri., 6AM–5PM PST) or get started by enrolling below.
Commercial insurance: An insurance plan you get from a private health insurance company. This can be insurance from your job, from a plan you bought yourself or from a Health Insurance Marketplace (for example, from HealthCare.gov). Medicare and Medicaid are not considered commercial insurance.
Public insurance: A health insurance plan you get from the federal or state government. This includes Medicare, Medicaid, TRICARE and DoD/VA insurance.
For example, a household size of 1 with income of less than $75,000 may meet the criteria for assistance. Add $25,000 for each additional person in the household. There is no maximum number of people you may add.
This Pulmozyme Co-pay Program is valid ONLY for patients with commercial (private or non-governmental) insurance who have a valid prescription for a Food and Drug Administration (FDA)-approved indication of a Genentech medication. Patients using Medicare, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DoD), TRICARE or any other federal or state government program (collectively, “Government Programs”) to pay for their medications are not eligible. The program is not valid for medications that are eligible to be reimbursed in their entirety by private insurance plans or other programs.
Under the program, the patient will pay a co-pay. After reaching the maximum program benefit, the patient will be responsible for all remaining out-of-pocket expenses. The amount of the program’s benefits cannot exceed the patient’s out-of-pocket expenses for the cost of the drug fees associated with Pulmozyme. The program benefit will reset every January 1st. This program is not health insurance or a benefit plan. The program does not obligate the use of any specific product or provider. Patients receiving assistance from charitable free medicine programs (such as the Genentech Patient Foundation) or any other charitable organizations for the same expenses covered by the program are not eligible. The co-pay benefit cannot be combined with any other rebate, free trial or similar offer for the medication. No party may seek reimbursement for all or any part of the benefit received through this program.
The program may be accepted by participating pharmacies, physicians’ offices or hospitals. Once a patient is enrolled, this program will not honor claims with date of service or medication dispensing that precede program enrollment date by more than 180 days. Claims must be submitted within 365 days from the date of service unless otherwise indicated. Use of this program must be consistent with all relevant health insurance requirements. Participating patients, pharmacies, physician offices and hospitals are responsible for reporting the receipt of all program benefits as required by any insurer or by law. Program benefits may not be sold, purchased, traded or offered for sale.
The patient or their guardian must be 18 years or older to receive program assistance. This program is only valid in the United States and U.S. Territories. This program is void where prohibited by law and shall follow state restrictions in relation to AB-rated generic equivalents (e.g., MA, CA) where applicable. Eligible patients will be automatically re-enrolled in the program on an annual basis. Eligible patients will be removed from the program after 3 years of inactivity (e.g., no claims submitted in a 3-year timeframe). Program eligibility and automatic re-enrollment are contingent upon the patient’s ability to meet all requirements set forth by the program. 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.
Pulmozyme (dornase alfa) [package insert]. South San Francisco, CA: Genentech, Inc; 2021.
Pulmozyme (dornase alfa) [package insert]. South San Francisco, CA: Genentech, Inc; 2021.
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Data on file. Genentech, a member of the Roche Group.
Data on file. Genentech, a member of the Roche Group.
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Pulmozyme Instructions for Use. South San Francisco, CA: Genentech, Inc; 2021.
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