Patients & Caregivers Site

Financial Assistance Options

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.

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Pulmozyme Co-pay Assistance Program
Independent Co-pay Assistance Foundations
Genentech Patient Foundation

Use our financial assistance tool to see which programs may be right for your patient.

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If your patient has insurance coverage and needs help affording Pulmozyme, these programs may help:

Pulmozyme Co-pay Assistance Program

Co-pay Card Assistance

With the Pulmozyme Co-pay Assistance Program, eligible patients with commercial insurance could pay as little as $30 for a 30-day supply of Pulmozyme. It covers any additional out-of-pocket costs for Pulmozyme, after you pay $30 for each 30-day supply, up to $10,000 per year.

Patients may be eligible if they:

  • Have a valid prescription for Pulmozyme for an FDA-approved use
  • Reside in the United States or U.S. Territories
  • Are over the age of 18, or have a Legally Authorized Person over the age of 18 to manage the program
  • Have commercial (private or non-governmental) insurance. This includes plans available through state and federal health insurance exchanges
  • Are not currently receiving Pulmozyme from the Genentech Patient Foundation
  • Are not currently receiving assistance from any other charitable organization for any of their out-of-pocket costs that are covered by the Pulmozyme Co-pay Assistance Program
  • Are not using a state or federal healthcare plan to pay for their medication. This includes, but is not limited to, Medicare, Medicaid and TRICARE

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 expenses. 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. The 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. The patient, guardian, prescriber, hospital and any other person using the program agree not to seek reimbursement for all or any part of the benefit received by the patient through the offer of this program. Genentech reserves the right to rescind, revoke or amend the program without notice at any time. Additional terms and conditions apply.

View full TERMS AND CONDITIONS.

Independent Co-pay Assistance Foundations

Independent Co-pay Assistance

An independent co-pay assistance foundation is a charitable organization providing financial assistance to patients with specific disease states, regardless of treatment. Patients commercially or publicly insured, including those covered by Medicare and Medicaid, can contact the foundations directly to request assistance. Eligibility requirements, all aspects of the application process, turnaround times and the type or amount of assistance available (if any) can vary by foundation.

These foundations may be able to help. Please check their websites for up-to-date information.

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:

Genentech Patient Foundation

Genentech Patient Foundation

The Genentech Patient Foundation gives free Pulmozyme to people who have been prescribed this medicine and don’t have insurance or that have financial concerns and meet certain eligibility criteria.

Your patient may be eligible if their insurance coverage and income match one of these situations:

  • Uninsured patients with incomes under $150,000
  • Insured patients without coverage for Pulmozyme with incomes under $150,000
  • Insured patients with coverage for a Genentech medicine:
    • With unaffordable out-of-pocket costs
    • Who have pursued other forms of financial assistance
    • With household size and income within certain guidelines
 

Genentech reserves the right to modify or discontinue the program at any time and to verify the accuracy of information submitted.

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.

Get started with enrollment by following the steps below.

Option 1: Submit forms online

If your practice has a registered account for My Patient Solutions, you can get started by logging into your account.

Don't have an account?

  • An online tool to help you enroll patients in Pulmozyme Access Solutions and manage your service requests at your convenience

Option 2: Print forms and fax or text

Step 1: Print one of the Patient Consent Forms below for your patient to complete.

Step 2: Print and complete the Prescriber Foundation Form below.

Step 3: Submit completed forms via fax or text.

Both forms are required. No action can be taken until a completed Patient Consent Form and Prescriber Foundation Form have been received. 

What to expect next:

  • The request will be processed within 5 business days upon receipt of both required forms
  • Your office will be contacted to discuss the application outcome and any next steps

Not sure which programs may be able to help you? We'll walk you through some potential options with the financial assistance tool.

Get started
Pulmozyme® (dornase alfa) Support Services

Helpful Resources for Your Practice

Find information and resources for benefits investigations, billing and coding, and more.

Find Resources

  • 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.

Indication and Usage

Pulmozyme (dornase alfa) is indicated for daily administration in conjunction with standard therapies for the management of cystic fibrosis (CF) patients to improve pulmonary function.

In CF patients with an FVC ≥ 40% of predicted, daily administration of Pulmozyme has also been shown to reduce the risk of respiratory tract infections requiring parenteral antibiotics.

Important Safety Information

Pulmozyme is contraindicated in patients with known hypersensitivity to dornase alfa, Chinese Hamster Ovary cell products, or any component of the product.

The most common adverse reactions associated with the use of Pulmozyme include: voice alteration, pharyngitis, rash, laryngitis, chest pain, conjunctivitis, rhinitis, decrease in FVC of ≥ 10%, fever, dyspepsia, and dyspnea. There have been no reports of anaphylaxis attributed to the administration of Pulmozyme. Mild to moderate urticaria and mild skin rash have been observed and have been transient.

Pediatric Use

The safety and effectiveness of Pulmozyme have been established in pediatric patients 5 years of age and older. The safety of Pulmozyme, 2.5 mg by inhalation, was studied with 2 weeks of daily administration in 65 patients with cystic fibrosis aged 3 months to < 5 years. While clinical trial data are limited in pediatric patients younger than 5 years of age, the use of Pulmozyme should be considered for pediatric CF patients who may experience potential benefit in pulmonary function or who may be at risk of respiratory tract infection.

The safety of Pulmozyme, 2.5 mg by inhalation, was studied with 2 weeks of daily administration in 98 pediatric patients with cystic fibrosis 3 months to 10 years of age (65 aged 3 months to < 5 years, 33 aged 5 to ≤ 10 years). The PARI BABY™ reusable nebulizer (which uses a facemask instead of a mouthpiece) was utilized in patients unable to demonstrate the ability to inhale or exhale orally throughout the entire treatment period (54/65, 83% of the younger; and 2/33, 6% of the older patients). Overall, the nature of adverse reactions was similar to that seen in the placebo-controlled trials in older patients. The number of patients reporting cough was higher in the younger age group as compared to the older age group (29/65, 45%; compared to 10/33, 30%) as was the number reporting moderate to severe cough (24/65, 37%; compared to 6/33, 18%). The number of patients reporting rhinitis was higher in the younger age group as compared to the older age group (23/65, 35%; compared to 9/33, 27%) as was the number reporting rash (4/65, 6% as compared to 0/33, 0%).

You may report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at 1-888-835-2555.

Please see full Pulmozyme Prescribing Information for additional Important Safety Information.

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    Non-US Residents visit: Pulmozyme.global