Disease(S) Brand Name Drug Name Drug Company Phone Number Website Calaspargase No Financial Assistance Offered at This Asparlas Servier Pegol-Mknl Time
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Co-Pay Assistance Resource Guide for Blood Cancer Patients Acute Lymphoblastic Leukemia (ALL) Disease(s) Brand Name Drug Name Drug Company Phone Number Website calaspargase No financial assistance offered at this Asparlas Servier pegol-mknl time. https://www.pfizertogether.com/hcp/bes BESPONSA Ozogamicin Wyeth 1-877-744-5675 ponsa/patient-financial-assistance Acute Lymphoblastic http://www.amgen.com/responsibility/ac Leukemia (ALL) - B- cess-to-medicine/reimbursement- Blincyto Blinatumomab Amgen 1-855-669-9360 cell Precursor support-services-and-financial- assistance-programs/ https://www.hcp.novartis.com/products/k Kymriah Tisagenlecleucel Novartis 1-844-459-6742 ymriah/acute-lymphoblastic-leukemia- children/access/ http://www.oncologyaccessnow.com/ind Gleevec® Imatinib Mesylate Novartis 1-800-282-7630 ex.jsp *not offering patient assistance nor cost savings program* Gleevec® Generic Imatinib Mesylate Teva 1-844-546-8639 https://www.tevagenerics.com/patients/fr Ph+ Acute equently-asked-questions/#q-1-1 Lymphoblastic Generic Imatinib Imatinib Mesylate Sun Pharma 1/844-502-5950 https://rxoutreach.org/ Leukemia (ALL) https://www.takedaoncology1point.com/ Iclusig® Ponatinib Takeda 1-844-817-6468 patient/financial-assistance Bristol-Myers Sprycel® Dasatinib 1-877-526-7334 https://www.sprycel.com/sprycel-assist Squibb Trisenox Arsenic Trioxide Teva 1-877-237-4881 http://www.tevacares.org/ http://www.amgen.com/responsibility/ac Acute Lymphoblastic cess-to-medicine/reimbursement- Leukemia (ALL) Blincyto Blinatumomab Amgen 1-855-669-9360 support-services-and-financial- (Ph negative) assistance-programs/ Acute Myeloid Leukemia (AML) Disease(s) Brand Name Drug Name Drug Company Phone number Website https://www.bmsaccesssupport.bmscust Onureg Azacitidine BMS 1-800-861-0048 omerconnect.com/patient Good Days http://www.needymeds.org/drug_list.taf? Dacogen Decitabine 1-877-968-7233 Program _function=name&name=Dacogen http://www.pfizerrxpathways.com/?step= Idamycin Idarubicin Pfizer 1-866-706-2400 1&step=1&step=1 https://www.celgenepatientsupport.com/ IDHIFA Enasidenib Celgene 1-800-931-8691 enrollment/ Acute Myeloid Mylotarg Ozogamicin Pfizer 1-844-989-7284 www.pfizerrxpathways.com Leukemia Nivestym (a biosimilar to filgrastim-aafi Pfizer 1-844-989-7284 www.pfizerrxpathways.com Neupogen) https://www.copay.novartisoncology.co RYDAPT Midostaurin Novartis 1-877-557-7756 m Abbvie/Genentec https://www.genentech- Venclexta Venetoclax 1-855-692-6729 h access.com/hcp/brands/venclexta.html Page 1 of 13 Acute Myeloid https://www.pfizeroncologytogether.com Daurismo Glasdegib Pfizer 877-744-5675 Leukemia (AML) 75 yrs. / and older or Abbvie/Genentec https://www.genentech- Comorbidities (no Venclexta Venetoclax 1-855-692-6729 h access.com/hcp/brands/venclexta.html chemo option) Acute Myeloid Leukemia (AML) Mylotarg Ozogamicin Pfizer 1-844-989-7284 www.pfizerrxpathways.com CD33-Positive AML Tx for blastic plasmacytoid dendritic cell neoplasm (BPDCN) Stemline Elzonris tagraxofusp-erzs 1-833-478-3654 https://www.stemlinearc.com/ in adult and pediatric Therapeutics patients two years and older Jazz (t-AML) or AML with Daunorubicin - Pharmaceutical Myelodysplasia-related VYXEOS 1-855-589-9367 www.vyxeos.com Cytarabine Jump Start changes (AML-MRC) Program Acute Myeloid Agios Leukemia (AML) with a https://www.needymeds.org/papforms/m Tibsovo ivosidenib Pharmaceuticals, 1-844-409-1141 susceptible IDH1 yaefe2609.pdf Inc. mutation Relapsed or refractory Acute Myeloid Leukemia with an https://www.celgenepatientsupport.com/ IDHIFA Enasidenib Celgene 1-800-931-8691 isocitrate enrollment/ dehydrogenase-2 (IDH2) mutation https://www.copay.novartisoncology.co Relapsed or refractory RYDAPT Midostaurin Novartis 1-877-557-7756 m Acute Myeloid https://www.astellaspharmasupportsoluti Leukemia (AML) with a Astellas Pharma XOSPATA gilteritinib 1-844-632-9272 ons.com/products/xospata/patient_enroll FLT3 mutation US ment_process.aspx Newly-diagnosed therapy-related acute myelod leukemia (t- AML) or AML with Daunorubicin - Jazz myelodysplasia-related Vyxeos 1-855-589-9367 www.vyxeos.com Cytarabine Pharmaceuticals changes (AML-MRC) including pediatric patients 1 year and older. Acute Promyelocytic Leukemia Disease(s) Brand Name Drug Name Drug Company Phone number Website Jazz Acute Promyelocytic Daunorubicin - Pharmaceutical VYXEOS 1-855-589-9367 www.vyxeos.com Leukemia Cytarabine Jump Start Program Acute Graft Versus Host Disease (GvHD) Disease(s) Brand Name Drug Name Drug Company Phone number Website Steroid-refractory acute graft-versus-host https://www.incytecares.com/jakafi- disease in adult and Jakafi® Ruxolitinib Incyte 1-855-452-5234 copay-assistance.aspx pediactric patients 12 years and older Chronic Graft Versus Host Disease (cGVHD) Disease(s) Brand Name Drug Name Drug Company Phone number Website Page 2 of 13 Chronic Graft Versus Host Disease (cGVHD) Pharmacyclics/ https://www.imbruvica.com/patient- after failure of one or ImbruvicaTM Ibrutinib 1-877-877-3536 Janssen support/access-support more lines of systemic therapy Chronic Lymphocytic Leukemia (CLL)/Small Lymphocytic Lymphoma (SLL) Disease(s) Brand Name Drug Name Drug Company Phone number Website http://www.oncologyaccessnow.com/ind Arzerra Ofatumumab Novartis 1-800-282-7630 ex.jsp http://www.verastem.com/wp- COPIKTRA duvelisib Verastem 1-833-570-2273 content/uploads/2018/08/verastem- cares-form.pdf Chronic Lymphocytic Pharmacuclics/Ja https://www.imbruvica.com/patient- Leukemia (CLL)/Small ImbruvicaTM Ibrutinib 1-877-877-3536 nssen Biotech support/access-support Lymphocytic Lymphoma (SLL) https://www.genentech- Rituximab and Rituxan Hycela Genentech 1-888-249-4918 access.com/hcp/brands/rituxanhycela/fi Hyaluronidase nd-patient-assistance.html Abbvie/Genentec https://www.genentech- Venclexta Venetoclax 1-855-692-6729 h access.com/hcp/brands/venclexta.html Chronic Lymphocytic Leukemia (CLL) Disease(s) Brand Name Drug Name Drug Company Phone number Website Chronic Lymphocytic http://www.oncologyaccessnow.com/ind Arzerra Ofatumumab Novartis 1-800-282-7630 Leukemia (CLL) ex.jsp Page 3 of 13 Bendamustine Bendeka Teva 1-888-587-3263 http://bendeka.com/Support/assistance Hydrochloride http://www.genentech- Gazyva™ Obinutuzumab Genentech 1-888-249-4918 access.com/gazyva/patients Pharmacyclics/ https://www.imbruvica.com/patient- ImbruvicaTM Ibrutinib 1-877-877-3536 Janssen support/access-support http://www.genentech- Rituxan® Rituximab Genentech 1-888-249-4918 access.com/rituxan-nhl-cll/patients https://www.genentech- Rituximab and Rituxan Hycela Genentech 1-888-249-4918 access.com/hcp/brands/rituxanhycela/fi Chronic Lymphocytic Hyaluronidase nd-patient-assistance.html Leukemia (CLL) Treanda Bendamustine Teva 1-877-237-4881 http://www.tevacares.org/ Abbvie/Genentec https://www.genentech- Venclexta Venetoclax 1-855-692-6729 h access.com/hcp/brands/venclexta.html https://www.calquence.com/patient/supp AstraZeneca Calquence acalabrutinib 1-844-275-2360 ort-for-patients/commercial- Pharmaceuticals insurance.html 1-844-6ACCESS http://www.zydeligaccessconnect.com/h Zydelig® Idelalisib Gilead (1-844-622-2377) cp http://www.verastem.com/wp- COPIKTRA duvelisib Verastem 1-833-570-2273 content/uploads/2018/08/verastem- Chronic Lymphocytic cares-form.pdf Leukemia (CLL) with 17p deletion Abbvie/Genentec https://www.genentech- Venclexta Venetoclax 1-855-692-6729 h access.com/hcp/brands/venclexta.html Previously untreated Abbvie/Genentec https://www.genentech- chronic lymphocytic Venclexta Venetoclax 1-855-692-6729 h access.com/hcp/brands/venclexta.html leukemia (CLL) Chronic Myeloid Leukemia (CML) Disease(s) Brand Name Drug Name Drug Company Phone number Website Chronic Myeloid 1-855-4-BOSULIF Bosulif® Bosutinib Pfizer https://www.bosulif.com/bosulif-steps Leukemia (CML) 1-855-426-7854 http://www.oncologyaccessnow.com/ind Gleevec® Imatinib Mesylate Novartis 1-800-282-7630 ex.jsp *not offering patient assistance nor cost savings program* Gleevec® Generic Imatinib Mesylate Teva 1-844-546-8639 https://www.tevagenerics.com/patients/fr equently-asked-questions/#q-1-1 Chronic Myeloid Gleevec® Generic Imatinib Mesylate Sun Pharma 1-844-502-5950 https://rxoutreach.org/ Leukemia (CML) https://www.takedaoncology1point.com/ Iclusig® Ponatinib Takeda 1-844-817-6468 patient/financial-assistance Synribo Omacetaxine Teva 1-877-237-4881 http://www.tevacares.org/ Bristol-Myers Sprycel® Dasatinib 1-877-526-7334 https://www.sprycel.com/sprycel-assist Squibb Tasigna® Nilotinib Novartis 1-866-972-5244 www.CoPay.NovartisOncology.com Newly-diagnosed 1-855-4-BOSULIF chronic phase (CP) Bosulif® Bosutinib Pfizer https://www.bosulif.com/bosulif-steps 1-855-426-7854 (Ph+)(CML) Chronic phase (CP) Bristol-Myers Sprycel® Dasatinib 1-877-526-7334 https://www.sprycel.com/sprycel-assist (Ph+)(CML) Squibb PH+ CML chronic phase/intolerant prior Tasigna® Nilotinib Novartis 1-866-972-5244 www.CoPay.NovartisOncology.com to TKI Page 4 of 13 Adult patients with chronic phase chronic myeloid leukemia (CP- https://www.takedaoncology1point.com/ Iclusig® Ponatinib Takeda 1-844-817-6468 CML) with resistance or patient/financial-assistance intolerance to at least 2 prior kinase inhibitors Hairy Cell Leukemia Disease(s) Brand Name Drug Name Drug Company Phone number Website https://www.myaccess360.com/hcp/hcp- AstraZeneca Hairy Cell Leukemia LUMOXITI pasudotox-tdfk 1-844-275-2360 branded-lumoxiti/support- Pharmaceuticals services/affordability-support.html Hodgkin lymphoma Disease(s) Brand Name Drug Name Drug Company Phone number Website https://www.merckaccessprogram- KEYTRUDA