COLUMVI

Indicated For

relapsed or refractory diffuse large B-cell lymphoma (DLBCL), large B-cell lymphoma (LBCL)

About This Medication

# Genentech Patient Foundation Patient Guide: How to Get COLUMVI (glofitamab-gxbm) at Low or No Cost COLUMVI (glofitamab-gxbm) is a prescription medication used to treat certain types of relapsed or refractory diffuse large B-cell lymphoma (DLBCL) in adults after two or more lines of systemic therapy.[1] The **Genentech Patient Foundation** offers free medicine to eligible patients facing financial hardship, whether uninsured or insured with unaffordable costs, helping you access **COLUMVI** without high out-of-pocket expenses.[1][2][4] ## About COLUMVI and Why Assistance Matters **COLUMVI (glofitamab-gxbm)** is a bispecific CD20-directed CD3 T-cell engager that helps your immune system target and destroy cancer cells expressing CD20, commonly used for aggressive lymphomas like DLBCL.[1] Treatment typically involves an initial step-up dose to reduce cytokine release syndrome risk, followed by fixed doses every 3 weeks for up to 12 cycles.[1] Without insurance coverage or with high copays, the cost can exceed $30,000 per dose, making it unaffordable for many. The Genentech Patient Foundation bridges this gap by providing the medication at no cost if you qualify based on financial need and insurance status.[2][7] This guide explains eligibility, application steps, and support options in simple terms. Always consult your doctor for personalized medical advice. ## Who Qualifies for the Genentech Patient Foundation? The program helps U.S. residents prescribed a participating Genentech medicine like **COLUMVI**, focusing on financial need and insurance gaps.[1][4][7] You may qualify if: - You are **uninsured** or lack coverage for **COLUMVI**.[1][7] - You are **insured** but the out-of-pocket maximum exceeds 7.5% of your yearly household income.[7] - Your household income is under $150,000 (some exceptions apply).[7] The foundation does not require citizenship or immigration info and supports patients treated by U.S.-licensed physicians.[7] It's not for those on government insurance like Medicare, Medicaid, or VA benefits.[7] ### Income Eligibility Breakdown Specific Federal Poverty Level (FPL) percentages aren't publicly detailed, but eligibility emphasizes household income under $150,000 or insurance costs over 7.5% of income.[7] Use the Confirm Financial Eligibility form or call (888) 941-3331 to check.[4] Here's a general table based on program criteria: | Household Size | Max Annual Income (Estimate) | Key Notes | |---------------|------------------------------|-----------| | 1 | Under $150,000 | Uninsured or high OOP costs [7] | | 2 | Under $150,000 | Adjusted for family size [7] | | 3 | Under $150,000 | Financial hardship primary [4] | | 4+ | Under $150,000 | Call for exact verification [2] | *Note: Exact thresholds vary; contact a Foundation Specialist for your situation.*[2][4] ## Insurance Requirements - **Uninsured patients**: Primary candidates; provide free **COLUMVI** if financially eligible.[1][7] - **Insured patients**: Qualify if coverage exists but costs (e.g., OOP max >7.5% income) are unaffordable. Not for government-funded plans (Medicare, Medicaid). Insured patients may get referrals to independent foundations.[7] - Exclusions: Accumulator/Maximizer plans, AFP vendors, or plans requiring foundation application.[6] Genentech Access Solutions can help explore coverage first.[4] ## Step-by-Step Application Process Applying is straightforward and free. Both **Patient Consent Form** (you complete) and **Prescriber Foundation Form** (your doctor completes) are required.[1][7][9] 1. **Download or Access Forms**: Get the Patient Consent Form (English/Spanish) at gene.com/patients/enrollment. Prescriber form at GenentechPatientFoundation.com.[1][7] 2. **Complete Your Part**: Fill Patient Consent Form (Boxes 1-2), including household size, insurance status (uninsured/insured but unaffordable), DOB, address.[1][8] 3. **Doctor Completes Their Part**: Ask your doctor's office to fill the Prescriber Foundation Form, confirming prescription for **COLUMVI** and eligibility.[7] 4. **Submit Together**: - **Online**: eSubmit or My Patient Solutions.[1][3] - **Text**: Photo to 650-877-1111.[1] - **Fax**: 833-999-4363.[1][7] - **Phone Help**: Call (888) 941-3331 (Mon-Fri, 6am-5pm PT) or (888) 249-4918.[2] No extra documents needed initially; unrequested info delays processing.[9] Submit both forms for action.[1] ## Timeline and Delivery - **Processing**: 5 business days after receiving both forms. Your office and you will be contacted with outcome.[1][8] - **Approval Notification**: Foundation Specialist calls to discuss next steps, including shipment.[1] - **Delivery**: Medicine ships through a pharmacy; details provided post-approval.[7] Call (888) 941-3331 for status updates.[2] ## Alternatives if Denied - **Genentech Access Solutions**: Helps with insurance appeals, copay assistance, or other options.[4][5] - **Independent Foundations**: Referrals for insured patients.[7] - **Reapply**: If situation changes (e.g., insurance denial).[6] - **State Programs**: Foundation Specialists suggest local resources.[2] - No biosimilar alternatives for **COLUMVI** currently.[ ] ## Important Disclaimer This guide is for informational purposes only and based on publicly available program details as of latest updates. Eligibility isn't guaranteed and subject to change. The Genentech Patient Foundation determines approval case-by-case. Not medical advice—discuss **COLUMVI** with your healthcare provider. Genentech not liable for application errors. Proof of appeal unnecessary and may delay.[6] Contact (888) 941-3331 for multilingual support.[2] *Word count: ~950*

Program information last verified: March 30, 2026