Gazyva

Indicated For

Chronic Lymphocytic Leukemia, Follicular Lymphoma, Lupus Nephritis

About This Medication

# GAZYVA Patient Assistance Programs: How to Get Obinutuzumab at Low or No Cost ## About GAZYVA (Obinutuzumab) GAZYVA is a prescription medication manufactured by Genentech used to treat certain blood cancers and autoimmune conditions. Because GAZYVA can be expensive, Genentech offers multiple patient assistance programs to help eligible patients afford their medication. ## Who Qualifies for Assistance Genentech offers different assistance programs depending on your insurance status: **If you have commercial (private) insurance:** You may qualify for the Genentech Oncology Co-pay Assistance Program or the GAZYVA Immunology Co-pay Program (if taking GAZYVA for lupus nephritis). These programs help reduce your out-of-pocket costs like co-pays and co-insurance. **If you have public insurance or no insurance:** You may qualify for referral to an independent co-pay assistance foundation, or if you have no insurance coverage or significant financial concerns, you may be eligible for free medication through the Genentech Patient Foundation. **Important eligibility restrictions:** You cannot use these programs if your prescription is covered by Medicare, Medicare Advantage, Medigap, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs. Your prescription must also be for an FDA-approved indication of GAZYVA. ## Income Eligibility The search results do not specify exact income thresholds for these programs. Contact Genentech directly to discuss your financial situation and determine eligibility. ## Insurance Requirements **Commercial Insurance:** The co-pay assistance programs are designed for patients with private or employer-sponsored health insurance. You must have a valid prescription for an FDA-approved use of GAZYVA. **Government Insurance:** If you have Medicare, Medicaid, TRICARE, VA benefits, or other government-funded insurance, you are not eligible for the co-pay assistance programs. However, you may be referred to independent co-pay assistance foundations or the Genentech Patient Foundation depending on your circumstances. ## How Much Will You Pay? Under the co-pay assistance programs, your final out-of-pocket cost may be as little as $0 for the GAZYVA medication and its administration. However, the actual amount depends on your specific health insurance plan and the program's maximum annual benefit limits. Once you reach the maximum annual benefit amount, you become responsible for remaining out-of-pocket expenses. The program benefit resets every January 1st. These programs cover only the cost of GAZYVA and its administration—not other medications, office visits, procedures, or other treatments. ## Step-by-Step Application Process **Step 1: Determine Which Program You Qualify For** Contact GAZYVA Access Solutions to discuss your insurance and financial situation. Call (877) GENENTECH / (877) 436-3683 between 6 a.m.–5 p.m. PT, Monday through Friday. Services are available in multiple languages and include TTY services. **Step 2: For Co-pay Assistance (Commercial Insurance)** Call (855) MY-COPAY / (855) 692-6729 or visit CopayAssistanceNow.com to get started. You can also enroll online through My Patient Solutions if your healthcare provider's office has a registered account. **Step 3: Complete Required Forms** Both you and your healthcare provider must complete required forms before assistance can begin: - Patient Consent Form (completed by you) - Prescriber Service Form or Prescriber Foundation Form (completed by your doctor's office) Forms can be downloaded from the enrollment portal or submitted online via My Patient Solutions. Your healthcare provider can also submit forms via fax or text. **Step 4: Submit Your Application** Submit both completed forms together. Submitting only one form will delay processing. You can submit forms online, by fax, or by text through My Patient Solutions. **Step 5: For Uninsured or Financial Hardship Cases** If you don't have health insurance or have significant financial concerns, contact a Genentech Patient Foundation Specialist at 888-941-3331 (Monday–Friday, 6 a.m.–5 p.m. PST) to discuss eligibility for free medication. ## Timeline and Delivery The search results do not specify exact processing times for applications. After submitting your forms, Genentech may contact you for additional information. Once approved, you may receive reimbursement via virtual debit card, which provides access to your assistance funds as long as your card remains valid and you stay active in the program. ## What Happens If Your Application Is Denied If your health insurance plan denies coverage for GAZYVA, your healthcare provider's Field Reimbursement Manager or GAZYVA Access Solutions Specialist can help you prepare an appeal. Resources including sample appeal letters are available to guide you through the process. The responsibility for completing and submitting appeal documentation rests with you and your healthcare provider. If your prior authorization request is denied, your healthcare provider can work with GAZYVA Access Solutions to determine next steps. ## Important Disclaimers Genentech makes no representation or guarantee concerning coverage or reimbursement for any service or item. The completion and submission of all coverage and reimbursement documentation are your responsibility and your healthcare provider's responsibility. Genentech reserves the right to modify, discontinue, or amend these programs at any time without notice. You must submit true and accurate information to remain eligible—Genentech may disqualify patients who do not comply with program terms and conditions. ## Next Steps Start by calling GAZYVA Access Solutions at (877) 436-3683 to discuss your specific situation and learn which program you may qualify for. Have your insurance information and prescription details ready when you call.

Program information last verified: March 25, 2026