Herceptin

Indicated For

HER2-positive breast cancer, gastric cancer

About This Medication

# Genentech Patient Foundation Patient Guide: How to Get Herceptin at Low or No Cost ## About This Program The **Genentech Patient Foundation** is a patient assistance program that provides free or low-cost Herceptin (trastuzumab) to eligible patients who face financial hardship or lack adequate insurance coverage. Herceptin is a targeted therapy used to treat HER2-positive breast cancer. If you're struggling to afford this vital medication, this program may help you access it at no cost. ## About Herceptin (Trastuzumab) Herceptin is a monoclonal antibody used to treat HER2-positive breast cancers. It works by targeting cancer cells that overexpress the HER2 protein. As a biologic medication, Herceptin can be expensive, and the Genentech Patient Foundation exists to ensure that cost is not a barrier to receiving this treatment. ## Who Qualifies for Assistance You may qualify for the Genentech Patient Foundation if you meet one of these criteria: - **Uninsured**: You have no health insurance coverage for Herceptin - **Underinsured with financial hardship**: You have insurance but face significant out-of-pocket costs that create financial difficulty - **Income-based eligibility**: Your household income falls below certain thresholds (specific limits vary by family size) The program is designed to help patients living in the United States who are being treated by a US-licensed physician. The foundation does not require or collect citizenship or immigration information. ## Income Eligibility While specific income thresholds are not detailed in the program materials, the Genentech Patient Foundation uses a sliding scale based on: | Factor | Details | |--------|----------| | **Household Income** | Must be below program thresholds (varies by family size) | | **Family Size** | Number of people in your household, including yourself | | **Insurance Status** | Uninsured, underinsured, or insured with high out-of-pocket costs | | **Out-of-Pocket Maximum** | If insured, your plan's out-of-pocket maximum should exceed 7.5% of your yearly income | To determine if you qualify based on your specific financial situation, you can use the Confirm Financial Eligibility form or call a Foundation Specialist at **(888) 941-3331** (Monday–Friday, 6 a.m.–5 p.m. PT). The program offers support in multiple languages. ## Insurance Requirements The Genentech Patient Foundation can assist: - **Uninsured patients**: Those with no health insurance - **Commercially insured patients**: Those with private insurance who face high out-of-pocket costs - **Underinsured patients**: Those whose insurance coverage is insufficient or creates financial hardship **Important**: This program is **not** designed for patients covered by Medicare, Medicaid, or other government insurance programs. However, you may still apply while pursuing an insurance appeal—proof of appeal is not required to receive assistance. ## Step-by-Step Application Process ### Step 1: Complete the Patient Consent Form You (or your legally authorized representative) must complete the **Patient Consent Form**, available in English and Spanish. This form collects: - Your personal and contact information - Household size and income information - Insurance details (if applicable) - Information about your deductible and out-of-pocket costs - Your consent to receive assistance You can complete this form online or print and sign it. ### Step 2: Notify Your Doctor's Office Once you've completed the Patient Consent Form, inform your doctor's office that you're applying for assistance from the Genentech Patient Foundation. Your prescriber will need to complete their portion of the application. ### Step 3: Your Doctor Completes the Prescriber Foundation Form Your healthcare provider must complete the **Prescriber Foundation Form**, which includes: - Verification of your Herceptin prescription - Clinical information about your treatment - The prescriber's signature and credentials **Both forms are required.** No action can be taken until both the completed Patient Consent Form and Prescriber Foundation Form have been received. ### Step 4: Submit Both Forms You or your doctor's office can submit the completed forms using one of these methods: - **Online submission**: If your practice has a registered account for My Patient Solutions, log in and submit electronically - **Fax**: Send to **(833) 999-4363** - **Text**: Text a photo of the signed forms to **(650) 877-1111** - **Mail**: Mail the forms to the address provided on the form ## Timeline and What to Expect Once the Genentech Patient Foundation receives both completed forms, your application will be processed within **5 business days**. After the eligibility determination is made, both you and your prescriber will be contacted to discuss: - Your application outcome - Next steps for receiving your medication - How your Herceptin will be delivered Once approved, your medication will be shipped to you, your physician's office, or a participating pharmacy, depending on what works best for your treatment plan. ## Ongoing Coverage and Reauthorization If you're approved for the Genentech Patient Foundation, you will continue to receive free Herceptin as long as you remain eligible. The program does not require annual re-enrollment, but your eligibility may be reviewed if your financial or insurance situation changes significantly. ## What If Your Application Is Denied? If you're denied assistance, you have options: - **Appeal**: You can work with your doctor to file an appeal - **Explore alternatives**: Ask your healthcare provider about biosimilar alternatives to Herceptin, such as Trazimera (Pfizer) or Hercessi (Accord), which may have different assistance programs - **Contact a Foundation Specialist**: Call **(888) 941-3331** to discuss your specific situation and explore other options ## Contact Information **Genentech Patient Foundation** - **Phone**: (888) 941-3331 (Monday–Friday, 6 a.m.–5 p.m. PT) - **Fax**: (833) 999-4363 - **Text**: (650) 877-1111 A Foundation Specialist is ready to help answer your questions and guide you through the application process. They have local knowledge and can tell you the best options for help in your area. ## Important Disclaimer This guide provides general information about the Genentech Patient Foundation. Program eligibility, requirements, and benefits may change. For the most current and accurate information, visit Gene.com/patients or call the Foundation Specialists directly. This program is intended to assist patients living in the United States and being treated by a US-licensed physician. Always consult with your healthcare provider about your treatment options and financial assistance programs.

Program information last verified: March 30, 2026