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Oncology

Rozlytrek

Generic: entrectinib

Manufacturer: Genentech  ·  Program: Genentech Patient Foundation

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Eligibility Criteria

Insurance Requirement

Uninsured or insured without coverage for the medicine; not for government programs; commercially insured may qualify for separate co-pay program

Residency

US resident

Individual Income Limit

$150,000/year

Income cap ~$150,000/year regardless of household size; varies by drug

Program Information

Processing Time

2–3 weeks

Delivery Method

shipped to patient or physician office

Application Method

Multiple

Reauthorization

Required — annual

Typically Required Documents

ProvisionRX prepares and organizes all required documentation as part of your enrollment management. This list is provided for informational purposes.

  • Prescriber Service Form
  • Patient Consent Form
  • Proof of income
  • Proof of residency
  • Proof of insurance status

Indicated For

ROS1-positive non-small cell lung cancer, NTRK gene fusion-positive solid tumors

About This Medication

# Genentech Patient Foundation Patient Guide: How to Get Rozlytrek (entrectinib) at Low or No Cost Rozlytrek (entrectinib) is a targeted therapy used to treat certain types of cancer, such as solid tumors with NTRK gene fusions, ROS1-positive non-small cell lung cancer, and other advanced cancers in adults and children. The **Genentech Patient Foundation** offers this medication **at no cost** to eligible patients facing financial hardship who lack insurance coverage for it or meet specific income criteria. ## About Rozlytrek (entrectinib) **Rozlytrek** is an oral prescription medicine that works by blocking specific proteins (TRK and ROS1) that cause cancer cells to grow. It's approved for: - Adults and children 12+ with solid tumors that have **NTRK** gene fusions and no other satisfactory treatments. - Adults with **ROS1-positive** non-small cell lung cancer (NSCLC). Common side effects include fatigue, constipation, diarrhea, nausea, dizziness, and changes in vision or taste. Serious risks involve liver problems, heart issues, or lung inflammation. Always follow your doctor's instructions and report side effects to FDA at 1-800-FDA-1088. This guide focuses on the **Genentech Patient Foundation**, which provides free medicine for up to one year (with reauthorization) to qualifying U.S. patients treated by U.S.-licensed physicians. No citizenship proof is required. ## Who Qualifies? Eligibility falls into three main groups based on insurance and finances: 1. **Uninsured patients** (no health insurance) with household income under **$150,000**. 2. **Insured patients** whose plan covers Genentech medicines but has an **out-of-pocket maximum >7.5% of yearly income**. 3. **Underinsured patients** unable to afford cost-sharing for Rozlytrek. **Notes:** Insured patients must first pursue other assistance options. Government programs (Medicare, Medicaid) are generally ineligible, though exceptions may apply—call to confirm. Patients in Accumulator/Maximizer plans or required to use AFP vendors do not qualify. ## Income Eligibility Breakdown Specific Federal Poverty Level (FPL) percentages aren't publicly detailed, but the program uses household income and size. General guideline: Income < **$150,000** for uninsured. Use the online "Confirm Financial Eligibility" tool or call (888) 941-3331. | Household Size | Max Annual Income (Uninsured Estimate) | Insured OOP Max (>7.5% Income) | |----------------|---------------------------------------|--------------------------------| | 1 | Under $150,000 | Varies by plan/income | | 2 | Under $150,000 | Varies by plan/income | | 3 | Under $150,000 | Varies by plan/income | | 4 | Under $150,000 | Varies by plan/income | | 5+ | Under $150,000 (adjusted) | Varies by plan/income | *Estimates based on program criteria; exact thresholds confirmed during application. Provide household size and income on forms.* ## Insurance Requirements - **Uninsured** or **no coverage for Rozlytrek**: Primary qualifiers. - **Commercially insured**: May qualify if OOP costs exceed 7.5% of income; separate co-pay program available. - **Not eligible**: Medicare, Medicaid, other government programs; plans requiring Foundation application via AFP/Accumulator. Proof of insurance status is required. Foundation Specialists can verify coverage. ## Step-by-Step Application Process Applications use **multiple methods**: online, fax, text, or phone. Both forms must be submitted together. 1. **Gather Documents**: - **Proof of income** (tax returns, pay stubs, etc.). - **Proof of residency** (utility bill, etc.). - **Proof of insurance status** (insurance card or denial letter). 2. **Complete Patient Consent Form** (English/Spanish): - Fill Boxes 1-2 online at gene.com/patients/enrollment. - Include household size, income, deductible. 3. **Doctor Completes Prescriber Foundation Form**: - Available at GenentechPatientFoundation.com. - Confirm diagnosis, Rozlytrek prescription. 4. **Submit Together**: | Method | Details | |---------------------|----------------------------------| | **Online (Fastest)**| My Patient Solutions (HCP login) or eSubmit. | | **Fax** | (833) 999-4363 | | **Text Photo** | (650) 877-1111 | | **Phone Help** | (888) 941-3331 or (877) 436-3683 (Mon-Fri, 6am-5pm PT) | 5. **Processing**: Within **5 business days**. You'll be contacted with outcome. Download brochure/forms at gene.com/patients/patient-foundation. ## Timeline and Delivery - **Approval**: 5 business days after complete submission. - **Delivery**: Shipped free to your home or doctor's office via specialty pharmacy. - **Duration**: Up to **1 year** of free Rozlytrek; **reauthorization required** annually (reverification of eligibility). Track status by calling Foundation Specialist. ## Alternatives if Denied - **Genentech Co-pay Program**: For commercially insured (separate application). - **Other Assistance**: State programs, non-profits (e.g., Patient Access Network), or manufacturer co-pay cards. - **Appeal Insurance**: Apply while appealing denial—no proof needed. - **Call (888) 941-3331** for local resources or reapplication guidance. No biosimilar alternatives for Rozlytrek. ## Important Disclaimer This guide is for informational purposes only and based on publicly available program details as of 2026. Eligibility, terms, and income thresholds can change—always verify with Genentech at (888) 941-3331. Not medical/financial advice. Consult your doctor for treatment decisions. Genentech reserves rights to modify/terminate program.

Program information last verified: March 30, 2026

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