Xofluza

Genentech Patient Foundation Patient Guide: How to Get Xofluza at Low or No Cost

About This Program

The Genentech Patient Foundation provides free or low-cost Xofluza (baloxavir marboxil) to eligible patients who struggle to afford their antiviral medication. Xofluza is a prescription antiviral used to treat acute uncomplicated influenza in patients 12 years of age and older. This program is available to everyone regardless of race, citizenship/immigration status, age, disability, gender identity, or sexual orientation.

Who Qualifies for Assistance

You may qualify for the Genentech Patient Foundation if you meet one of these three situations:

Situation 1: You Have No Health Insurance

• Your household income is under the limits shown in the table below

Situation 2: You Have Health Insurance But It Doesn't Cover Xofluza

• Your household income is under the limits shown in the table below

Situation 3: You Have Health Insurance That Covers Xofluza, But Your Out-of-Pocket Costs Are Too High

• Your out-of-pocket maximum (set by your insurance plan) is more than 7.5% of your yearly household income
• Your household income falls within the limits shown in the table below

Income Eligibility Breakdown

To qualify, your total yearly household income must be under these limits:

Important Note: Household income is calculated as your Adjusted Gross Income (AGI) minus specific deductions. This is typically the same as what appears on your tax return.

Insurance Requirements

The program is designed to help both uninsured and underinsured patients. If your health insurance plan or employer requires you to apply to a Patient Assistance Program as a condition of coverage, you will not be eligible for the Genentech Patient Foundation. In that case, contact Genentech Access Solutions for alternative options.

How to Apply: Step-by-Step

Step 1: Confirm Your Eligibility

Before applying, verify that you meet the income and insurance requirements. You can:

• Use the Confirm Financial Eligibility form on the Genentech Patient Foundation website
• Call the Foundation Specialists at (888) 941-3331 (support available in multiple languages)

Step 2: Gather Required Documents

Have the following information ready:

• Proof of income (such as a 1040 tax form or recent pay stubs)
• Your household size and composition
• Current health insurance information (if applicable)
• Your doctor's name and contact information
• Confirmation that you have been prescribed Xofluza

Step 3: Complete the Application

You can apply through:

• Phone: Call (888) 941-3331 to speak with a Foundation Specialist
• Online: Visit the Genentech Patient Foundation website to complete enrollment forms
• Through Your Doctor: Your healthcare provider can submit a Prescriber Foundation Form on your behalf

Step 4: Submit Your Application

Provide all required documentation along with your completed application. The Foundation Specialists can guide you through this process and answer questions about what documents you need.

Timeline and Delivery

Once your application is approved, Xofluza will be shipped directly to you or to your healthcare provider's office. Processing may take time, so apply as soon as possible after receiving your prescription. The exact timeline depends on the completeness of your application and verification of your information.

What If Your Application Is Denied?

If you don't qualify for the Genentech Patient Foundation, other assistance options may still be available:

• Genentech Access Solutions can help you understand your insurance coverage and explore other financial assistance programs
• Visit Genentech-Access.com for additional resources
• Contact (888) 941-3331 to discuss alternative options with a specialist

Important Disclaimers

• The Genentech Patient Foundation reserves the right to modify or discontinue this program at any time
• Genentech may verify the accuracy of information you submit
• This program is subject to all applicable federal and state laws
• If you have questions about whether a Patient Assistance Diversion Program applies to your situation, ask your healthcare provider or insurance company

Contact Information

Genentech Patient Foundation

• Phone: (888) 941-3331
• Website: GenentechPatientFoundation.com
• Languages: Support available in multiple languages

For Insurance Questions:

• Genentech Access Solutions
• Website: Genentech-Access.com