Patient Assistance Program
Uninsured
Patients with no insurance may be eligible* for financial support for UDENYCA® through the
Patient
Assistance Program (PAP)
.
Patient Eligibility Criteria
- Uninsured, functionally underinsured or Medicare patients that demonstrate financial hardship and cannot afford their cost-sharing obligation
-
Must meet all eligibility requirements to qualify
-
U.S. resident and must physically reside in the U.S. or U.S. territory
-
Be under the care of a U.S. licensed provider with an established practice located in the U.S.
-
Do not have any other financial support options
-
Diagnosis and dosing must be consistent with FDA-approved prescribing information for UDENYCA® (pegfilgrastim-cbqv)
-
Adjusted annual household income of ≤ 500% of Federal Poverty Level (FPL)
-
The patient must receive the drug in the outpatient setting incident to the prescribing
physician's professional services
Proactive Alternative Funding Notifications
-
Coherus COMPLETE™ may also be able to help your patients find financial support through charitable foundations. Patient Access Specialist can research alternative coverage options for your patients.
- Must be enrolled in Coherus COMPLETETM
If a patient received UDENYCA® within the past six months, they may be eligible for Retro
PAP. Please
contact Coherus COMPLETETM at 844-4-UDENCYA / 1-844-483-3692 for additional information.