Patient Advocacy

The North Carolina Oncology Management Society’s Patient Advocacy Committee provides members with current patient advocacy issues relating to oncology patients that have the potential to affect the professional or business interests of oncology practices across North Carolina.

The following resources may be used to identify financial assistance programs for patients receiving specific oncology agents:

Additional information may be found in the ACCC Patient Assistance and Reimbursement Guide.

Bobbie Buell has introduced a one-stop resource tool to assist in identifying financial assistance programs.

This tool can be found at assistPoint.com.

WHAT YOU CAN DO THIS MINUTE:

  • Search by generic, brand name, manufacturer, or ICD-9 for the enrollment forms you need
  • Get Enrollment Form PDFs for 113 cancer drugs
  • Get NDC numbers for all of those drugs
  • Find the HCPCS J-code for each drug
  • Get Coding and Billing Guidelines for many drugs
  • Learn more about the drugs you give

WHAT YOU WILL BE ABLE TO DO:

  • Get enrollment forms for every drug you use
  • “Auto-fill” enrollment forms through an interface with your Revenue Cycle Management, Practice Management, or EMR systems
  • Complete several forms at once by answering just a few questions
  • Have several options for electronic signature
  • Have ‘live’ links to the disease-specific Foundations right on the drug page
  • Track your registrations and forms for all programs on the site
  • Allow patients to finish registration and signatures right on the patient site
  • And, whatever you tell us you need!

Injectable Drugs

Brand Name Drug Name Phone Number Website
Abraxane Paclitaxel Protein Bound 1-800-931-8691 www.celgenepatientsupport.com
Adcetris Brentuximab vedotin 1-855-473-2436 www.seagensecure.com
Adriamycin Doxorubicin 1-800-675-8416 www.healthwellfoundation.org
Alimta Pemetrexed 1-866-472-8663 www.lillypatientone.com
Aloxi Palonsetron 1-866-613-4724 www.eisaireimbursement.com
Aranesp Darbepoetin 1-888-427-7478 www.AmgenAssistOnline.com
Arranon Nelarabine 1-866-265-6491 www.gskcta.com
Arzerra Ofatumumab 1-866-265-6491 www.gskcta.com
Avastin Bevacizumab 1-866-422-2377 www.genentech-access.com
Bexxar Tositumomab 1-866-265-6491 www.gskcta.com
BiCNU Carmustine 1-800-861-0048 www.bmsaccesssupport.com
Blenoxane Bleomycin 1-800-675-8416 www.healthwellfoundation.org
Campath Alemtuzumab 1-877-422-6728 www.campath.com
Camptosar Irinotecan 1-866-706-2400 www.pfizerrxpathways.com
Clolar Clofarabine 1-888-847-4877 www.visitspconline.com
Cyramza Ramucircumab 1-866-472-8663 www.lillypatientone.com
Cytosar-U ARA-C 1-800-675-8416 www.healthwellfoundation.org
Cytoxan Cyclophosphamide 1-800-675-8416 www.healthwellfoundation.org
Dacogen Decitabine 1-800-769-3880 www.dacogen.com/Patient-Assistance.aspx
Doxil Doxorubicin Liposome 1-800-652-6227 www.jjpaf.org
DTIC Dacarbazine 1-800-675-8416 www.healthwellfoundation.org
Eligard Leuprolide 1-888-847-4877 www.visitspconline.com
Elitek Rasburicase 1-888-847-4877 www.visitspconline.com
Ellence Epirubicin 1-866-706-2400 www.pfizerrxpathways.com
Eloxatin Oxaliplatin 1-888-847-4877 www.visitspconline.com
Emend Fosaprepitant 1-855-257-3932 www.merckaccessprogram.com
Erbitux Cetuximab 1-800-861-0048 www.bmsaccesssupport.com
Etopophos Etoposide 1-800-861-0048 www.bmsaccesssupport.com
Etopophos VP-16 1-800-736-0003 www.bmsaccesssupport.com
Faslodex Fulvestrant 1-800-292-6363 www.astrazeneca-us.com/help-affording-your-medicines
Firmagon Degarelix 1-877-971-3778 https://firmagon.cmcopilot.com
Folinic Acid Leucovorin 1-800-675-8416 www.healthwellfoundation.org
Folotyn Pralatrexate 1-888-537-8277 www.spectrumpatientaccess.com
FUDR Floxuridine 1-800-675-8416 www.healthwellfoundation.org
Gazyva Obinutuzumab 1-866-422-2377 www.genentech-access.com
Haloven Erbulin mesylate 1-866-613-4724 www.eisaipatientassistance.com
Herceptin Trastuzumab 1-866-422-2377 www.genentech-access.com
Hexalen Altretamine 1-866-613-4724 www.eisaireimbursement.com
Hycamptin Tototecan 1-866-265-6491 www.gskcta.com
Idamycin Idarubicin 1-866-706-2400 www.pfizerrxpathways.com
Ifex Ifosfamide 1-800-675-8416 www.healthwellfoundation.org
Interferon Interferon alfa-2a 1-800-675-8416 www.healthwellfoundation.org
Intron A Interferon alfa-2b 1-855-257-3932 www.merckaccessprogram.com
Isodax Romidepsin 1-800-931-8691 www.celgenepatientsupport.com
Ixempra Ixabepilone 1-800-736-0003 www.bmsaccesssupport.com
Kadcyla Ado-trastuzumab emtansine 1-866-422-2377 www.genentech-access.com
Keytruda Pembrolizumab 1-855-257-3932 www.merckaccessprogram.com
Kyprolis Carfilzomib 1-855-669-9360 www.onyx.com/therapies/patient-access/onyx-360
Leukeran Chlorambucil 1-866-265-6491 www.gskcta.com
Leukine Sargramostim 1-888-847-4877 www.visitspconline.com
Lupron Leuprolide Acetate 1-800-222-6885 www.abbviepaf.org
Marquibo Vincristine sulfate liposome 1-888-537-8277 www.spectrumpatientaccess.com
Mesnex Mesna 1-800-675-8416 www.healthwellfoundation.org
Mozobil Plerixafor 1-888-847-4877 www.visitspconline.com
Mustargen Nitrogen Mustard 1-866-337-6996 www.lundbeck.com/us
Mylotarg Gemtuzumab Ozogamicin 1-866-706-2400 www.pfizerrxpathways.com
Navelbine Vinorelbine 1-800-675-8416 www.healthwellfoundation.org
Neosar Cyclophosphamide 1-800-675-8416 www.healthwellfoundation.org
Neulasta Pegfilgrastim 1-888-427-7478 www.AmgenAssistOnline.com
Neumega Interleukin-2 1-866-706-2400 www.pfizerrxpathways.com
Neupogen Filgrastim 1-888-427-7478 www.AmgenAssistOnline.com
Nplate Romiplstim 1-888-427-7478 www.AmgenAssistOnline.com
Oncaspar Pegaspargase 1-800-490-3262 www.sigmatau.com/support/support_oncaspar.asp
Ontak Denileukin diftitox 1-866-613-4724 www.eisaireimbursement.com
Paraplatin Carboplatin 1-800-675-8416 www.healthwellfoundation.org
Perjeta Pertuzumab 1-866-422-2377 www.genentech-access.com
Platinol Cisplatin 1-800-675-8416 www.healthwellfoundation.org
Procrit Epoetin Alpha 1-800-652-6227 www.jjpaf.org
Proleukin IL-2 1-877-776-5385 www.proleukin.com/mm/resources.aspx
Prolia Denosumab 1-888-427-7478 www.AmgenAssistOnline.com
Provenge Sipuleucel-t 1-877-336-3736 www.provenge.com/reimbursement.aspx
Rituxan Rituximab 1-866-422-2377 www.genentech-access.com
Sancuso Granisetron 1-800-676-5884 www.patientrxsolutions.com
Sandostatin LAR Octreotide Acetate 1-866-884-5906 www.oncologyaccessnow.com
Sarclisa Isatuximab-irfc 1-833-930-2273 www.sanoficareassist.com
Sylatron Peginterferon Alfa-2b 1-855-257-3932 www.merckaccessprogram.com
Synribo Omacetaxine Mepesuccinate 1-888-587-3263 www.tevacore.com
Taxol Paclitaxel 1-800-675-8416 www.healthwellfoundation.org
Taxotere Docetaxel 1-888-847-4877 www.visitspconline.com
Toposar Etoposide 1-800-675-8416 www.healthwellfoundation.org
Toresel Temsirolimus 1-866-706-2400 www.pfizerrxpathways.com
Trisenox Arsenic trioxide 1-888-587-3263 www.cephalononcologycore.com
Vectibix Panitumumab 1-888-427-7478 www.AmgenAssistOnline.com
Velban Vinblastine 1-800-675-8416 www.healthwellfoundation.org
Velcade Bortezomib 1-866-835-2233 www.velcade.com/Paying-for-treatment
VePsid Etopiside 1-800-675-8416 www.healthwellfoundation.org
Vidaza Azacitidine 1-800-931-8691 www.celgenepatientsupport.com
Vumon Teniposide 1-800-736-0003 www.bmsaccesssupport.com
Xgeva Denosumab 1-888-427-7478 www.AmgenAssistOnline.com
Xofigo Radium Ra233 dichloride 1-855-696-3446 www.xofigo-us.com/hcp/patient-support
Yervoy Ipilimumab 1-800-736-0003 www.bmsaccesssupport.com
Zaltrap Ziv-Aflibercept 1-888-847-4877 www.visitspconline.com
Zevalin Ibritumomab Tiuxetin 1-888-537-8277 www.spectrumpatientaccess.com
Zinecard Dexrazoxane 1-866-706-2400 www.pfizerrxpathways.com
Zoladex Goserlin 1-800-292-6363 www.astrazeneca-us.com/help-affording-your-medicines
Zometa Zoledronic acid 1-800-245-5356 www.patientassistancenow.com

Oral Drugs

Brand Name Drug Name Phone Number Website
Afinitor Everolimus 1-800-277-2254 www.oncologyaccessnow.com
Arimidex Anastrozole 1-800-292-6363 www.astrazeneca-us.com/help-affording-your-medicines
Aromasin Exemestane 1-866-706-2400 www.pfizerrxpathways.com
Bosulif Bosutinib 1-866-706-2400 www.pfizerrxpathways.com
Caprelsa Vandetanib 1-800-292-6363 www.astrazeneca-us.com/help-affording-your-medicines
Casodex Bicalutamide 1-800-292-6363 www.astrazeneca-us.com/help-affording-your-medicines
Cometriq Cabozantinib 1-855-253-3273 www.cometriq.com\hcp/access
Droxia Hydroxyurea 1-800-736-0003 www.bmsaccesssupport.com
Emcyt Estramustine 1-866-706-2400 www.pfizerrxpathways.com
Emend Aprepitant 1-855-257-3932 www.merckaccessprogram.com
Erivedge Vismodegib 1-866-422-2377 www.genentech-access.com
Exjade Deferasirox 1-866-884-5906 www.oncologyaccessnow.com
Farestpm Toremifene 1-800-676-5884 www.patientrxsolutions.com
Femara Letrozole 1-800-245-5356 www.patientassistancenow.com
Gilotrif Afatinib 1-800-859-9673 www.gilotrif.com/solutions_plus.html
Gleevec Imatinib 1-800-277-2254 www.patientassistancenow.com
Hycamptin Tototecan Oral 1-866-265-6491 www.gskcta.com
Iclusig Ponatinib 1-855-447-7277 www.ariadpass.com
Imbruvica Ibrutinib 1-877-877-3536 www.imbruvica.com/youandi
Inlyta Zxitinib 1-866-706-2400 www.pfizerrxpathways.com
Iressa Gefitinib 1-800-292-6363 www.astrazeneca-us.com/help-affording-your-medicines
Jakafi Ruxolitinib 1-855-452-5234 www.jakafi.com/incytecares
Matulane Procarbazine 1-800-490-3262 www.sigmatau.com/support/support_oncaspar.asp
Megace Megastrol 1-800-675-8416 www.healthwellfoundation.org
Mekinist Trametinib 1-866-265-6491 www.gskcta.com
Myleran Busulfan 1-866-265-6491 www.gskcta.com
Nexavar Sorafenib 1-866-639-2827 www.nexavar-us.com
Nilandron Nilutamide 1-888-847-4877 www.visitspconline.com
Panretin Alitretinoin 1-866-613-4724 www.eisaireimbursement.com
Pomalyst Pomalidomide 1-800-931-8691 www.celgenepatientsupport.com
Promacta Eltrombopag 1-866-265-6491 www.gskcta.com
Reblimid Lenalidomide 1-800-931-8691 www.celgenepatientsupport.com
Sprycel Dasatinib 1-800-861-0048 www.bmsaccesssupport.com
Stivarga Regorafenib 1-866-639-2827 www.stavarga-us.com/hcp/gist/support.html
Subsys Fentanyl Sublingual Spray 1-855-766-6502 https://sybsysspray.com
Sutent Sunitinib 1-866-706-2400 www.pfizerrxpathways.com
Sylvant Siltuximab 1-855-299-8844 www.janssenaccessone.com
Tafinlar Dabrafenib 1-866-265-6491 www.gskcta.com
Tarceva Erlotinib 1-866-422-2377 www.genentech-access.com
Tasigna Nilotinib 1-866-884-5906 www.oncologyaccessnow.com
Temodar Temozolomide 1-800-727-5400 www.merckhelps.com
Thalomid Thalidomide 1-800-931-8691 www.celgenepatientsupport.com
TheraCys BCG 1-888-847-4877 www.visitspconline.com
Treanda Bendamustine 1-888-587-3263 www.tevacore.com
Tykerb Lapatinib 1-866-265-6491 www.gskcta.com
Votrient Paxopanib 1-866-265-6491 www.gskcta.com
Xalkori Crizotinib 1-866-706-2400 www.pfizerrxpathways.com
Xeloda Capecitabine 1-866-422-2377 www.genentech-access.com
Xtandi Enzalutamide 1-855-898-2634 www.astellasaccess.com
Zelboraf Vemurafenib 1-866-422-2377 www.genentech-access.com
Zolinza Vorinostat 1-800-727-5400 www.merckaccessprogram.com
Zydelig Idelalisib 1-844-622-2377 www.xydeligaccessconnect.com
Zykadia Ceritinib 1-800-245-5356 www.patientassistancenow.com
Zytiga Abiraterone acetate 1-800-652-6227 www.jjpaf.org

Foundations & Support Resources

Foundations and Support Resources Website
Agingcare.com www.agingcare.com
American Breast Cancer Foundation www.abcf.org
Assistance Fund www.theassistancefund.org
Avon Foundation for Women www.avonbhop.org
BenefitsCheckUp www.benefitscheckup.org
CancerCare www.cancercare.org
CancerCare Copayment Assistance Foundation www.cancercarecopay.org
Cancer Financial Assistance Coalition www.cancerfac.org
Chronic Disease Fund www.cdfund.org/Copay-Assistance.aspx
Co-Pay Relief www.copays.org
Cord Blood Banking www.cordbloodbanking.com
HealthWell Foundation www.healthwellfoundation.org
The Leukemia & Lymphoma Society www.lls.org
Mesothelioma Group www.mesotheliomagroup.com/treatment
NeedyMeds www.needymeds.com
Partnership for Prescription Assistance www.pparx.org
Patient Access Network Foundation www.panfoundation.org
Patient Advocate Foundation www.patientadvocate.org
Patient Services, Inc. www.patientservices.org
RxAssist www.rxassist.org
RxHope www.rxhope.com
RxOutreach www.rxoutreach.com