Clovis Oncology Rubraca Connections

Clovis Oncology’s Rubraca Connections is a comprehensive patient financial support program designed to help patients who are prescribed Rubraca (rucaparib) tablets. Services include finding financial support programs and dealing with delays in coverage. The Table lists indications for Rubraca, as well as support programs available for patients.

Rubraca Connections Services

Rubraca Connections $0 Co-Pay Program

The Rubraca Connections $0 Co-Pay Program offers financial assistance for eligible patients. Patients enrolled in the program will have $0 out-of-pocket drug costs, regardless of income, and may receive support of up to $30,000 per calendar year. To be eligible for the Rubraca Connections $0 Co-Pay Program, patients must:

• Be a resident of the United States, Puerto Rico, or other US territories
• Have private or commercial insurance
• Not be covered by federal- or state-funded insurance
• Not be cash-paying patients without commercial insurance.

Eligible patients can enroll in the Rubraca Connections $0 Co-Pay Program by completing the online enrollment form at or by calling Rubraca Connections at 844-779-7707. Click here to access complete terms and conditions for Rubraca Connections Services.

Rubraca Connections QuickStart Program

The Rubraca Connections QuickStart Program may provide the first 15 days of Rubraca at no cost, up to 3 refills (or 60 days). This program is for eligible patients who have commercial or government insurance and are experiencing delays in coverage for Rubraca. To be eligible for the Rubraca Connections QuickStart Program, patients must:

• Have a prescription for Rubraca for an FDA-approved indication
• Have private, commercial, or government insurance and be experiencing a delay in medication coverage
• Not bill the cost of Rubraca provided through this program to an insurance provider
• Obtain a separate QuickStart prescription for the pharmacy supporting the program.

To enroll in the Rubraca Connections QuickStart Program, the patient and the prescriber should complete the Rubraca Connections Prescription Form and fax the completed form to 844-779-7717 or to a network specialty pharmacy.

Rubraca Connections Patient Assistance Program

The Rubraca Connections Patient Assistance Program provides free medication to eligible uninsured or underinsured patients. To be eligible for the Rubraca Connections Patient Assistance Program, patients must:

• Have a household income that meets income requirements
• Be a resident of the United States
• Be uninsured or rendered uninsured
• Have a prescription for an FDA-approved indication for Rubraca.

To enroll a patient in this program, the patient and the prescriber can complete the Rubraca Connections Prescription Form and fax it to 844-779-7717, or mail it to the address listed on the form. Alternatively, patients can enroll by calling Rubraca Connections at 844-779-7707.

Additionally, patients who receive Rubraca tablets from a network specialty pharmacy receive 24/7 support. Contact your IOD pharmacy to learn more about potential support for your patients.

TABLE Clovis Oncology Drug