EpizymeNOW Patient Support Services

Epizyme provides a comprehensive set of support services through its EpizymeNOW Patient Support Program, which includes several financial and patient support services to facilitate access to its oncology drug Tazverik (tazemetostat) tablets. See the Table for indications and program information.

EpizymeNOW Support Services

Support services for patients include help with determining insurance benefits, prior authorization, and/or the appeal process related to the use of Tazverik. All support is subject to eligibility criteria and program terms and conditions.

Co-Pay Assistance Program

Patients with commercial insurance may be eligible to receive copayment assistance to help reduce their out-of-pocket costs for Tazverik. To be eligible for this program, patients must:

• Have commercial prescription drug insurance that covers Tazverik
• Have a valid prescription for Tazverik
• Be a resident of the United States, including the US territories
• Have no primary or secondary insurance coverage under Medicare, Medicaid, or any other federal or state healthcare program.

This offer is not valid for patients paying cash.

Patient Assistance Program

Qualified patients who are uninsured, rendered uninsured, or underinsured and have financial need may receive a free limited supply of Tazverik. To be eligible for the Patient Assistance Program, a patient must have a valid prescription, be a resident of the United States or its territories, and meet the financial requirements based on income and other supporting financial documentation. Medicare Part D patients must have coverage for Tazverik but be currently experiencing financial hardship.

Quick Start Program

New patients may receive an initial 15-day supply of Tazverik (up to 60 days until their prior authorization or coverage request for Tazverik is approved) if a prior authorization decision takes >5 business days and an immediate medical need to start the treatment is determined. The patient must have a valid prescription and prescription drug coverage under either a commercial health plan or a government program, including Medicare or Medicaid, and must be actively pursuing initial coverage or reauthorization of coverage for Tazverik. The patient must also be a resident of the United States or its territories.

Bridge Supply Program

Eligible patients with a valid prescription may receive an emergency 15-day supply of Tazverik (up to 60 days until their coverage request is approved), if they are taking Tazverik and have an unexpected disruption in their drug coverage of >5 calendar days. The patient must have prescription drug coverage under either a commercial health plan or a government program, including Medicare or Medicaid, and be a resident of the United States or its territories.

Application and Enrollment

Enrollment in the EpizymeNOW Patient Support Program requires submission of the enrollment form.

The form must be completed and signed by both the physician and patient. The completed form may be faxed to 833-437-1437.

Tazverik is distributed through the Onco360 specialty pharmacy network. The medication will be delivered to the patient’s home unless the category “Approved On-Site Self-Dispensing Pharmacy” is selected.

TABLE Epizyme Oncology Drug