GlaxoSmithKline: Together with GSK Oncology Patient Support Services

GlaxoSmithKline (GSK), through its Together with GSK Oncology program, provides claims assistance, access, and reimbursement support services for its oncology drugs (Table).

Together with GSK Oncology

Commercial Co-pay Assistance Program

Eligible patients with commercial insurance may receive assistance with their out-of-pocket expenses for Zejula, Blenrep, or Jemperli, including up to $100 per administration for intravenous drugs, for a total annual limit of $26,000. Patients may be eligible if they:

• Have a commercial medical or prescription insurance plan
• Are uninsured
• Reside in the United States, including the District of Columbia, Puerto Rico, or the US Virgin Islands
• Are not eligible for or enrolled in a government-funded program.

Patient Assistance Program

Uninsured patients who meet eligibility requirements may access medication free of charge through GSK’s Patient Assistance Program. Medicare patients who meet specific program requirements may also be eligible for this program.

To qualify for the Zejula, Blenrep, or Jemperli Patient Assistance Program, a patient must:

• Live in the United States, the District of Columbia, Puerto Rico, or the US Virgin Islands
• Meet one of the following criteria:
  • Be uninsured
  • Have private commercial insurance but have no coverage (medical or pharmacy) for the product, as demonstrated to the program through the defined Appeals Process criteria
  • Not be currently receiving prescription drug coverage through a government program (excluding Medicare), which includes Medicaid, Veterans Affairs, Department of Defense, or TRICARE benefits
  • Not be eligible for Puerto Rico’s government health plan Mi Salud, or have applied and been denied
  • Meet certain income eligibility requirements.

For assistance with the Zejula, Blenrep, or Jemperli Patient Assistance Program, please call Together with GSK Oncology at 844-447-5662. Click here to review program terms and conditions.

Ophthalmology Support Services

Blenrep is available only through the Blenrep REMS (Risk Evaluation and Mitigation Strategy), a restricted distribution program to help manage the risk of ocular toxicity. The Ophthalmology Support Services program helps eligible, enrolled patients who are taking Blenrep locate an eye care professional, schedule an eye care appointment, and provide reminders for scheduled eye care appointments. To learn more, call Together with GSK Oncology at 844-447-5662.

Zejula Quick Start and Bridge Programs

For patients experiencing delay in coverage at first dispense of Zejula (Quick Start) or coverage interruptions while already on treatment (Bridge), download and fill out the enrollment form, then fax to Together with GSK Oncology at 800-645-9043 to check for eligibility. Click here to access the form.

TABLE GlaxoSmithKline Oncology Drugs