TRODELVY ACCESS SUPPORT is a patient access and reimbursement support program. It will help you and your patient understand specific coverage and reimbursement guidelines for TRODELVY 180-mg single-dose vial.
Reimbursement support services include:
- Coverage verification
- Prior authorization information
- Claims status information
- Billing and coding information
- Alternate assistance options
TRODELVY support may vary based on application criteria and is subject to change or discontinuation. Physician office must submit prior authorizations and appeals.
*TRODELVY Savings Program is not available to patients with any form of government insurance. Patients must meet certain eligibility criteria to qualify for this program. Once enrolled the patient pays $0 out-of-pocket for TRODELVY, with maximum benefit of $25,000 per year.
†Gilead PAP provides TRODELVY free of charge for eligible patients who are uninsured or underinsured. To qualify for assistance, patients must meet certain eligibility criteria.
‡Patients with Medicare or other government insurance who need assistance with cost-share requirements for TRODELVY may be eligible for co-pay or co-insurance assistance through an independent co-pay assistance foundation. Case managers can help patients assess their high-level eligibility for possible coverage for TRODELVY through an independent co-pay assistance foundation. If co-pay assistance needs are identified, the case managers can provide information about any available foundations. The foundation will determine the patient’s eligibility for co-pay or co-insurance assistance based on their own criteria and, completely independent of Gilead and its agents, will contact the patient directly regarding the application process. Gilead and its agents make no guarantee regarding reimbursement for any service or item.
To enroll a patient into TRODELVY ACCESS SUPPORT, please complete the Enrollment Form with your patient and fax to 1-833-851-4344.
For further information, please contact TRODELVY ACCESS SUPPORT:
Monday – Friday, 9 AM – 7 PM ET
Or fax inquiries to 1-833-851-4344
TRODELVY SAVINGS PROGRAM
The TRODELVY Savings Program provides savings on out-of-pocket expenses for TRODELVY 180-mg single-dose vial, up to $25,000 annually for commercially or privately insured patients. Terms and conditions apply.§
- Patients pay $0 out of pocket for TRODELVY, which includes co-pay and co-insurance up to $25,000 annually
- The Program only assists with cost of TRODELVY; patient is responsible for cost-share of treatments and office visits
- This Program does not support any claims covered, paid, or reimbursed, in whole or in part, by Medicaid, Medicare, or other federal or state healthcare programs
- See Reimbursement Process below for simple steps to receive savings
- For additional information, contact TRODELVY ACCESS SUPPORT at 1-844-TRODELVY (1-844-876-3358), option 4
Have your patient complete the Enrollment Form and attach the following:
An Explanation of Benefits or a dated pharmacy receipt indicating TRODELVY payment should be submitted, if available, within 120 days of the date of service to TRODELVY ACCESS SUPPORT.
Submit reimbursement claim and attachments via mail or fax.
MAIL: TRODELVY ACCESS SUPPORT
2730 S. Edmonds Ln.
Lewisville, TX 75067
Phone: 1-844-TRODELVY (1-844-876-3358), select option 4 for assistance.
§Terms & Conditions
Eligible patients receive up to a max benefit of $25,000 per year. This offer is not valid for prescriptions covered by or submitted for reimbursement, in whole or in part, under Medicare (including Medicare Part D), Medicaid, similar federal or state-funded programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico), or where otherwise prohibited by law. No claims for reimbursement for TRODELVY units dispensed under the TRODELVY Savings Program may be submitted to any public payor (ie, Medicare, Medicaid, Medigap, Tricare, VA, and DoD). Product dispensed pursuant to program rules and federal and state laws. Immunomedics reserves the right to rescind, revoke, or amend this offer without notice at any time. Not valid if reproduced. This offer is valid in the United States. Void where prohibited by law.
Gilead Patient Assistance Program
Patients who are uninsured or underinsured may be eligible to obtain access to TRODELVY at no cost through the Gilead Patient Assistance Program (PAP). To qualify for assistance, patients must meet certain eligibility criteria.
- To determine patient eligibility, fax a completed PAP Enrollment Form to 1-833-851-4344 or by mail:
TRODELVY ACCESS SUPPORT
2730 S. Edmonds Ln.
Lewisville, TX 75067
A Case Manager will contact your office with determination of patient’s eligibility.
For more information regarding the Patient Assistance Program, please contact TRODELVY ACCESS SUPPORT at 1-844-TRODELVY (1-844-876-3358).
Third-party Assistance Referrals
TRODELVY ACCESS SUPPORT Case Managers can provide patients who are unable to afford their medication (including those with Medicare, Medicaid, or other government-sponsored insurance) with information about independent third-party organizations that may be able to help with the cost of treatment.
Your practice or your patients can call 1-844-TRODELVY (1-844-876-3358), option 4, for more information.
Reimbursement, billing, and coding
Coverage, coding, and billing requirements for TRODELVY may vary by plan and patient. Please download the resource guide below to assist you with proper coding to help optimize reimbursement support.