ACCESS4ME™ OFFERS SUPPORT FOR ELIGIBLE PATIENTS
Access4Me is committed to ensuring your eligible patients have access to ROLVEDON.
Access4Me offers a comprehensive list of programs
Programs are designed so you can utilize product on hand without waiting for patient-specific shipments. For approved patients, simply utilize ROLVEDON™ from your existing supply, then submit the Product Replacement Form. Replacement product will be shipped directly to the facility where ROLVEDON was administered.
Patients who are uninsured or underinsured may be eligible to receive ROLVEDON at no cost through the Patient Assistance Program
Patient eligibility‡
- Uninsured or underinsured for ROLVEDON
- Must be a resident of the United States
- Demonstrates financial need
- Eligible patients must have an annual income of <500% of the federal poverty level (FPL) adjusted for family size (eg, $150,000/year for a family of 4*). See www.aspe.hhs.gov/poverty-guidelines for US federal poverty guidelines
*based on 2023 data
Access4Me will independently verify a patient's income with our income validation tool.‡
‡If the income validation tool is unable to return results, the patient will be required by Access4Me to provide proof of income. Proof of income may also be requested at any time for audit/verification.
Replacement product for approved patients is shipped on a monthly basis directly to the facility address where the product was administered. Product Replacement Form required.
Access4Me can provide information about financial assistance from independent charitable foundations.§
Access Specialists can help patients by:
- Verifying coverage and determining patient out-of-pocket costs for ROLVEDON
- Identifying independent charitable foundations with available funding for approved indications
- Provide information to assist patient with applying to the foundation chosen by the patient
- Communicating with physician's office throughout the referral process
§Independent foundations have their own eligibility rules and we cannot guarantee a foundation will help you. We do not endorse or prefer any particular foundation.
Terms and conditions apply. Contact Access4Me or your Field Reimbursement Manger for program rules and requirements.
FIRST-CYCLE Patient Support program
No income requirement
Eligible new patients can receive their first-cycle dose of ROLVEDON free of charge. When enrolling the patient, simply check First-Cycle Patient Support on the enrollment form.* Access4Me will conduct the benefits investigation, communicate the results to your office, and confirm eligibility for the free dose.
- Must be a new patient, enrolled in Access4Me
- Must be a resident of the United States
- No income requirement
- Limited to ONE free dose per patient
*Enrollment form must be received prior to the date of injection. Replacement product for approved patients is shipped directly to the facility address where the product was administered.
Utilization limits apply. Contact Access4Me or your Field Reimbursement Manager for complete terms and conditions or visit the Resources section.
ROLVEDON copay assistance program
- Reduce out-of-pocket costs for patients with commercial insurance
- Pay as little as $0 out-of-pocket cost for eligible patients with commercial insurance
- Maximum annual benefit of $15,000 per 12-month enrollment period
- Maximum of $5,500 per script
- No income requirement
Upon approval, the copay card is activated and shipped directly to the provider or injection center.
The program covers† up to $15,000 in assistance per year toward product-specific copay, coinsurance, and insurance deductibles for ROLVEDON treatments. Patients are responsible for any additional copay costs that exceed the program assistance limit.
- Must have commercial or private insurance that covers ROLVEDON
- Must have a copay for ROLVEDON
- Must be a resident of the United States
†Subject to annual assistance limit. Not an insurance or debit card program. This program is not valid for prescriptions covered by or submitted for reimbursement under Medicaid, Medicare, VA, DOD, TRICARE, or similar federal or state programs. This program does not cover or provide support for supplies, procedures, or any physician-related service associated with ROLVEDON. General, non–product-specific copay, coinsurance, or insurance deductibles are not covered. This program is not valid where prohibited by law, taxed, or restricted. Access4Me reserves the right to rescind, revoke, terminate, or amend this offer, eligibility, and terms of use at any time without notice. Additional program conditions may apply.
For questions about applying for coverage, program eligibility criteria, or denied claims, call Access4Me at 866-582-2737 (866-58-CARES) 8:00 AM to 8:00 PM (ET), Monday - Friday.Enroll your patient via the Access4Me Provider Portal at Access4MePortal.com.
To enroll via written form, select the appropriate support option on the Enrollment Form and fax to 833-281-7416.
To enroll by phone, your office or patients may call Access4Me at 866-582-2737 (866-58-CARES) 8:00 AM to 8:00 PM (ET), Monday - Friday.
Spectrum Pharmaceuticals reserves the right, at its sole discretion, to discontinue the Copay Assistance Program, the Patient Assistance Program, and the Claims Denial Program or may revise, change, or terminate these programs at any time.
Visit Access4MePortal.com for online enrollment and access to tools, forms and resources.