ACTEMRA Full Prescribing Information  |  ACTEMRA Important Safety Information

Frequently Asked Questions (FAQs)

How long does the ACTEMRA Co-pay Card Program last?

You may use the program for 12 months as long as you remain eligible.

Can I reapply to the program after the 12 months are up?

Yes. After 12 months, you may reapply, if the program is still available. However, your account is reset and any money left in your account does not transfer over.

If you reapply, you do not receive a new card. The same card can be used for up to 3 years, if you reapply every 12 months and continue to qualify for the program.

If I switch from ACTEMRA intravenous (IV) to ACTEMRA for self-injection (or vice versa), do I have to reapply to the program?

ACTEMRA Intravenous (IV) and ACTEMRA for self-injection are FDA-approved for use in moderate to severe RA patients that have had an inadequate response to a DMARD. If you are this type of RA patient, and switching from ACTEMRA IV to ACTEMRA for self-injection, you do not need to reapply for the program. Once you qualify and are enrolled in the program, you are eligible to receive $15,000 per 12-month period, subject to submission of documents required for funding of the card with co-pay assistance payments. Note that ACTEMRA for self-injection is not approved for use in patients with systemic juvenile idiopathic arthritis (SJIA) and patients with polyarticular juvenile idiopathic arthritis (PJIA) and ACTEMRA IV is not approved for use in giant cell arteritis (GCA) patients. The ACTEMRA Co-Pay Card Program provides drug co-pay assistance for out-of-pocket costs of ACTEMRA only when ACTEMRA IV or ACTEMRA self-injection is prescribed for an approved use.

If I switch from one Genentech medicine to the other, do I have to reapply to the program?

Yes. Each card can be used for either Rituxan or ACTEMRA only. If you switch to a different Genentech medicine , you must reapply to receive assistance for the new medicine.

What if I forgot to apply and have already received treatment?

You must be enrolled in the program before your treatment. However, under certain circumstances, an exception may be possible. Please call (855) RA-COPAY (855-722-6729) for more information.

How many treatments does the program cover?

If you qualify, you can use the program for any ACTEMRA treatment, prescribed based on an FDA-approved use for that drug, during the 12-month period following the enrollment date, up to a total of $15,000. You pay $5 per drug co-pay, after meeting requirements for submission of documentation related to the administration of any ACTEMRA treatment.

Does the program help with the costs of the intravenous (IV) infusion or doctor's visits?

No. The program only helps with the drug co-pay for ACTEMRA. It does not help with other costs, like IV infusions or doctor's visits.

Can the program be used by ACTEMRA patients with giant cell arteritis (GCA)?

Yes. The program is available to all eligible commercially insured ACTEMRA for self-injection patients with giant cell arteritis (GCA).

Can the program be used by ACTEMRA patients with systemic juvenile idiopathic arthritis (SJIA) or polyarticular juvenile idiopathic arthritis (PJIA) who are under 18?

Yes. The program is available to all eligible commercially insured patients taking ACTEMRA for intravenous use (IV) for an approved indication. The patient's guardian or legally authorized person who is 18 years or older would need to apply for the co-pay assistance on behalf of the patient under 18.

What if I forget to bring the card to the appointment?

You can call (855) RA-COPAY (855-722-6729) from your doctor's office. The help desk hours are from 6 a.m.–5 p.m. ET, Monday through Friday, except major holidays. We will give the account number over the phone.

May I use the ACTEMRA Co-pay Card Program at an outside infusion center?

Yes. You may use the program anywhere you get your ACTEMRA treatments as long as your infusion center accepts the card.

Will I be asked for other information throughout the 12-month period?

Yes. You will be asked to send copies of your detailed Explanation of Benefits (EOB) statements after each infusion or injection. This information is required to fund the card.

Can I use the Genentech® Access to Care Foundation (GATCF) and the Genentech Rheumatology Co-pay Card Program at the same time?

No. Patients who are getting help with their drug co-pay for ACTEMRA from GATCF or other patient assistance programs cannot use the ACTEMRA Co-pay Card Program. Call (866) 681-3261 or visit Genentech-Access.com/Rheumatology to learn more about GATCF and other patient assistance programs from Genentech Rheumatology Access Solutions.

Can I get a refund from a health plan for the co-pay paid by the card?

No. You cannot receive a refund from a health plan or anyone else for the amount paid by the card.

How do I find out how much money is left on the card?

You can log in to your account to learn your card balance and expiration dates. You can also call (855) RA-COPAY (855-722-6729) from
6 a.m.–5 p.m. ET, Monday through Friday, except major holidays.

If you have any additional questions, please call (855) RA-COPAY (855-722-6729) from 6 a.m.–5 p.m. ET, Monday through Friday, except major holidays.

 

*Eligible commercially insured patients can receive up to $15,000 per 12-month period. They pay $5 per drug co-pay until the $15,000 limit is reached.

ACTEMRA is a prescription medicine called an interleukin-6 (IL-6) receptor antagonist. ACTEMRA is used to treat:

  • Adults with moderately to severely active rheumatoid arthritis (RA), after at least one other medicine called a Disease Modifying Anti-Rheumatic Drug (DMARD) has been used and did not work well.
  • Adults with giant cell arteritis (GCA).
  • People with active polyarticular juvenile idiopathic arthritis (PJIA) ages 2 and above.
  • People with active systemic juvenile idiopathic arthritis (SJIA) ages 2 and above.

ACTEMRA is not approved for subcutaneous use in people with PJIA or SJIA.

It is not known if ACTEMRA is safe and effective in children with PJIA or SJIA under 2 years of age or in children with conditions other than PJIA or SJIA.

ACTEMRA can cause serious side effects, including serious infections. ACTEMRA changes the way your immune system works, which can make you more likely to get infections or make any current infection worse. Some people have serious infections while taking ACTEMRA, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Your healthcare provider should test you for TB before starting ACTEMRA.

ACTEMRA can cause other serious side effects. These include:

  • Tears of the stomach or intestines
  • Changes in blood test results, including low neutrophil (white blood cells) and platelet (platelets help the blood to clot) counts, and increases in certain liver function test levels and blood cholesterol levels
  • An increased risk of certain cancers by changing the way a patient's immune system works
  • Hepatitis B infection
  • Serious allergic reactions, including death. These may happen with ACTEMRA infusions or injections, even if they did not occur with an earlier infusion or injection. If a patient has had hives, a rash, or experienced flushing after injecting, the patient should tell their doctor or nurse before their next injection
  • Nervous system problems

Do not take ACTEMRA if you are allergic to ACTEMRA or any of the ingredients in ACTEMRA.

Most common side effects in patients treated with ACTEMRA:

  • Upper respiratory tract infections (like common cold and sinus infections)
  • Headache
  • Increased blood pressure (also called hypertension)
  • Injection site reactions

ACTEMRA & pregnancy:

Patients must tell their doctor if they are planning to become pregnant, are pregnant, plan to breast-feed, or are breast-feeding. The patient and their doctor should decide if the patient will take ACTEMRA or breast-feed. Patients should not do both. If a patient is pregnant and taking ACTEMRA, they must join the pregnancy registry. To learn more, patients should call 1-877-311-8972 or talk to their doctor to register.

Patients must tell their doctor right away if they are experiencing any side effects. Report side effects to the FDA at 1-800-FDA-1088 or www.FDA.gov/medwatch. Call Genentech at 1-888-835-2555.

Please see the accompanying full Prescribing Information, including Boxed Warning and Medication Guide, for additional Important Safety Information.

ACTEMRA® and its logo are registered trademarks of Chugai Seiyaku Kabushiki Kaisha Corp., a member of the Roche Group.

The ACTEMRA Prepaid Mastercard® is issued by Comerica Bank pursuant to license by Mastercard International. No cash or ATM access. The card can be used only to purchase prescriptions at participating merchant locations where Debit Mastercard is accepted. Mastercard® is a registered trademark of Mastercard International Incorporated.