Resources

Financial Assistance

Update your billing and coding systems to include the permanent CYRAMZA® (ramucirumab) J-code: J9308, injection, ramucirumab, 5 mg. Issued by the Centers for Medicare & Medicaid Services (CMS), this permanent J-code is effective as of January 1, 2016.

Resources

Financial Assistance

Sometimes insurance isn’t enough to pay for cancer treatment.

Charitable assistance foundations

Through Lilly PatientOne, there may be a way to help your underinsured patients get the treatment they need with less financial stress. If your patients can’t afford their co-pay or coinsurance, Lilly PatientOne provides information about a number of charitable assistance foundations that may be able to help. We can even connect you with a foundation. Please remember, funding availability changes weekly, so contact a Lilly PatientOne representative at 1-866-4PatOne (1-866-472-8663) for the most recent updates.

View charitable foundations list

Lilly PatientOne Co-pay Program

Eligible patients can lower their co-pay or coinsurance costs by paying no more than $25 per dose.*

This offer is invalid for patients whose prescription claims are eligible to be reimbursed, in whole or in part, by any governmental program.

Program Overview Eligibility Criteria
Patient responsibility
ALIMTA® (pemetrexed for injection), CYRAMZA® (ramucirumab), ERBITUX® (cetuximab), LARTRUVO (olaratumab), Portrazza® (necitumumab)
Patient pays no more than $25 per dose.
Income cap
Patient’s annual gross household income is not more than the greater of $100,000 or 500% of the federal poverty level.
Maximum patient benefit
ALIMTA, CYRAMZA, ERBITUX, LARTRUVO, Portrazza
$42,000 per 12-month period
Eligible
  • Patients age 18 years or older
  • Residents of the United States or Puerto Rico
  • Patients must be treated with ALIMTA® (pemetrexed for injection), CYRAMZA® (ramucirumab), ERBITUX® (cetuximab), LARTRUVO (olaratumab), or Portrazza® (necitumumab) for an FDA-approved indication
  • Commercially insured patients
  • Patients must meet outlined income cap criteria
Ineligible
  • Participants in Medicaid, Medicare, Medigap, CHAMPUS, DOD, VA, TRICARE, or any state, patient, or pharmaceutical assistance program
  • This offer is not valid with any other financial support program, discount, or incentive involving ALIMTA, CYRAMZA, ERBITUX, LARTRUVO, or Portrazza
  • Patients, pharmacists, and prescribers must not seek reimbursement from health insurance or any third party for any part of the benefit received by the patient through this program

Patient enrollment steps

1 Review program eligibility with your patient based upon the full criteria listed in the application.
2 Click here to download an application form or call Lilly PatientOne at 1-866-4PatOne (1-866-472-8663) for a faxed copy.
3 Fax the completed application to 1-877-366-0585, and remind the patient to provide all required documentation.
  • Proof of income is required. Possible documents to prove income may include copy of W-2, copy of prior year's tax return, copy of most recent pay stub, or copy of Social Security check or award letter
4 Your patient’s application will be reviewed to determine eligibility.

What you and your patients can expect next

  • Approved patients will receive an enrollment letter and their co-pay card in the mail
  • Your office will be informed, through a faxed letter, of patient’s enrollment status and provided with direction to submit a claim for financial assistance

For more information, please call 1-866-4PatOne (1-866-472-8663).

Financial assistance is limited to the co-pay or coinsurance costs for doses of ALIMTA, CYRAMZA, ERBITUX, LARTRUVO, or Portrazza and does not cover any additional costs, including, but not limited to, fees related to the administration of ALIMTA, CYRAMZA, ERBITUX, LARTRUVO, or Portrazza.

† Additional patient terms and conditions will apply. See below for details.

‡ Uninsured patients may be eligible for programs offered by the Lilly Cares Foundation, Inc., an independent nonprofit organization. To determine eligibility, please call 1-866-4PatOne (1-866-472-8663) or visit LillyCares.com for more information.

Lilly PatientOne Co-pay Program Terms and Conditions

Eligibility: (1) You have been prescribed one of the following Lilly Oncology medicines covered by the Lilly PatientOne Co-pay Program (“Program”): ALIMTA® (pemetrexed for injection), CYRAMZA® (ramucirumab), ERBITUX® (cetuximab), LARTRUVO (olaratumab), or Portrazza® (necitumumab) (hereinafter collectively referred to as “prescribed Lilly Oncology medicine”). (2) You have commercial insurance that covers your prescribed Lilly Oncology medicine, but your insurance does not cover the full cost; that is, you have a co-pay or coinsurance obligation. (3) You are not participating in any state or federal healthcare program, including, without limitation, Medicaid, Medicare, Medigap, CHAMPUS, DOD, VA, TRICARE, or any state, patient, or pharmaceutical assistance program; patients who move from commercial insurance to a state or federal healthcare program will no longer be eligible. (4) You are 18 years of age or older and are receiving your prescribed Lilly Oncology medicine for an FDA-approved use. Please see a list of approved uses in the full US Prescribing Information, available from your doctor. (5) You are a resident of the United States or Puerto Rico. (6) Your adjusted gross household income is not more than the greater of $100,000 or 500% of the Federal Poverty Level (FPL). You must provide documented proof of your income, such as a copy of your most recent Federal Tax Return or Social Security Statement.

Program Benefits: (7) The patient must first pay a portion of his or her co-pay or coinsurance ($25 for each dose of the patient’s prescribed Lilly Oncology medicine). The Program will cover the remainder of the patient’s co-pay or coinsurance for the prescribed Lilly Oncology medicine, up to a maximum of $42,000 during a 12-month enrollment period. (8) In order to receive Program benefits, the patient or healthcare provider must submit an Explanation of Payment (EOP) form. The submitted form must include the name of the insurer and plan, and show that the prescribed Lilly Oncology medicine was the medication that was administered. (9) For enrolled patients, a claim for reimbursement must be submitted within 180 days of infusion to receive Program benefits. (10) Program benefits are limited to the co-pay or coinsurance costs for doses of the prescribed Lilly Oncology medicine only. The Program will not cover, and shall not be applied toward, the cost of any dosing procedure, any other healthcare provider service or supply charges or other treatment costs, or any costs associated with a hospital stay. (11) For enrolled patients, the Program may provide support for doses with a date of service that falls within 30 days prior to the date the application is received by the Program.

Program Timing: (12) The enrollment period is 12 months from the date of enrollment. Enrollment must be completed within 60 days of the date the application is received by the Program. (13) Patients must enroll on or before December 31, 2016, to be eligible to receive benefits. (14) Absent a change in Massachusetts law, effective July 1, 2017, Massachusetts residents will no longer be able to participate in this Program.

Additional Program Terms and Conditions: (15) Patients, pharmacists, and healthcare providers must not seek reimbursement from health insurance or any third party for any part of the benefit received by the patient through this Program. Patients must not seek reimbursement from any health savings, flexible spending, or other healthcare reimbursement accounts for the amount of assistance received from the Program. (16) Acceptance of this offer confirms that this offer is consistent with your insurance and that you will report the value of the co-pay assistance you receive as may be required by your insurance provider. (17) This offer is not valid with any other financial support program, patient assistance program (PAP), discount, or incentive involving the prescribed Lilly Oncology medicine. (18) Only valid in the United States and Puerto Rico; this offer is void where restricted or prohibited by law. (19) The Program benefits are nontransferable. (20) This offer is not conditioned on any past, present, or future purchase, including additional doses. (21) The Program is not insurance. (22) Lilly USA, LLC reserves the right to terminate, rescind, revoke, or amend this offer at any time without notice.