ALECENSA Access Solutions offers a range of access and reimbursement resources for your patients and practice after ALECENSA is prescribed, including help with benefits investigations (BIs), resources for prior authorizations (PAs), sample billing and coding information, resources for denials and appeals, information about distribution and referrals to potential financial assistance options.
Get help understanding insurance benefits and coverage, such as with benefits investigations and prior authorization resources.
ALECENSA Access Solutions can conduct a benefits investigation (BI) which can determine:
*If your patient’s request for a prior authorization is not granted, your ALECENSA Access Solutions Specialist can work with you to determine your next steps.
Get started with enrollment by following the steps below.
If your practice has a registered account for My Patient Solutions, you can get started by logging into your account.
Don't have an account?
Your patient is required to complete the Patient Consent Form. You can either upload their Patient Consent Form as part of your application or have your patient submit the form via fax, text or e-submit.
An online tool to help you enroll patients in ALECENSA Access Solutions and manage your service requests at your convenience
Step 1: Print one of the Patient Consent Forms below for your patient to complete.
Step 2: Print and complete the Prescriber Service Form below.
Step 3: Submit the completed forms via fax or text.
Both forms are required. We must have both the Patient Consent Form and the Prescriber Service Form before we can help you.
What to expect next:
Genentech reserves the right to modify or discontinue the program at any time and to verify the accuracy of information submitted.
The completion and submission of coverage- or reimbursement-related documentation are the responsibility of the patient and healthcare provider. Genentech makes no representation or guarantee concerning coverage or reimbursement for any service or item.
Patients facing a coverage delay may be eligible for the SureStart® Program while awaiting insurance verification. If you would like your patient considered for the SureStart® Program, you can indicate that when enrolling in ALECENSA Access Solutions with the Prescriber Service Form. You will also need to have your patient complete the Patient Consent Form.
Eligible patients can receive up to a 30-day supply of ALECENSA. Once coverage has been determined, the patient no longer qualifies for the SureStart® Program.
Subject to eligibility requirements and terms and conditions. This program is void where prohibited by law and may not be used in or by residents of restricted states, if applicable.
The ALECENSA SureStart® Program provides eligible patients who have experienced an insurance coverage delay of 30 days with one free 30-day supply of ALECENSA. If a coverage delay persists, a patient may be eligible for one 30-day refill of ALECENSA. There is no obligation to purchase any future product and receipt of free product is not contingent on any future purchase. Requests for the ALECENSA SureStart® Program cannot be processed without a completed and signed 1) ALECENSA Prescriber Service Form and 2) Patient Consent Form. Patients must be prescribed ALECENSA for an FDA-approved indication. Neither the prescriber, the pharmacy, nor any patient receiving free product via the ALECENSA SureStart® Program may seek reimbursement or credit for any part of the benefit received by the patient through this offer from any insurer, health plan, or government program.
The ALECENSA SureStart® Program cannot be counted towards any out-of-pocket costs under any plan (such as true out-of-pocket cost under a Medicare Part D prescription drug plan). The ALECENSA SureStart® Program enrollment team may notify the patient’s insurer that the patient is receiving a free supply of product from the program. Prescribers may not advertise or otherwise use the program as a means of promoting their services or Genentech’s products to patients. This program is void where prohibited by law and may not be used in or by residents of restricted states, where applicable. The free supply may not be sold, purchased or traded or offered for sale, purchase or trade. This program is not a benefit plan. Genentech reserves the right to rescind, revoke or amend the program without notice at any time.
When a medical treatment is authorized by the patient’s insurance plan for a limited period of time, it will generally require reverification of coverage for continued treatment. ALECENSA Access Solutions can help you obtain reverification for your patients.
If the patient’s health insurance plan denies the request for reverification, your practice may file an appeal on behalf of your patient.
Sample coding information and resources for denials and appeals
This coding information may assist you as you complete the payer forms for ALECENSA. These tables are provided for informational purposes only. Please visit CMS.gov or other payers’ websites to obtain additional guidance on their processes related to billing and coding.
Download sample coding and the important safety information for ALECENSA below.
Correct coding is the responsibility of the provider submitting the claim for the item or service. Please check with the payer to verify codes and special billing requirements. Genentech does not make any representation or guarantee concerning reimbursement or coverage for any service or item.
If your patient’s health insurance plan has issued a denial, your ALECENSA Access Solutions Specialist can provide resources as you prepare an appeal submission, as per your patient’s plan requirements.
If a plan issues a denial:
A sample appeal letter and additional considerations are available on the Practice Forms and Documents page.
Appeals cannot be completed or submitted by Genentech on your behalf.
My Patient Solutions is an online tool to help you enroll patients in ALECENSA Access Solutions and manage your service requests, all through one portal. It allows you the flexibility to work with ALECENSA Access Solutions when it’s convenient for you.
With My Patient Solutions, you can:
How to register
Account registration can be completed by one person for the entire practice and for multiple practice locations. For help with registration or if you have questions, call us at 877-GENENTECH (877-436-3683) (6AM-5PM PST, Monday through Friday).
Genentech has contracted with a network of authorized specialty distributors and specialty pharmacies (SPs) to service practices choosing to prescribe ALECENSA.
These partners have made a commitment to product integrity and have agreed to distribute only products purchased directly from Genentech and not to distribute ALECENSA through secondary channels.
Distributor | Telephone | Fax | Web Orders |
---|---|---|---|
ASD Healthcare (ABSG) | 800-647-0575 | 800-547-9413 | www.asdhealthcare.com |
Besse Medical (ABSG) | 800-543-2111 | 800-543-8695 | www.besse.com/home |
BioSolutions Direct (ABSG) | 866-860-3565 | 888-899-0063 | www.biosolutionsdirect.com |
Cardinal Health Specialty Distribution | 866-677-4844 | N/A | www.cardinalhealth.com/en/solutions/specialty-distribution.html |
Dakota Drug | 866-210-5887 | 763-421-0661 | www.dakdrug.com/ContactUs.aspx |
DMS Pharmaceutical | 877-788-1100 | 847-518-1105 | www.dmspharma.com/contact-us |
McKesson Plasma and Biologics (MPB) | 877-625-2566 | N/A | www.mckesson.com/Pharmaceutical-Distribution/Plasma-Biologics/ |
Metro Medical (Cardinal Health) | 800-768-2002 | 615-256-4194 | www.metromedicalorder.com |
Oncology Supply (ABSG) | 800-633-7555 | 800-248-8205 | www.oncologysupply.com/ |
Distributor | Telephone | Fax | Web Orders |
---|---|---|---|
ASD Healthcare (ABSG) | 800-647-0575 | 800-547-9413 | www.asdhealthcare.com |
Besse Medical (ABSG) | 800-543-2111 | 800-543-8695 | www.besse.com/home |
BioSolutions Direct (ABSG) | 866-860-3565 | 888-899-0063 | www.biosolutionsdirect.com |
Cardinal Health Specialty Distribution | 866-677-4844 | N/A | www.cardinalhealth.com/en/solutions/specialty-distribution.html |
CuraScript SD (Priority Health) | 877-599-7748 | 800-862-6208 | curascriptsd.com/Contact-Us |
McKesson Plasma and Biologics (MPB) | 877-625-2566 | N/A | www.mckesson.com/Pharmaceutical-Distribution/Plasma-Biologics/ |
Metro Medical (Cardinal Health) | 800-768-2002 | 615-256-4194 | www.metromedicalorder.com |
Oncology Supply (ABSG) | 800-633-7555 | 800-248-8205 | www.oncologysupply.com/ |
Distributor | Telephone | Fax | Web Orders |
---|---|---|---|
ASD Healthcare (ABSG) | 800-647-0575 | 800-547-9413 | www.asdhealthcare.com |
Besse Medical (ABSG) | 800-543-2111 | 800-543-8695 | www.besse.com/home |
BioSolutions Direct (ABSG) | 866-860-3565 | 888-899-0063 | www.biosolutionsdirect.com |
Cardinal Health Specialty Distribution | 866-677-4844 | N/A | www.cardinalhealth.com/en/solutions/specialty-distribution.html |
CuraScript SD (Priority Health) | 877-599-7748 | 800-862-6208 | curascriptsd.com/Contact-Us |
McKesson Specialty Health (McKesson Specialty Care Distribution Corporation) | 800-482-6700 | N/A | www.mckesson.com/specialty/ |
Metro Medical (Cardinal Health) | 800-768-2002 | 615-256-4194 | www.metromedicalorder.com |
Oncology Supply (ABSG) | 800-633-7555 | 800-248-8205 | www.oncologysupply.com/ |
Distributor | Telephone | Fax | Web Orders |
---|---|---|---|
ASD Healthcare (ABSG) | 800-647-0575 | 800-547-9413 | www.asdhealthcare.com |
Besse Medical (ABSG) | 800-543-2111 | 800-543-8695 | www.besse.com/home |
BioSolutions Direct (ABSG) | 866-860-3565 | 888-899-0063 | www.biosolutionsdirect.com |
Cardinal Health Specialty Distribution | 866-677-4844 | N/A | www.cardinalhealth.com/en/solutions/specialty-distribution.html |
CuraScript SD (Priority Health) | 877-599-7748 | 800-862-6208 | curascriptsd.com/Contact-Us |
McKesson Plasma and Biologics (MPB) | 877-625-2566 | N/A | www.mckesson.com/Pharmaceutical-Distribution/Plasma-Biologics/ |
McKesson Specialty Health (McKesson Specialty Care Distribution Corporation) | 800-482-6700 | N/A | www.mckesson.com/specialty/ |
Metro Medical (Cardinal Health) | 800-768-2002 | 615-256-4194 | www.metromedicalorder.com |
Oncology Supply (ABSG) | 800-633-7555 | 800-248-8205 | www.oncologysupply.com/ |
Distributor | Telephone | Fax | Web Orders |
---|---|---|---|
Cardinal Health Puerto Rico | 787-625-4200 | N/A | cardinalhealth.pr/ |
Cesar Castillo (Puerto Rico) | 787-999-1616 | 787-999-1618 | cesarcastillo.net/welcome/ |
Distributor | Telephone | Fax | Web Orders |
---|---|---|---|
Absolute Pharmacy Care (Puerto Rico Only) | 787-892-8700 | 787-264-5800 | N/A |
AcariaHealth | 800-511-5144 | 877-541-1503 | www.acariahealth.com |
Accredo | 888-608-9010 | 888-302-1028 | www.accredo.com |
Amber Pharmacy | 888-370-1724 | 877-645-7514 | www.amberpharmacy.com/ |
Ardon Health Specialty Pharmacy | 855-425-4085 | N/A | www.ardonhealth.com/ |
Biologics | 800-850-4306 | 800-823-4506 | biologics.mckesson.com/ |
CenterWell Specialty Pharmacy (formerly Humana Specialty Pharmacy) | 800-486-2668 | N/A | www.centerwellpharmacy.com/ |
CVS Specialty | 800-237-2767 | 800-323-2445 | www.cvsspecialty.com |
Elixir (formerly Envision) | 877-437-9012 | N/A | envisionpharmacies.com/Specialty |
Kroger Specialty Pharmacy | 855-802-3230 | 888-315-3270 | www.krogerspecialtypharmacy.com/ |
Lumicera Health Services | 855-847-3554 | 855-847-3558 | www.lumicera.com/ |
MC-RX (Medical Centre Specialty Pharmacy) | 855-828-1484 | N/A | www.mc-rx.com/ |
Nufactor | 800-323-6832 | N/A | www.nufactor.com/ |
Onco360 (OncoMed Specialty) | 877-662-6633 | 877-662-6355 | www.onco360.com |
Optum Specialty Pharmacy | 855-427-4682 | 877-342-4596 | specialty.optumrx.com/ |
Orlando Health Scripts | 800-508-7383 | N/A | www.orlandohealth.com/services-and-specialties/scripts-pharmacy/specialty-pharmacy#/Specialty+Pharmacy/ |
Oso Home Care Pharmacy | 800-310-6611 | N/A | osohomecare.com/ |
Perform Specialty | 855-287-7888 | 844-489-9565 | www.performspecialty.com/ |
Pruitt Health Pharmacy Services | 678-533-6459 | N/A | pruitthealth.com/microsite/facilityid504 |
Special Care Pharmacy (Puerto Rico Only) | 787-783-8579 | 787-783-2951 | specialcarepr.com |
US Bioservices (Amerisource Bergen SP) | 877-757-0667 | 888-418-7246 | www.usbioservices.com |
Walgreens Specialty Pharmacy | 888-782-8443 | N/A | www.walgreens.com/topic/pharmacy/specialty-pharmacy.jsp |
With Buy and Bill, the practice purchases the medication in advance, then bills the patient's health insurance plan for reimbursement. The practice is responsible for storing and handling the drug as well as collecting the patient's co-pay for both the drug and its administration. With Buy and Bill, practices can maintain a stock of the drug, giving them the flexibility to treat patients when clinically appropriate.
ALECENSA Access Solutions works with specialty pharmacies (SPs) to help patients receive their prescribed Genentech medicines.
In addition to distributing medicines, an SP may provide the following services:
You can work with your preferred SP or contact ALECENSA Access Solutions to learn which SP the patient’s health insurance plan mandates or prefers.
Genentech does not influence or advocate the use of any one specialty distributor or specialty pharmacy. We make no representation or guarantee of service or coverage of any item. For any product-specific distribution questions, call ALECENSA Access Solutions at 888-249-4918 (6AM-5PM PST, Monday through Friday).
We are serious about patient safety. If your Genentech product is spoiled, expired or damaged, we may be able to help you replace it.
Please contact Genentech Customer Service at (800) 551-2231 for any order or return-related questions.
IQVIA US Claims, January 2021-December 2022.
IQVIA US Claims, January 2021-December 2022.
ALECENSA [prescribing information]. South San Francisco, CA: Genentech USA, Inc; 2021.
ALECENSA [prescribing information]. South San Francisco, CA: Genentech USA, Inc; 2021.
Peters S, Camidge DR, Shaw AT, et al. Alectinib versus crizotinib in untreated ALK-positive non–small cell lung cancer. N Engl J Med. 2017;377:829-838.
Peters S, Camidge DR, Shaw AT, et al. Alectinib versus crizotinib in untreated ALK-positive non–small cell lung cancer. N Engl J Med. 2017;377:829-838.
Data on file. Genentech, Inc.
Data on file. Genentech, Inc.
Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer V.3.2023. © National Comprehensive Cancer Network, Inc. 2023. All rights reserved. Accessed April 20, 2023. To view the most recent and complete version of the guideline, go online to NCCN.org.
Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer V.3.2023. © National Comprehensive Cancer Network, Inc. 2023. All rights reserved. Accessed April 20, 2023. To view the most recent and complete version of the guideline, go online to NCCN.org.
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Sakamoto H, Tsukaguchi T, Hiroshima S, et al. CH5424802, a selective ALK inhibitor capable of blocking the resistant gatekeeper mutant. Cancer Cell. 2011;19:679-690.
Sakamoto H, Tsukaguchi T, Hiroshima S, et al. CH5424802, a selective ALK inhibitor capable of blocking the resistant gatekeeper mutant. Cancer Cell. 2011;19:679-690.
Kodama T, Hasegawa M, Takanashi K, Sakurai Y, Kondoh O, Sakamoto H. Antitumor activity of the selective ALK inhibitor alectinib in models of intracranial metastases. Cancer Chemother Pharmacol. 2014;74:1023-1028.
Kodama T, Hasegawa M, Takanashi K, Sakurai Y, Kondoh O, Sakamoto H. Antitumor activity of the selective ALK inhibitor alectinib in models of intracranial metastases. Cancer Chemother Pharmacol. 2014;74:1023-1028.
Löscher W, Potschka H. Blood-brain barrier active efflux transporters: ATP-binding cassette gene family. NeuroRx. 2005;2:86-98.
Löscher W, Potschka H. Blood-brain barrier active efflux transporters: ATP-binding cassette gene family. NeuroRx. 2005;2:86-98.
Schinkel AH, Jonker JW. Mammalian drug efflux transporters of the ATP binding cassette (ABC) family: an overview. Adv Drug Deliv Rev. 2003;55:3-29.
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Camidge DR, Dziadziuszko R, Peters S, et al. Updated efficacy and safety data and impact of the EML4-ALK fusion variant on the efficacy of alectinib in untreated ALK-positive advanced non-small cell lung cancer in the global phase III ALEX study [published online March 19, 2019]. J Thorac Oncol. doi:10.1016/j.jtho.2019.03.007.
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Peters S, Camidge DR, Shaw AT, et al. Alectinib versus crizotinib in untreated ALK-positive non–small cell lung cancer. N Engl J Med. 2017;377(protocol):1-384.
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