Patients can receive their first and subsequent doses of ZARXIO at no cost
Commercial Co-Pay Program for ZARXIO
The Sandoz One Source Commercial Co-Pay Program for ZARXIO supports eligible,* commercially insured patients with their out-of-pocket co-pay costs for ZARXIO.
Three ways to enroll:
1. Instruct your patients to enroll in co-pay online.
2. Submit an online Sandoz One Source enrollment form.
3. Download and fax the Sandoz One Source enrollment form to 1-844-726-3695.
Patient Support Services
Sandoz One Source™ provides comprehensive patient support services designed to help simplify and support patient access.
- Benefit Investigations
- Prior Authorization Support
- Appeals Support
- Commercial Co-Pay Program
- Independent Foundation Information
- Patient Assistance Program
- Billing and Coding Support
- General Payer Policy Information
Please see information about ZARXIO materials on the next page.
This website provides general information and is not intended to provide reimbursement or legal advice. Furthermore, it is not intended to increase or maximize payment by any payer. Because laws, regulations, and coverage policies are complex and updated frequently, you should check with your local Medicare carrier and payers often or go to www.cms.gov.
Nothing in the information provided shall be construed as a guarantee of Sandoz regarding levels of reimbursement, payment, or charge that reimbursement will be received. The ultimate responsibility for obtaining reimbursement lies with the physician, provider, or patient. Please consult with your counsel or reimbursement specialist for any practice-specific reimbursement or billing questions.
*Eligibility Requirements:
Maximum benefit of $10,000 annually. Prescription must be for an approved indication. This program is not health insurance. This program is for insured patients only; cash-paying or uninsured patients are not eligible. Patients are not eligible if prescription for ZARXIO is paid, in whole or in part, by any state or federally funded programs, including but not limited to Medicare (including Part D, even in the coverage gap) or Medicaid, Medigap, VA, DOD, or TriCare, or private indemnity plans that do not cover prescription drugs, or HMO insurance plans that reimburse the patient for the entire cost of their prescription drugs, or where prohibited by law. Co-Pay Program may apply to out-of-pocket expenses that occurred within 120 days prior to the date of the enrollment. Co-Pay Program may not be combined with any other rebate, coupon, or offer. Co-Pay Program has no cash value. Sandoz reserves the right to rescind, revoke, or amend this offer without further notice.
ZARXIO is a registered trademark of Novartis AG.
Sandoz One Source is a trademark of Novartis AG.