Financial assistance for your patients

Case managers can help identify financial assistance that may be available to your patients

Hans
Takeda Oncology
Here2Assist® patient

Hans, a Takeda Oncology Here2Assist® patient

Takeda Oncology Co-Pay Assistance Program

Patients who have private insurance and are concerned about out-of-pocket costs may be eligible for the Takeda Oncology Co-Pay Assistance Program.

To enroll

Please complete and submit a Takeda Oncology Here2Assist® enrollment form for your patient to be considered for the Takeda Oncology Co-Pay Assistance Program.

Your patient could pay as little as $0 per prescription. Terms and conditions apply.*

To re-enroll

Patients who continue to meet the eligibility requirements and need continued enrollment in the program after 12 months can be re-enrolled by starting the process below.

Choose your patient’s medication:

To replace a lost card

For help replacing your patient’s lost card, call a case manager at 1-844-817-6468, Option 2, Monday-Friday, 8AM-8PM ET.

Phyllis
Takeda Oncology
Here2Assist® patient

Phyllis, a Takeda Oncology Here2Assist® patient

Takeda Oncology Patient Assistance Program

Patients who are uninsured or whose prescription isn’t covered by their insurance may be able to receive their medication at no cost to them through the Takeda Oncology Patient Assistance Program (PAP).^†

Step 1

Complete the application together with your patient and submit it along with income documentation and a valid prescription for their medication.

Step 2

A case manager will review the application and notify both you and your patient if they are eligible for the program. Patients may be enrolled in the program for up to 1 year.^‡

Step 3

Once enrolled, a 1-month supply of medication will be delivered to them at no cost.

Step 4

Each month, a Takeda Oncology Here2Assist case manager will follow up with your patient to confirm that they are still being treated and are eligible to receive another month's supply of medication.

To renew or reapply
Patients can request to renew their application up to 2 months before the 1-year enrollment period ends. Medicare patients should submit their applications between October 15 and December 31 so their application can be reviewed for the new enrollment year starting January 1.

Additional resources from trusted programs and organizations

Below are some links to government-sponsored programs and nonprofit organizations that may help your patient with the cost of their prescription:   

Medicare Part D Extra Help Program ssa.gov

Medicaid Drug Rebate Program medicaid.gov

American Cancer Society cancer.org

Cancer Care Financial Assistance Program cancercare.org

Related resources

Takeda Oncology Here2Assist Enrollment Form

English Español

Takeda Oncology Patient Assistance Program Application

English Español

Takeda Oncology Co-Pay Assistance Program Brochure

Download

Takeda Oncology Here2Assist Patient Brochure

English Español

*By enrolling in the Takeda Oncology Co-Pay Assistance Program (the “Program”), you acknowledge that you currently meet the eligibility criteria and will comply with the following terms and conditions:

You must be at least 18 years old, a resident of the United States or a US Territory, and have commercial (private) prescription insurance that does not cover the entire cost of the medication. The Program is not valid for patients who are enrolled in any state or federal government program, including, but not limited to, Medicare, Medicare Advantage, Medigap, Medicaid, Department of Defense (DoD), Veterans Affairs (VA), TRICARE, Puerto Rico Government Insurance, or any state patient or pharmaceutical assistance program. Patients who become eligible for or start using government insurance will no longer be eligible for the Program. The Program is not valid if the entire cost of your prescription is reimbursable by a private insurance plan or other private health or pharmacy benefit programs. You are responsible for reporting receipt of Program assistance to any insurer, health plan, or other third party who pays for or reimburses any part of the medication cost, as may be required.

You agree that you will not submit the cost of any portion of the product dispensed pursuant to this Program to a federal or state healthcare program (including, but not limited to, Medicare, Medicare Advantage, Medicaid, TRICARE, VA, DOD, etc.), for purposes of counting it toward your out-of-pocket expenses, and to notify Takeda Oncology Here2Assist® if you become eligible for a federal or state healthcare program. This Program is not conditioned on any past, present or future purchase of any Takeda product, including refills. This Program is valid for 12 months, and your co-pay card may be renewed every 12 months, subject to continued eligibility. This offer is not valid with any other program, discount, or offer involving your prescribed Takeda Oncology medication. This offer may be rescinded, revoked, or amended without notice. No reproductions. This offer is void where prohibited by law, taxed, or restricted. Limit one offer per purchase. No income requirements or membership fees. This Program is not health insurance. Cash value of 1/100 of 1¢. For questions about this offer, please contact the Takeda Oncology Co-Pay Assistance Program, a patient support service of Takeda Oncology Here2Assist, at 1-844-817-6468, Option 2, Monday-Friday, 8AM-8PM ET.

^†To be eligible for the Patient Assistance Program, patients must meet certain financial and insurance coverage criteria. A Patient Assistance Program Application must be submitted in order to confirm patient eligibility.

^‡Enrollment for patients on Medicare will automatically end on December 31.