Patient Financial Support for VORANIGO^®

ServierONE connects your patients to the right support programs and services that help them access VORANIGO tablets.

We offer:

Support with insurance coverage and reimbursement
Financial assistance to help eligible patients pay for VORANIGO tablets
Prescription fulfillment through our network of specialty pharmacies and distributors
Tools and resources to navigate the world of insurance
Access to a one-on-one Patient Experience Manager

Enroll your Patient

Click logo for Important Safety Information.

See All the Details for VORANIGO Financial Support Programs

Select:

Copay Program Bridge Program QuickStart Program Patient Assistance Program Forms & Guides

The VORANIGO^® Copay Can Help Commercially Insured Patients With Out-Of-Pocket Costs

The Copay Program lowers the out-of-pocket cost of VORANIGO for eligible patients with commercial prescription insurance to no more than $25 per prescription if the copay exceeds that amount.

This program is available to eligible patients who meet the following criteria:

U.S./Puerto Rico resident
Commercially insured and paying a portion of their cost
Don’t have government prescription coverage

Enroll Your Patient in the Copay Program

Enroll Patient

Key Features

Financial Assistance: The ServierONE Copay program offers financial support to eligible patients to help cover copayments, coinsurance, or deductible costs associated with their treatment.

Easy Enrollment: Patients can easily enroll in the ServierONE Copay program by completing a simple application process.

Supportive Services: In addition to copay assistance, the program may also provide access to support services, such as reimbursement navigation and financial counseling, to help alleviate the financial burden of treatment.

Renewable Benefits: Eligible patients may take advantage of the ServierONE Copay Program for multiple prescription refills, ensuring continued access to treatment without the added financial strain.

If you have questions, please call 1-800-813-5905 , Monday through Friday, 8 AM to 8 PM ET.

The VORANIGO^® Bridge Program Helps Patients Who Experience a Short-Term Insurance Coverage Gap

The Bridge Program is designed to provide a one-time, 1-month supply of VORANIGO to qualified patients who experience a short-term lapse in coverage. This program gives patients access to VORANIGO while their insurance issues are being resolved.

Patients may be eligible for the Bridge Program if they meet the following criteria:

U.S./Puerto Rico resident
Commercially insured
Have completed the VORANIGO enrollment form

Apply to the Bridge Program via Online or Fax

Via Online

Patients should complete their portion of the VORANIGO Enrollment below.

Patient VORANIGO E-Enrollment Form

Via Fax

Apply on behalf of patients by either downloading and faxing the form to Servier Patient Support Program at 1-877-770-7102 or completing the appropriate sections of the VORANIGO Enrollment Form online.

Key Features

Temporary Assistance: The Servier Bridge Program provides temporary medication support to eligible patients facing interruptions in access to their medication due to insurance coverage gaps, prior authorization delays, or other challenges.

Quick Response: Our program aims to respond promptly to patient needs, ensuring that individuals can continue their treatment without significant delays.

Case Management: Patients enrolled in the ServierONE Bridge Program may receive individualized case management support to help navigate insurance coverage issues and other barriers to medication access.

If you have questions, please call 1-800-813-5905 , Monday through Friday, 8 AM to 8 PM ET.

The VORANIGO^® QuickStart Program Helps Patients Who Experience a Delay in Insurance Coverage

The QuickStart Program is intended for patients who experience an insurance coverage delay lasting five or more business days. Eligible patients receive one 30-day supply as prescribed by their healthcare provider. If coverage is further delayed, patients may be eligible to receive another 30-day supply refill per Servier approval.

Patients may be eligible for the QuickStart Program if they meet the following criteria:

U.S./Puerto Rico resident
Commercially or government insured
Have completed the VORANIGO enrollment form

Apply to the QuickStart Program via Online or Fax

Via Online

Apply on behalf of patients online by completing the VORANIGO E-Enrollment Form

Complete VORANIGO E-Enrollment Form

Via Fax

Apply on behalf of patients by either downloading and faxing the form to Servier Patient Support Program at 1-877-770-7102

Key Features

Covers insurance delays: Eligible new patients facing coverage delays of 5 or more business days may receive a prescription with an option for a refill, totaling 60 days, upon submission of a completed prior authorization.

Seamless process: QuickStart prescriptions will be reviewed and filled by ServierONE. If using a network specialty pharmacy, they will collaborate with ServierONE to ensure uninterrupted access to treatments.

If you have questions, please call 1-800-813-5905 , Monday through Friday, 8 AM to 8 PM ET.

The Patient Assistance Program (PAP) Helps Uninsured and Underinsured Patients Access Important Treatments

PAP is dedicated to assisting uninsured and underinsured patients by offering medication to those who meet our eligibility criteria. This program is designed to ensure that financial constraints do not hinder access to a prescribed Servier treatment. The benefits of PAP are reassessed at the beginning of each calendar year.

Patients may be eligible for PAP if they meet the following criteria:

U.S./Puerto Rico resident
Commercially, privately, or government insured
Uninsured or underinsured
Household gross annual income does not exceed 600% of the US Federal Poverty Level to qualify financially
If you have questions about qualifying, call us at 1-800-813-5905 for further assistance.

Apply to PAP via Online or Fax

Via Online

Apply on behalf of patients online by completing the VORANIGO E-Enrollment Form

Patient VORANIGO E-Enrollment Form

Via Fax

You can apply on behalf of patients by completing the appropriate sections of the VORANIGO Enrollment Form and then faxing it to ServierONE Patient Support Program at 1-877-770-7102

How to enroll in the Patient Assistance Program (PAP)

1

Prescription & Enrollment Form

If your patient is facing insurance coverage issues for VORANIGO, please submit a Patient Enrollment Form. Ensure that both the patient and healthcare provider sections are completed. Once finished, fax the form to 1-877-770-7102.

2

Benefit Investigation

ServierONE will review your patient’s insurance coverage. Please note that if a prior authorization is denied, your office will need to file an appeal. If the appeal is also denied, you will proceed to the next step.

3

Other Assistances

Other forms of assistance may be available, including assistance from independent foundations for patients with governmental and commercial insurance. Servier can provide information on a independent foundations that may be available to eligible patients. These foundations are not affiliated with Servier and operate independently. Please contact each foundation directly to obtain more information about eligibility and application processes.

4

Financial Criteria/Qualifications

ServierONE will confirm that your patient meets the financial eligibility requirements to be enrolled in PAP.

5

Enrollment Complete

If your patient is approved, they will be enrolled in PAP for a calendar year.

Key Features

Overview: The program is dedicated to assisting uninsured and underinsured patients by offering medication to those who meet our eligibility criteria.

Income Eligibility: The ServierONE Patient Assistance Program is available to patients who meet specific income criteria, ensuring that those in financial need can benefit from the program.

Application Support: Our dedicated program representatives are available to support patients with the application process, including guidance on required documentation and eligibility requirements.

Renewable Benefits: Qualified patients may receive ongoing support through the ServierONE Patient Assistance Program, ensuring continued access to their treatment as needed.

If you have questions, please call 1-800-813-5905 , Monday through Friday, 8 AM to 8 PM ET.

Additional VORANIGO^® Resources from ServierONE

The resources below can provide further support as you navigate the insurance process for VORANIGO.

Letter of Medical Necessity (LOMN) Template
A customizable Letter of Medical Necessity

Sample Formulary Exception Letter
An example of a letter you can send to insurance companies to request an exception to their formulary to allow VORANIGO coverage

List of Foundations
Independent foundations may provide other forms of financial assistance

Appeal Checklist
Key elements for filing a response to a Treatment Denial

Appeal Guidelines
Highlights key aspects of the Appeal

Appeal Letter Template
A customizable Appeal template when facing a Prior Authorization Denial

If you have questions, please call 1-800-813-5905 , Monday through Friday, 8 AM to 8 PM ET.

VORANIGO^® IMPORTANT SAFETY INFORMATION AND INDICATIONS

IMPORTANT SAFETY INFORMATION

WARNINGS AND PRECAUTIONS

Hepatotoxicity: VORANIGO can cause hepatic transaminase elevations, which can lead to hepatic failure, hepatic necrosis, and autoimmune hepatitis. Monitor liver laboratory tests (AST, ALT, GGT, total bilirubin, and alkaline phosphatase) prior to the start of VORANIGO, every 2 weeks during the first 2 months of treatment, then monthly for the first 2 years of treatment, and as clinically indicated, with more frequent testing in patients who develop transaminase elevations. Reduce the dose, withhold, or permanently discontinue VORANIGO based on severity.

Embryo-Fetal Toxicity: Based on findings from animal studies, VORANIGO can cause fetal harm when administered to a pregnant woman. Advise pregnant women and females of reproductive potential of the potential risk to a fetus. Advise females of reproductive potential to use effective nonhormonal contraception during treatment with VORANIGO and for 3 months after the last dose, since VORANIGO can render some hormonal contraceptives ineffective. Advise male patients with female partners of reproductive potential to use effective contraception during treatment with VORANIGO and for 3 months after the last dose.

ADVERSE REACTIONS
The most common (≥15%) adverse reactions included fatigue, headache, COVID-19, musculoskeletal pain, diarrhea, nausea, and seizure. Grade 3 or 4 (≥2%) laboratory abnormalities were ALT increased, AST increased, GGT increased, and neutrophils decreased.

DRUG INTERACTIONS
Avoid concomitant use of VORANIGO with strong and moderate CYP1A2 inhibitors. Avoid concomitant use with moderate CYP1A2 inducers and smoking tobacco. Avoid concomitant use with CYP3A substrates, where a minimal concentration change can reduce efficacy. If concomitant use of hormonal contraception cannot be avoided, use nonhormonal contraception methods.

LACTATION
Advise women not to breastfeed during VORANIGO treatment and for 2 months after the last dose.

IMPAIRED FERTILITY
VORANIGO may impair fertility of females and males of reproductive potential.

INDICATIONS

VORANIGO (40 mg tablets) is indicated for the treatment of adult and pediatric patients 12 years and older with Grade 2 astrocytoma or oligodendroglioma with a susceptible isocitrate dehydrogenase-1 (IDH1) or isocitrate dehydrogenase-2 (IDH2) mutation following surgery including biopsy, sub-total resection, or gross total resection.

IMPORTANT SAFETY INFORMATION

WARNINGS AND PRECAUTIONS

Hepatotoxicity: VORANIGO can cause hepatic transaminase elevations, which can lead to hepatic failure, hepatic necrosis, and autoimmune hepatitis. Monitor liver laboratory tests (AST, ALT, GGT, total bilirubin, and alkaline phosphatase) prior to the start of VORANIGO, every 2 weeks during the first 2 months of treatment, then monthly for the first 2 years of treatment, and as clinically indicated, with more frequent testing in patients who develop transaminase elevations. Reduce the dose, withhold, or permanently discontinue VORANIGO based on severity.

Embryo-Fetal Toxicity: Based on findings from animal studies, VORANIGO can cause fetal harm when administered to a pregnant woman. Advise pregnant women and females of reproductive potential of the potential risk to a fetus. Advise females of reproductive potential to use effective nonhormonal contraception during treatment with VORANIGO and for 3 months after the last dose, since VORANIGO can render some hormonal contraceptives ineffective. Advise male patients with female partners of reproductive potential to use effective contraception during treatment with VORANIGO and for 3 months after the last dose.

ADVERSE REACTIONS
The most common (≥15%) adverse reactions included fatigue, headache, COVID-19, musculoskeletal pain, diarrhea, nausea, and seizure. Grade 3 or 4 (≥2%) laboratory abnormalities were ALT increased, AST increased, GGT increased, and neutrophils decreased.

DRUG INTERACTIONS
Avoid concomitant use of VORANIGO with strong and moderate CYP1A2 inhibitors. Avoid concomitant use with moderate CYP1A2 inducers and smoking tobacco. Avoid concomitant use with CYP3A substrates, where a minimal concentration change can reduce efficacy. If concomitant use of hormonal contraception cannot be avoided, use nonhormonal contraception methods.

LACTATION
Advise women not to breastfeed during VORANIGO treatment and for 2 months after the last dose.

IMPAIRED FERTILITY
VORANIGO may impair fertility of females and males of reproductive potential.

INDICATIONS

VORANIGO (40 mg tablets) is indicated for the treatment of adult and pediatric patients 12 years and older with Grade 2 astrocytoma or oligodendroglioma with a susceptible isocitrate dehydrogenase-1 (IDH1) or isocitrate dehydrogenase-2 (IDH2) mutation following surgery including biopsy, sub-total resection, or gross total resection.

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Servier and the Servier Logo are registered trademarks of LES LABORATOIRES SERVIER.
All other trademarks, registered or unregistered, are the property of their respective owners.
US-PAT-00044 12/24

Patient Financial Support for VORANIGO®

See All the Details for VORANIGO Financial Support Programs

Patient Financial Support for VORANIGO^®