ONTRUZANT® (trastuzumab-dttb) for Injection, for Intravenous Use 21 mg/ml

Please read the Prescribing Information for ONTRUZANT, including the
information about heart problems, infusion reactions (lung problems),
and harm to an unborn baby, and discuss it with your doctor.


THE ORGANON CO-PAY ASSISTANCE PROGRAM

The Organon Co-pay Assistance Program offers assistance to eligible patients who need help affording ONTRUZANT.

  • Once enrolled, eligible, privately insured patients pay the first $5 of their co-pay per infusion
  • Maximum co-pay assistance program benefit is $25,000 per patient, per calendar year

Co-pay assistance from the Organon Co-pay Assistance Program is not insurance. Restrictions apply. See Terms and Conditions.

You may be eligible if you:

  • Are a resident of the United States
  • Have private health insurance that provides coverage for ONTRUZANT under a medical benefit program
  • Have been prescribed ONTRUZANT for an FDA-approved indication
  • Meet all other Terms and Conditions of the program

The Organon Co-pay Assistance Program is not valid for patients covered under a Government Program, as that term is defined in the Terms and Conditions. The Organon Co-pay Assistance Program is not valid for uninsured patients.

You and your health care provider must submit all required information. Please see the enrollment form for details.

Other financial support options

What if I am not eligible for the Organon Co-pay Assistance Program?

You may be able to get help from an independent co-pay assistance foundation. A representative can provide you with information about independent foundations that may be able to provide financial support to patients who do not qualify for the Organon Co-pay Assistance Program. Each independent foundation has its own eligibility criteria and application process.



WELCOME TO

Welcome to The Organon Access Program for ONTRUZANT® (trastuzumab-dttb)

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