If you prescribe brand-name Valcyte, your commercially insured

Patients could pay $15 per monthly co-pay

Valcyte Co-pay Card Image

Patients who are eligible for the Valcyte® $15 Co-pay Card
program could:

  • Reduce their out-of-pocket costs to $15 per monthly co-pay,
    regardless of their annual income level
  • Cover up to $10,000 per year in co-pay obligations

Enroll your patients in the Valcyte® $15 Co-pay Card Program today

Enroll now

Additional Resources

To enroll in GATCF, please fax the following forms to Genentech Access Solutions® (fax 1-800-305-1830):

  • Patient Authorization and Notice of Request for Transmission of Health Information to Genentech Access Solutions and Genentech® Access to Care Foundation (PAN) form signed by the patient. Download English or Spanish.
  • A completed Statement of Medical Necessity (SMN) with appropriate services indicated. Download English.

For more information, call 1-888-754-7651 (Mon-Fri).