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Manufacturer-Supported Programs

Who is Eligible

Pharmaceutical manufacturers may provide financial assistance to patients who are prescribed their medications. Patients who do not have any drug coverage or only partial coverage may wish to seek assistance from a patient support program offered by a manufacturer. The extent of coverage and eligibility criteria is made by each of the programs.

Medications with Assistance Programs

See below for a list of patient support program offered by pharmaceutical manufacturers for specific drugs. For the most up-to-date eligibility criteria and enrolment forms, please contact the patient support program directly.

Eculizumab (Soliris®)

DRUG

PROGRAM

FORM

Eculizumab (Soliris®)

OneSourceTM Program
Phone: 1-888-765-4747

  • Explores medication coverage options for patients requiring this medication.
  • To make a request for compassionate supply through Alexion’s Global Access to Medicines (GATM) portal, see ‘How To’ Manual for My Access Programs

OneSource Enrolment Form

‘How To’ Manual for My Access Programs

Rituximab

Manufacturer-supported programs are available for each of the four Rituximab medications approved in Ontario. Each program provides different offerings for patients with GN.

DRUG

PROGRAM

FORM

Rituximab (Rituxan®)

Jointeffort® Program
Phone: 1-888-748-8926

Jointeffort Enrolment Form (GPA or MPA)

Rituximab (Riximyo®)

XPOSE® Program
Phone: 1-888-449-7673

Riximyo Enrolment Form

Riximyo Medical Clearance Form

Rituximab (RuxienceTM)

Pfizer Liaison Program
Phone: 1-844-533-0150
1-855-935-FLEX(3539)

Ruxience Enrolment Form (GPA & MPA)

Rituximab (Truxima®)

Teva Support Solutions® Program
Phone: 1-877-714-2469

Truxima Enrolment Form

Tacrolimus

DRUG

PROGRAM

FORM

Tacrolimus prolonged release tablets (Envarsus PA®)

ENVARSUS® PA Patient Support Program
Phone: 1-877-261-4586

  • This program will consider supporting patients with GN conditions (e.g., lupus nephritis, membranous nephropathy).

Envarsus Enrolment Form

Belimumab

DRUG

PROGRAM

FORM

Belimumab (Benlysta )

Monarch Program
Phone: 1-855-788-3135

  • This program may provide financial assistance to patients with active lupus nephritis.

Benlysta Enrolment Form

Disclaimer: The information contained herein (“Information”) is intended for informational purposes only, and no warranty as to its accuracy is provided or implied. The Information was collected from third party sources and is subject to change without notice. Ontario Health (Ontario Renal Network) makes no warranty that the Information is current. The Information is intended for use by healthcare professionals to advise patients of drug funding options that may be available to them. Do not act or rely upon the Information without exercising your independent judgment or seeking the advice of a qualified professional. Anyone using the Information does so at his or her own risk. The drug funding options described on this website are managed and funded by third parties, not by Ontario Health (Ontario Renal Network). Please direct any inquiries to the applicable agency/entity who manages the drug funding option.

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