PROCRITline.com - Patient Assistance

PATIENT ASSISTANCE

Welcome

PROCRITline provides easy access to reimbursement information and support including:

	Benefit Verification
	Prior Authorization research
	Appeal process and procedure research
	Alternate sources of payment
	General billing and coding questions
	Information regarding patient assistance

THE INFORMATION PROVIDED REPRESENTS NO STATEMENT, PROMISE, OR GUARANTEE BY Ortho Biotech Products, L.P. CONCERNING LEVELS OF REIMBURSEMENT. PLEASE CONSULT YOUR PAYER ORGANIZATION WITH REGARD TO LOCAL OR ACTUAL COVERAGE AND REIMBURSEMENT POLICIES AND DETERMINATION PROCESSES.

Patient Assistance Program

Ortho Biotech will provide assistance to certain eligible PROCRIT patients at no charge, based on medical and financial need. Our toll-free PROCRITline^TM -- 1-800-553-3851 -- is available Monday through Friday from 9 a.m. to 8 p.m., Eastern Standard Time, to answer questions from patients and health-care providers. Our fax number is 1-800-987-5572.

The toll-free PROCRITline number is convenient and easy to use

When calling about a patient specific reimbursement issue, please have the following information available:

	Selected patient's information
	Name and telephone number of insurance plan(s), policy number(s) and name of subscriber
	Physician's name, address, and telephone number
	Patient's financial information if calling on behalf of an uninsured patient

Patients must authorize disclosure of this information.

Patient Assistance Program Application Form - PROCRIT

Click here to view and to print the application for the Patient Assistance Program for PROCRIT® (Epoetin alfa). This form requires the Adobe Reader for viewing and printing.

PROCRIT® (Epoetin alfa) Full Prescribing Information, including Boxed WARNINGS

Benefit Verification Form

Click here to view and to print the application for Insurance Benefit Verification for PROCRIT and LEUSTATIN. This form requires the Adobe Reader for viewing and printing.

LEUSTATIN® (cladribine) Injection Full Prescribing Information, including Boxed WARNINGS

Patient Assistance Program Application Form - LEUSTATIN

Click here to view and to print the application for the Patient Assistance Program for LEUSTATIN® (cladribine) Injection. This form requires the Adobe Reader for viewing and printing.

Important Safety Information

WARNINGS: INCREASED MORTALITY, SERIOUS CARDIOVASCULAR and THROMBOEMBOLIC EVENTS, and INCREASED RISK OF TUMOR PROGRESSION OR RECURRENCE

Renal failure: Patients experienced greater risks for death and serious cardiovascular events when administered erythropoiesis-stimulating agents (ESAs) to target higher versus lower hemoglobin levels (13.5 vs. 11.3 g/dL; 14 vs. 10 g/dL) in two clinical studies. Individualize dosing to achieve and maintain hemoglobin levels within the range of 10 to 12 g/dL.

Cancer:

ESAs shortened overall survival and/or increased the risk of tumor progression or recurrence in some clinical studies in patients with breast, non-small cell lung, head and neck, lymphoid, and cervical cancers (see WARNINGS: Table 1).

To decrease these risks, as well as the risk of serious cardio- and thrombovascular events, use the lowest dose needed to avoid red blood cell transfusion.

Use ESAs only for treatment of anemia due to concomitant myelosuppressive chemotherapy.

ESAs are not indicated for patients receiving myelosuppressive therapy when the anticipated outcome is cure.

Discontinue following the completion of a chemotherapy course.

Perisurgery: PROCRIT® (Epoetin alfa) increased the rate of deep venous thromboses in patients not receiving prophylactic anticoagulation. Consider deep venous thrombosis prophylaxis.

(See WARNINGS: Increased Mortality, Serious Cardiovascular and Thromboembolic Events, WARNINGS: Increased Mortality and/or Increased Risk of Tumor Progression or Recurrence, INDICATIONS AND USAGE, and DOSAGE AND ADMINISTRATION.)

Please see full Prescribing Information, including Boxed WARNINGS for PROCRIT® (Epoetin alfa)

Medication Guide for PROCRIT
Please read the Medication Guide for PROCRIT and discuss with your doctor.

Patient Instructions for Use
Instructions if you or your caregiver has been trained to give PROCRIT injections at home.

Boxed WARNINGS: LEUSTATIN® (cladribine) Injection

LEUSTATIN (cladribine) Injection should be administered under the supervision of a qualified physician experienced in the use of antineoplastic therapy. Suppression of bone marrow function should be anticipated. This is usually reversible and appears to be dose dependent. Serious neurological toxicity (including irreversible paraparesis and quadraparesis) has been reported in patients who received LEUSTATIN Injection by continuous infusion at high doses (4 to 9 times the recommended dose for Hairy Cell Leukemia). Neurologic toxicity appears to demonstrate a dose relationship; however, severe neurological toxicity has been reported rarely following treatment with standard cladribine dosing regimens.

Acute nephrotoxicity has been observed with high doses of LEUSTATIN (4 to 9 times the recommended dose for Hairy Cell Leukemia), especially when given concomitantly with other nephrotoxic agents/therapies.

Please see full Prescribing Information, including Boxed WARNINGS for LEUSTATIN® (cladribine)