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PSSGuide_2020
Lymphoma

Drugs for Lymphoma

Here are the drugs and financial support services available to patients receiving treatment for Lymphoma.
Hodgkin Lymphoma

Adcetris (brentuximab vedotin)

Drug company: Seattle Genetics
855-473-2873

Adcetris is a CD30-directed antibody-drug conjugate used for the treatment of patients with several types of classical Hodgkin lymphoma.

SeaGen Secure offers 1 financial assistance program for patients using Adcetris:

SeaGen Secure Patient Assistance Program

Patients who are uninsured and meet certain financial criteria will be eligible to receive Adcetris at no cost. With this program, assistance begins with a temporary 3-month period.

Keytruda (pembrolizumab)

Drug company: Merck
855-257-3932

Keytruda is a PD-1 inhibitor used for the treatment of adult and pediatric patients with refractory classical Hodgkin lymphoma, or classical Hodgkin lymphoma that relapsed after 3 or more lines of therapy.

The Merck Access Program offers 2 financial assistance programs for patients using Keytruda:

Merck Co-pay Assistance Program

Privately insured patients will pay the first $25 of their copay per Keytruda infusion. The maximum benefit per calendar year is $25,000.

Merck Patient Assistance Program

Patients without insurance or prescription coverage may be eligible to receive Keytruda for free. Eligible patients must have a household income of $62,450 or less for individuals, $84,550 or less for couples, or $128,750 or less for a family of 4. Patients with insurance, including Medicare Part D, who still have trouble paying for medicines, may request that an exception be made, provided their household income is not above a set limit.

Opdivo (nivolumab)

Drug company: Bristol-Myers Squibb
800-861-0048

Opdivo is a PD-1 inhibitor used for the treatment of patients with classical Hodgkin lymphoma.

Bristol-Myers Squibb (BMS) Access Support offers 2 financial assistance programs for patients using Opdivo:

BMS Oncology Co-Pay Assistance Program

The program provides financial assistance with out-of-pocket deductibles, copay, or coinsurance costs for eligible, privately insured patients who have been prescribed Opdivo. Patients pay a $25 copay, while BMS covers the remaining amount, up to $25,000 annually per medication.

Bristol-Myers Squibb Patient Assistance Foundation

Patients who don’t have public or private insurance that helps to pay for Opdivo may be eligible for help paying for their prescription medication if they receive treatment as an outpatient and have an annual income of less than 300% of the federal poverty level, up to $37,470 for an individual or $50,730 for a family of 2..

Non-Hodgkin Lymphoma (NHL)

Adcetris (brentuximab vedotin)

Drug company: Seattle Genetics
855-473-2873

Adcetris is a CD30-directed antibody-drug conjugate used for the treatment of patients with several types of systemic anaplastic large-cell lymphoma, a form of non-Hodgkin lymphoma (NHL). Adcetris is also used for patients with other CD30-expressing untreated peripheral T-cell lymphomas (types of NHL), alone or in combination with cyclophosphamide, doxorubicin, and prednisone; and for patients with primary cutaneous anaplastic large-cell lymphoma or CD30-expressing mycosis fungoides, after systemic therapy.

SeaGen Secure offers 1 financial assistance program for patients who have been prescribed Adcetris:

SeaGen Secure Patient Assistance Program

Patients who are uninsured and meet certain financial criteria will be eligible to receive Adcetris at no cost. With this program, assistance begins with a temporary 3-month period.

Beleodaq (belinostat) for Injection

Drug company: Acrotech Biopharma
888-537-8277

Beleodaq is a histone deacetylase (HDAC) inhibitor used for the treatment of patients with relapsed or refractory peripheral T-cell lymphoma, a type of NHL.

Acrotech Biopharma, through its Specialty Therapy Access Resources (STAR) program, offers 2 financial assistance programs for patients who are prescribed Beleodaq:

STAR Co-pay Assistance

Eligible, privately insured patients will pay $0 for the first injection of Beleodaq and then $25 for each subsequent injection, with a maximum benefit of up to $10,000 annually.

STAR Patient Assistance Program

This program provides Beleodaq free of charge to enrolled patients who meet the income, insurance, and residency eligibility criteria.

Bendeka (bendamustine HCl) Injection

Drug company: Teva
888-587-3263

Bendeka is an alkylating drug used for the treatment of patients with indolent B-cell non-Hodgkin lymphoma that has progressed during or after 6 months of Rituxan therapy.

Teva offers 1 financial assistance program for patients using Bendeka:

Teva Cares Foundation Patient Assistance Program

Patients without prescription drug coverage who meet specific financial criteria may receive Bendeka for free. The financial criteria specify that the patient’s annual income must not exceed $60,700 for 1 person, $82,300 for 2 people, $103,900 for 3 people, $125,000 for 4 people, or $147,100 for 5 people.

Folotyn (pralatrexate)

Drug company: Acrotech Biopharma
888-537-8277

Folotyn is a folate analog metabolic inhibitor used for the treatment of patients with relapsed or refractory peripheral T-cell lymphoma.

Spectrum Therapy Access Resources (STAR) offers 2 financial assistance programs for patients using Folotyn:

STAR Co-pay Assistance

Eligible, privately insured patients will pay $0 out of pocket for the first injection of Folotyn and then $25 for each subsequent injection, with a benefit of up to $10,000 per calendar year.

STAR Patient Assistance Program

This program provides Folotyn free of charge to enrolled patients who meet the income, insurance, and residency eligibility requirements.

Imbruvica (ibrutinib) Capsules/Tablets

Drug company: Pharmacyclics
877-877-3536

Imbruvica is a kinase inhibitor used for the treatment of patients with Waldenström’s macroglobulinemia (a type of NHL).

Pharmacyclics’ You&i Support Program offers 2 financial assistance programs for patients using Imbruvica:

You&i Instant Savings Program

Patients with private insurance will pay no more than $10 monthly for Imbruvica. Eligible patients may qualify for instant savings on their commercial insurance copay, deductible, and coinsurance medication costs for Imbruvica.

Johnson & Johnson Patient Assistance Foundation

This program provides Imbruvica free of charge to patients who meet certain financial limits and are uninsured, underinsured, or enrolled in Medicare Part D.

Mozobil (plerixafor)

Drug company: Sanofi Genzyme
833-930-2273

Mozobil is a hematopoietic stem-cell mobilizer used, in combination with granulocyte colony-stimulating factor, for the treatment of patients with non-Hodgkin lymphoma.

The Sanofi Genzyme CareASSIST Patient Support Program provides 1 financial assistance program for patients who are prescribed Mozobil:

CareASSIST Patient Assistance Programn

Through this program, patients who are uninsured or do not have coverage for Mozobil may be eligible to receive their medication at no cost. To be eligible, the patient’s annual household income must not be more than $100,000, or 500% of the federal poverty level. Patients enrolled in Medicare Part B who have no supplemental insurance may also be eligible to receive Mozobil through this program.

Poteligeo (mogamulizumab-kpkc)

Drug company: Kyowa Kirin
833-552-2737

Poteligeo is a CCR4-directed monoclonal antibody used for the treatment of adults who have relapsed or refractory mycosis fungoides, a type of non-Hodgkin lymphoma (NHL), and for patients with Sézary syndrome (cutaneous T-cell lymphoma), a rare type of NHL, after at least 1 systemic therapy.

Kyowa Kirin Cares offers 2 financial assistance programs for patients who have been prescribed Poteligeo:

Kyowa Kirin Cares Co-Pay Assistance Program

Patients with private insurance may be eligible to receive copay assistance for their Poteligeo prescription.

Kyowa Kirin Cares Patient Assistance Program

Uninsured patients whose annual gross income is less than or equal to 400% of the federal poverty level may be eligible to receive financial assistance for Poteligeo.

Rituxan (rituximab)

Drug company: Genentech
888-941-3331

Rituxan is a CD20-directed cytolytic antibody used for the treatment of patients with non-Hodgkin lymphoma.

Genentech offers 2 financial assistance programs for patients using Rituxan:

Genentech BioOncology Co-pay Assistance Program

Eligible patients with private insurance will pay just a $5 copay per prescription or infusion of Rituxan, with an annual benefit limit of $25,000. Retroactive requests for assistance will be honored if the prescription was filled within 120 days before enrollment in this program.

Genentech Patient Foundation

This foundation provides Rituxan free of charge to uninsured or underinsured patients whose annual household income is less than $150,000 and who meet specific financial criteria. For households with more than 4 people, add $25,000 per each additional member. Rituxan is also provided free for patients who are unable to afford their out-of-pocket costs and cannot find other financial assistance.

Truxima (rituximab-abbs)

Drug company: Teva
888-587-3263

Truxima, a biosimilar to Rituxan, is a CD20-directed cytolytic antibody used for the treatment of patients with relapsed or refractory low-grade or follicular CD20-positive B-cell non-Hodgkin lymphoma (NHL) as a single agent, or for patients with untreated follicular, CD20-positive, B-cell NHL in combination with first-line chemotherapy and, in patients achieving a response to Rituxan plus chemotherapy, as a single-agent maintenance therapy. Truxima is also used, alone, for patients with non-progressing (or stable), low-grade, CD20-positive, B-cell NHL after cyclophosphamide, vincristine, and prednisone chemotherapy.

Teva offers 2 financial assistance programs for patients who have been prescribed Truxima:

Truxima Patient Savings Program

Eligible patients with private insurance may pay as little as $0 for Truxima, with a maximum annual limit of $25,000. The program may cover eligible out-of-pocket costs incurred by the patient for Truxima within 90 days before program enrollment.

Teva Cares Foundation Patient Assistance Program

This program provides Truxima at no cost to patients who do not have insurance or whose insurance does not cover Truxima. Patients with health insurance must try other types of assistance before they can be approved for this program. Uninsured patients must meet certain financial requirements.

Valchlor (mechlorethamine)

Drug company: Helsinn
855-482-5245

Valchlor is an alkylating drug used for the topical treatment of stage IA or stage IB mycosis fungoides–type cutaneous T-cell lymphoma (a type of NHL), in patients who have received skin-directed therapy.

Helsinn offers 1 financial assistance program for patients who have been prescribed Valchlor:

Valchlor Co-pay Program

Eligible patients who have commercial health insurance whose copay or coinsurance is more than $10 per prescription of Valchlor will pay no more than $10 per prescription in out-of-pocket copay costs for Valchlor.

Yescarta (axicabtagene ciloleucel)

Drug company: Kite Pharma
844-454-5483

Yescarta is a CD19-directed genetically modified CAR T-cell immunotherapy used, after 2 or more lines of systemic therapies, for the treatment of adults with relapsed or refractory large B-cell lymphoma, including primary mediastinal large B-cell lymphoma or high-grade B-cell lymphoma.

Kite Pharma offers 1 patient assistance program for patients who have been prescribed Yescarta:

Kite Konnect

This program helps patients and healthcare teams throughout treatment with Yescarta. (For more information call 844-454-5483.)

Zolinza (vorinostat) Capsules

Drug company: Merck
800-727-5400

Zolinza is a histone deacetylase inhibitor used for the treatment of patients with cutaneous T-cell lymphoma (a type of NHL), that is progressive, persistent, or recurrent with or after 2 systemic therapies.

Merck offers 1 financial assistance program for patients who have been prescribed Zolinza:

Merck Patient Assistance Program

Uninsured patients who cannot afford to pay for Zolinza and have a household income of $49,960 or less for individuals, $67,640 or less for couples, or $103,000 or less for a family of 4, may qualify to receive their medication for free.

Diffuse Large B-Cell Lymphoma (DLBCL, a Subtype of NHL)

Keytruda (pembrolizumab)

Drug company: Merck
855-257-3932

Keytruda is a PD-1 inhibitor used for the treatment of pediatric and adult patients with refractory primary mediastinal large B-cell lymphoma, or patients whose disease relapsed (returned) after 2 or more therapies.

Merck offers 2 financial assistance programs for patients who are prescribed Keytruda:

Merck Co-pay Assistance Program

Privately insured patients will pay the first $25 of their copay per Keytruda infusion. The maximum benefit per calendar year is $25,000.

Merck Patient Assistance Program

Patients without insurance or prescription coverage may be eligible to receive Keytruda at no cost. Eligible patients must have a household income of $62,450 or less for individuals, $84,550 or less for couples, or $128,750 or less for a family of 4. Patients with insurance, including Medicare Part D, who still have trouble paying for their medicines, may request that an exception be made, provided their household income is not above a set limit.

Kymriah (tisagenlecleucel)

Drug company: Novartis
844-459-6742

Kymriah is a CD19-directed genetically modified CAR T-cell immunotherapy used for the treatment of adults with relapsed or refractory large B-cell lymphoma (a type of non-Hodgkin lymphoma) after 2 or more systemic therapies, including diffuse large B-cell lymphoma (DLBCL) not otherwise specified, high-grade B-cell lymphoma, and DLBCL arising from follicular lymphoma.

Novartis offers 1 financial assistance program for patients who have been prescribed Kymriah:

Kymriah Cares

This program offers financial assistance to eligible patients to help them access Kymriah. Patients must meet program eligibility criteria to qualify for support. Patients should work with their treatment center to submit a Service Request Form for Patient Support to Kymriah Cares.

Polivy (polatuzumab vedotin-piiq) for Injection

Drug Company: Genentech
888-941-3331

Polivy is a CD79b-directed antibody-drug conjugate used in combination with Bendeka and Rituximab for the treatment of adults with relapsed or refractory diffuse large B-cell lymphoma, after at least 2 previous therapies.

Genentech offers 2 financial assistance programs for patients who have been prescribed Polivy:

Genentech BioOncology Co-pay Assistance Program

Patients with private insurance will pay just a $5 copay per prescription or infusion of Polivy, with an annual benefit limit of $25,000. Retroactive requests for assistance will be honored if the prescription was filled within 120 days before enrollment in this program.

Genentech Patient Foundation

This foundation provides Polivy free of charge to uninsured or underinsured patients whose annual household income is less than $150,000 and who meet specific financial criteria. For households with more than 4 people, add $25,000 per each additional member. Polivy is also provided free for patients who are unable to afford their out-of-pocket costs and cannot find other financial assistance.

Rituxan Hycela (rituximab/hyaluronidase human) Injection

Drug Company: Genentech
888-941-3331

Rituxan Hycela is a combination of rituximab (a CD20-directed cytolytic antibody) and hyaluronidase human (an endoglycosidase) used for the treatment of patients with untreated diffuse large B-cell lymphoma (DLCBL), in combination with chemotherapy with the CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) regimen, or with other anthracycline-based chemotherapy regimens.

Genentech offers 2 financial assistance programs for patients using Rituxan Hycela:

Genentech BioOncology Co-pay Assistance Program

Patients with private insurance will pay just a $5 copay per prescription or infusion of Polivy, with an annual benefit limit of $25,000. Retroactive requests for assistance will be honored if the prescription was filled within 120 days before enrollment in this program.

Genentech Patient Foundation

This foundation provides Polivy free of charge to uninsured or underinsured patients whose annual household income is less than $150,000 and who meet specific financial criteria. For households with more than 4 people, add $25,000 per each additional member. Polivy is also provided free for patients who are unable to afford their out-of-pocket costs and cannot find other financial assistance.

Yescarta (axicabtagene ciloleucel)

Drug company: Kite Pharma
844-454-5483

Yescarta is a CD19-directed genetically modified CAR T-cell immunotherapy used, after 2 or more lines of systemic therapies, for the treatment of adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) not otherwise specified, or DLBCL arising from follicular lymphoma.

Kite Pharma offers 1 patient assistance program for patients using Yescarta:

Kite Konnect

This program helps patients and healthcare teams throughout treatment with Yescarta. (For more information call 844-454-5483.)

Follicular Lymphoma (a Subtype of NHL)

Aliqopa (copanlisib) for Injection

Drug company: Bayer
833-254-7672

Aliqopa is a kinase inhibitor used for the treatment of adult patients with relapsed follicular lymphoma who have received at least 2 systemic therapies.

Aliqopa Resource Connections offers 2 financial assistance programs for patients using Aliqopa:

Aliqopa $0 Co-Pay Program

This program allows patients with private insurance to pay $0 copay for Aliqopa, with a yearly savings of up to $25,000.

Aliqopa Resource Connections Patient Assistance Program

For eligible patients who are uninsured or underinsured, this program provides Aliqopa at no cost.

Copiktra (duvelisib)

Drug company: Verastem
833-570-2273

Copiktra is a dual PI3 kinase used for the treatment of adults with relapsed or refractory follicular lymphoma, after at least 2 systemic therapies.

Verastem Cares offers 3 financial assistance programs for patients who have been prescribed Copiktra:

Verastem Cares Co-Pay Assistance

Through this program, patients with private insurance may pay as little as $5 for their prescription of Copiktra, with a maximum annual benefit of $25,000 and no patient income requirement.

Verastem Cares Bridge Rx Program

This program will provide a free 14-day supply of Copiktra to patients with coverage delays or who have experienced loss of insurance lasting more than 5 days.

Verastem Cares Patient Assistance Program

Patients who are uninsured and have an annual income of $150,000 or less may qualify to receive Copiktra for free.

Gazyva (obinutuzumab)

Drug company: Genentech
888-941-3331

Gazyva is a CD20-directed cytolytic antibody used, in combination with bendamustine followed by Gazyva alone, for the treatment of patients with follicular lymphoma whose disease relapsed after, or is refractory to, a rituximab-containing regimen; and in combination with chemotherapy followed by Gazyva alone in patients achieving a partial remission, for adults with previously untreated advanced (stage II bulky, III, or IV) follicular lymphoma.

Genentech offers 2 financial assistance programs for patients using Gazyva:

Genentech BioOncology Co-pay Assistance Program

Eligible patients with private insurance will pay just a $5 copay per prescription or infusion of Gazyva, with an annual benefit limit of $25,000. Retroactive requests for assistance will be honored if the prescription was filled within 120 days before enrollment in this program.

Genentech Access to Care Foundation

This foundation provides Gazyva free of charge to uninsured or underinsured patients whose annual household income is less than $150,000 and who meet specific financial criteria. For households with more than 4 people, add $25,000 per each additional member. Gazyva is also provided free for patients who are unable to afford their out-of-pocket costs and cannot find other financial assistance.

Revlimid (lenalidomide) Capsules

Drug Company: Celgene
800-931-8691

Revlimid is a thalidomide analog used for the treatment of patients with previously treated follicular lymphoma, in combination with Rituximab or a biosimilar to Rituximab.

Celgene Patient Support offers 3 financial assistance programs for patients who have been prescribed Revlimid:

Celgene Commercial Co-pay Program

This program reduces the cost of the copay for Revlimid to $25 or less for patients who have private insurance that does not cover the full cost of Revlimid.

Celgene Patient Assistance Program

Patients with no insurance or not enough insurance to cover their medication, who meet certain financial criteria may be able to receive Revlimid for free.

Celgene Patient Support

This program connects patients who have public insurance to outside resources that may help with the cost of copays, deductibles, and co-insurance.

Rituxan Hycela (rituximab/hyaluronidase human) Injection

Drug Company: Genentech
888-941-3331

Rituxan Hycela is a combination of rituximab (a CD20-directed cytolytic antibody) and hyaluronidase human (an endoglycosidase) used for the treatment of patients with relapsed or refractory follicular lymphoma as a single agent; for patients with untreated follicular lymphoma, in combination with first-line chemotherapy; and for patients achieving a complete or partial response to rituximab and chemotherapy, as a single-drug maintenance therapy. Rituxan Hycela is also used, as a single medication, for the treatment of patients with nonprogressing or stable follicular lymphoma after first-line chemotherapy with cyclophosphamide, vincristine, and prednisone.

Genentech offers 2 financial assistance programs for patients using Rituxan Hycela:

Genentech BioOncology Co-pay Assistance Program

Patients with private insurance will pay just a $5 copay per prescription or infusion of Rituxan Hycela, with an annual benefit limit of $25,000. Retroactive requests for assistance will be honored if the prescription fill occurred within 120 days prior to enrollment in this program.

Genentech Patient Foundation

This foundation provides Rituxan Hycela free of charge to uninsured or underinsured patients whose annual household income is less than $150,000 and who meet specific financial criteria. For households with more than 4 people, add $25,000 per each additional member. Rituxan Hycela is also provided free for patients who are unable to afford their out-of-pocket costs and cannot find other financial assistance.

Zevalin (ibritumomab tiuxetan)

Drug company: Acrotech Biopharma
888-537-8277

Zevalin is a CD20-directed radiotherapeutic antibody used for the treatment of patients with relapsed or refractory, low-grade or follicular B-cell non-Hodgkin lymphoma, or patients with untreated follicular lymphoma who achieve a partial or complete response to first-line chemotherapy.

Spectrum Therapy Access Resources (STAR) offers 2 financial assistance programs for patients using Zevalin:

STAR Patient Assistance Program

This patient assistance program provides Zevalin free of charge to enrolled patients who meet the income, insurance, and citizenship or residency eligibility criteria.

STAR Co-pay Assistance

Eligible, privately insured patients will pay $0 out of pocket for the first injection of Zevalin and then $25 for each subsequent injection, with a benefit of up to $10,000 per calendar year.

Zydelig (idelalisib) Tablets

Drug company: Gilead
844-622-2377

Zydelig is a kinase inhibitor used for the treatment of patients with follicular B-cell non-Hodgkin lymphoma.

Zydelig AccessConnect offers 3 financial assistance programs for patients using Zydelig:

Zydelig AccessConnect Copay Coupon Card

Patients with private insurance and copays above $5 are eligible for this program. With the Copay Coupon Card, patients will pay only the first $5 per prescription fill of Zydelig. The maximum benefit allowed is 25% of the catalog price for a 12-month supply of Zydelig.

Zydelig QuickStart Program

The Zydelig QuickStart Program gives eligible patients who have an insurance coverage delay of more than 5 business days quick access to a free, one-time, 30-day supply of Zydelig.

Zydelig AccessConnect Patient Assistance Program

Patients with no insurance or those who have been denied coverage may be eligible to receive Zydelig free of charge through this program. Eligible patients must meet certain financial criteria.

Mantle-Cell Lymphoma (A Type Of NHL)

Calquence (acalabrutinib) Capsules

Drug company: AstraZeneca
844-275-2360

Calquence is a kinase inhibitor used for the treatment of adults with mantle-cell lymphoma who have received at least 1 previous therapy.

AstraZeneca Access 360 offers 2 financial assistance program for patients using Calquence:

CALQUENCE Co-pay Savings Program

Eligible patients who have private insurance will pay $0 per month and may have access to up to $26,000 annually to assist with the out-of-pocket prescription costs associated with Calquence.

AZ&Me Prescription Savings Program

This program offers free medication from AstraZeneca to qualifying patients without isnuracne, those in Medicare Part D, and those who receive their medication through participating healthcare facilities.

Imbruvica (ibrutinib) Capsules/Tablets

Drug company: Pharmacyclics
877-877-3536

Imbruvica is a kinase inhibitor used for the treatment of adults with mantle-cell lymphoma, after at least 1 previous therapy.

Pharmacyclics’ You&i Support Program offers 2 financial assistance programs for patients using Imbruvica:

You&i Instant Savings Program

Patients with private insurance will pay no more than $10 monthly for Imbruvica. Eligible patients may qualify for instant savings on their commercial insurance copay, deductible, and coinsurance medication costs for Imbruvica

Johnson & Johnson Patient Assistance Foundation

This program provides Imbruvica free of charge to patients who meet certain financial limits and are either uninsured, underinsured, or enrolled in Medicare Part D.

Revlimid (lenalidomide) Capsules

Drug company: Celgene
800-931-8691

Revlimid is a thalidomide analog used for the treatment of patients with mantle-cell lymphoma whose disease has relapsed or progressed after 2 therapies, one of which was bortezomib.

Celgene Patient Support offers 3 financial assistance programs for patients using Revlimid:

Celgene Commercial Co-pay Program

This program reduces the copay for Revlimid to $25 or less for patients who have private insurance and an annual household income of up to 100,000.

Celgene Patient Assistance Program

Patients with no insurance or not enough insurance to cover their medication who meet certain financial criteria may be able to receive Revlimid for free.

Celgene Patient Support

This program connects patients with public insurance to outside resources that may help with the cost of copays, deductibles, and insurance premiums.

Velcade (bortezomib) for Injection

Drug company: Takeda Oncology
866-835-2233

Velcade is a proteasome inhibitor used for the treatment of patients with mantle-cell lymphoma.

Takeda Oncology offers 2 financial assistance programs for patients using Velcade:

Velcade Reimbursement Assistance Program

For patients with Medicare, Medicaid, or private insurance, this program will help find supplemental coverage if needed and provide assistance with copays.

Velcade Patient Assistance Program

Patients without insurance coverage may qualify to receive Velcade free of charge through this program. Patient eligibility is based on household income, treatment setting, and medically appropriate need.

Marginal-Zone Lymphoma (a Subtype of NHL)

Imbruvica (ibrutinib)

Drug company: Pharmacyclics
877-877-3536

Imbruvica is a kinase inhibitor used for the treatment of marginal-zone lymphoma, a type of non-Hodgkin lymphoma, in patients who require systemic therapy and have received at least 1 previous anti-CD20–based therapy.

Pharmacyclics’ You&i Support Program offers 2 financial assistance programs for patients using Imbruvica:

You&i Instant Savings Program

Patients with private insurance will pay no more than $10 monthly for Imbruvica. Eligible patients may qualify for instant savings on their commercial insurance copay, deductible, and coinsurance medication costs for Imbruvica.

Johnson & Johnson Patient Assistance Foundation

This program provides Imbruvica free of charge to patients who meet certain financial limits and are either uninsured, underinsured, or enrolled in Medicare Part D.

Revlimid (lenalidomide) Capsules

Drug company: Celgene
800-931-8691

Revlimid is a thalidomide analog used for the treatment of patients with mantle-cell lymphoma whose disease has relapsed or progressed after 2 therapies, one of which was bortezomib.

Celgene Patient Support offers 3 financial assistance programs for patients using Revlimid:

Celgene Commercial Co-pay Program

This program reduces the copay for Revlimid to $25 or less for patients who have private insurance and an annual household income of up to 100,000.

Celgene Patient Assistance Program

Patients with no insurance or not enough insurance to cover their medication who meet certain financial criteria may be able to receive Revlimid for free.

Celgene Patient Support

This program connects patients with public insurance to outside resources that may help with the cost of copays, deductibles, and insurance premiums.

Small Lymphocytic Lymphoma

Calquence (acalabrutinib) Capsules

Drug company: AstraZeneca
844-275-2360

Calquence is a kinase inhibitor used for the treatment of adults with mantle-cell lymphoma who have received at least 1 previous therapy.

AstraZeneca Access 360 offers 2 financial assistance program for patients using Calquence:

CALQUENCE Co-pay Savings Program

Eligible patients who have private insurance will pay $0 per month and may have access to up to $26,000 annually to assist with the out-of-pocket prescription costs associated with Calquence.

AZ&Me Prescription Savings Program

This program offers free medication from AstraZeneca to qualifying patients without isnuracne, those in Medicare Part D, and those who receive their medication through participating healthcare facilities.

Copiktra (duvelisib)

Drug company: Verastem
833-570-2273

Copiktra is a dual PI3 kinase inhibitor used for the treatment of adults with relapsed or refractory small lymphocytic lymphoma, after at least 2 other therapies.

Verastem Cares offers 3 financial assistance programs for patients who have been prescribed Copiktra:

Verastem Cares Co-Pay Assistance

Patients who have private insurance may pay as little as $5 for their prescription of Copiktra, with a maximum annual benefit of $25,000 and no patient income requirement.

Verastem Cares Bridge Rx Program

This program provides a free 14-day supply of Copiktra to eligible patients who experience coverage delays or loss of insurance of longer than 5 days.

Verastem Cares Patient Assistance Program

Patients who are uninsured and have an annual income of $150,000 or less may qualify to receive Copiktra for free.

Gazyva (obinutuzumab)

Drug company: Genentech
888-941-3331

Gazyva is a CD20-directed cytolytic antibody used, in combination with bendamustine followed by Gazyva alone, for the treatment of patients with follicular lymphoma whose disease relapsed after, or is refractory to, a rituximab-containing regimen; and in combination with chemotherapy followed by Gazyva alone in patients achieving a partial remission, for adults with previously untreated advanced (stage II bulky, III, or IV) follicular lymphoma.

Genentech offers 2 financial assistance programs for patients using Gazyva:

Genentech BioOncology Co-pay Assistance Program

Eligible patients with private insurance will pay just a $5 copay per prescription or infusion of Gazyva, with an annual benefit limit of $25,000. Retroactive requests for assistance will be honored if the prescription was filled within 120 days before enrollment in this program.

Genentech Access to Care Foundation

This foundation provides Gazyva free of charge to uninsured or underinsured patients whose annual household income is less than $150,000 and who meet specific financial criteria. For households with more than 4 people, add $25,000 per each additional member. Gazyva is also provided free for patients who are unable to afford their out-of-pocket costs and cannot find other financial assistance.

Imbruvica (ibrutinib) Capsules/Tablets

Drug company: Pharmacyclics
877-877-3536

Imbruvica is a Bruton tyrosine kinase inhibitor used for the first-line treatment of patients with small lymphocytic lymphoma (SLL), with or without 17p deletion. Imbruvica is also used, in combination with Gazyva, for the first-line treatment of patients with SLL.

Pharmacyclics’ You&i Support Program offers 2 financial assistance programs for patients using Imbruvica:

You&i Instant Savings Program

Patients with private insurance will pay no more than $10 monthly for Imbruvica. Eligible patients may qualify for instant savings on their commercial insurance copay, deductible, and coinsurance medication costs for Imbruvica.

Johnson & Johnson Patient Assistance Foundation

This program provides Imbruvica free of charge to patients who meet certain financial limits and are uninsured, underinsured, or enrolled in Medicare Part D.

Venclexta (venetoclax tablets)

Drug company: AbbVie/Genentech
888-941-3331

Venclexta is a BCL-2 inhibitor used for the treatment of adults with small lymphocytic lymphoma (SLL), with or without 17p deletion, who have received at least 1 previous therapy. Venclexta is also used, in combination with Gazyva or with rituximab, for the first-line treatment of patients with SLL.

Genentech offers 2 financial assistance programs for patients who have been prescribed Venclexta:

Genentech BioOncology Co-pay Assistance Program

Eligible patients with private insurance will pay just a $5 copay per prescription or infusion of Venclexta, with an annual benefit limit of $25,000. Retroactive requests for assistance will be honored if the prescription was filled within 120 days before enrollment in this program.

Genentech Patient Foundation

This foundation provides Venclexta free of charge to uninsured or underinsured patients whose annual household income is less than $150,000 and who meet specific financial criteria. For households with more than 4 people, add $25,000 per each additional member. Venclexta is also provided free for patients who are unable to afford their out-of-pocket costs and cannot find other financial assistance.

Zydelig (idelalisib) Tablets

Drug company: Gilead
844-622-2377

Zydelig is a kinase inhibitor used for the treatment of patients with small lymphocytic lymphoma after 2 or more systemic therapies.

Zydelig AccessConnect offers 3 financial assistance programs for patients using Zydelig:

Zydelig AccessConnect Copay Coupon Card

Patients with private insurance and copays above $5 are eligible for this program. With the Copay Coupon Card, patients will pay only the first $5 per prescription fill of Zydelig. The maximum benefit allowed is 25% of the catalog price for a 12-month supply of Zydelig.

Zydelig QuickStart Program

The Zydelig QuickStart Program gives eligible patients who have an insurance coverage delay of more than 5 business days quick access to a free, one-time, 30-day supply of Zydelig.

Zydelig AccessConnect Patient Assistance Program

Patients with no insurance or those who have been denied coverage may be eligible to receive Zydelig free of charge through this program. Eligible patients must meet certain financial criteria.

Table. Drugs Prescribed for Lymphoma

Hodgkin Lymphoma
  • Drug name (generic name)
  • Drug company
  • Indication
  • Patient support services
    Drug name (generic name)
  • Adcetris (brentuximab vedotin)
  • Drug company
  • Seattle Genetics
  • Indication
  • Treatment of classical Hodgkin lymphoma
  • Patient support services
  • SeaGen Secure Patient Assistance Program
    855-473-2436
Non-Hodgkin Lymphoma (NHL)
  • Drug name (generic name)
  • Drug company
  • Indication
  • Patient support services
    Drug name (generic name)
  • Adcetris (brentuximab vedotin)
  • Drug company
  • Seattle Genetics
  • Indication
  • Treatment of systemic anaplastic large-cell lymphoma or other CD30-expressing peripheral T-cell lymphomas, alone or in combination with cyclophosphamide, doxorubicin, and prednisone

    Treatment of primary cutaneous anaplastic large-cell lymphoma, or CD30-expressing mycosis fungoides, after systemic therapy
  • Patient support services
  • SeaGen Secure Patient Assistance Program
    855-473-2873
    Drug name (generic name)
  • Bendeka (bendamustine hydrochloride) Injection
  • Drug company
  • Teva
  • Indication
  • Indolent B-cell NHL progressing during or within 6 months of rituxan treatment or rituxan-containing regimen
  • Patient support services
  • Teva Cares Foundation Patient Assistance Program
    877-237-4881
    Drug name (generic name)
  • Mozobil (plerixafor)
  • Drug company
  • Sanofi
  • Indication
  • NHL, in combination with granulocyte colony-stimulating factor
  • Patient support services
  • CareASSIST Patient Assistance Program
    833-930-2273
    Drug name (generic name)
  • Poteligeo (mogamulizumab-kpkc)
  • Drug company
  • Kyowa Kirin
  • Indication
  • Treatment of relapsed fungoides or refractory mycosis

    Treatment of Sézary syndrome
  • Patient support services
  • Kyowa Kirin Cares Co-Pay Assistance Program
    833-552-2737
    Drug name (generic name)
  • Truxima (rituximab-abbs)
    Drug company
  • Teva
  • Indication
  • Treatment of relapsed or refractory low-grade or follicular CD20-positive B-cell NHL

    Untreated follicular CD20-positive B-cell NHL, in combination with first-line chemotherapy

    Non-progressing, low-grade, CD20-positive, B-cell NHL
  • Patient support services
  • Truxima Patient Savings Program
    888-587-3263

    Teva Cares Foundation Patient Assistance Program
    888-587-3263
    Drug name (generic name)
  • Valchlor (mechlorethamine)
  • Drug company
  • Helsinn
  • Indication
  • Treatment of stage IA/IB mycosis fungoides-type cutaneous T-cell lymphoma
  • Patient support services
  • Valchlor Co-pay Program
    855-482-5245
    Drug name (generic name)
  • Yescarta (axicabtagene ciloleucel)
  • Drug company
  • Kite Pharma
  • Indication
  • Relapsed or refractory primary mediastinal large B-cell lymphoma (a type of NHL), after at least 2 systemic therapies

    Relapsed or refrac­tory high-grade B-cell lymphoma (a type of NHL), after at least 2 systemic therapies
  • Patient support services
  • Kite Konnect
    844-454-5483
    Drug name (generic name)
  • Zolinza (vorinostat) Capsles
  • Drug company
  • Merck
  • Indication
  • Cutaneous T-cell lymphoma (a type of NHL) that is progressive, persistent, or recurrent with or after 2 systemic therapies
  • Patient support services
  • Merck Patient Assistance Program
    800-727-5400
Diffuse Large B-Cell Lymphoma (DLBCL)
  • Drug name (generic name)
  • Drug company
  • Indication
  • Patient support services
    Drug name (generic name)
  • Keytruda (pembrolizumab)
  • Drug company
  • Merck
  • Indication
  • Treatment of patients with refractory primary mediastinal large B-cell lymphoma, or patients whose disease relapsed after 2 therapies
  • Patient support services
  • Merck Co-pay Assistance Program
    855-257-3932

    Merck Patient Assistance Program
    855-257-3932
    Drug name (generic name)
  • Kymriah (tisagenlecleucel)
  • Drug company
  • Novartis
  • Indication
  • Treatment of relapsed or refractory large B-cell lymphoma after 2 systemic therapies, including DLBCL not specified.
    high-grade B-cell lymphoma
    DLBCL arising from follicular lymphoma
  • Patient support services
  • Kymriah Cares
    844-459-6742
    Drug name (generic name)
  • Yescarta (axicabtagene ciloleucel)
  • Drug company
  • Kite Pharma
  • Indication
  • Relapsed or refractory DLBCL not otherwise specified, after at least 2 systemic therapies

    Relapsed or refractory DLBCL arising from follicular lymphoma, after at least 2 systemic therapies
  • Patient support services
  • Kite Konnect
    844-454-5483
Follicular Lymphoma
    Drug name (generic name)
  • Gazyva (obinutuzumab)
  • Drug company
  • Genentech
  • Indication
  • Follicular lymphoma, in combination with bendamustine followed by Gazyva alone, in patients whose disease relapsed after, or is refractory to, a Rituxan-containing regimen

    Untreated advanced follicular lymphoma, in combination with chemotherapy followed by Gazyva alone, in patients achieving a partial remission
  • Patient support services
  • Genentech BioOncology Co-pay Assistance Program
    855-692-6729

    Genentech Patient Foundation
    888-941-3331
    Drug name (generic name)
  • Rituxan Hycela (rituximab/hyaluronidase human) Injection
  • Drug company
  • Genentech
  • Indication
  • Relapsed or refractory follicular lymphoma, as a single drug

    Untreated follicular lymphoma, in combination with first-line chemotherapy

    Maintenance therapy of follicular lymphoma, as a single drug, in patients with complete or partial response to rituximab plus chemotherapy

    Nonprogressing or stable follicular lymphoma, after first-line chemotherapy
  • Patient support services
  • Genentech BioOncology Co-pay Assistance Program
    855-692-6729

    Genentech Patient Foundation
    888-941-3331
Mantle-Cell Lymphoma
  • Drug name (generic name)
  • Drug company
  • Indication
  • Patient support services
Marginal-Zone Lymphoma
  • Drug name (generic name)
  • Drug company
  • Indication
  • Patient support services
Small Lymphocytic Lymphoma (SLL)
Last modified: March 12, 2020

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