Using the Program
Participating practices, institutions or specialty pharmacies must complete a one-time registration so they may process HEMLIBRA Co-pay Program* payments. To register, call (844) HEM-COPAY (844-436-2672).
 | The doctor sends the prescription to the hemophilia treatment center (HTC) pharmacy or specialty pharmacy. The doctor or the patient provides the patient's RxBIN, PCN, Group Number and Member ID to the HTC pharmacy or specialty pharmacy. |
| The HTC pharmacy or specialty pharmacy uses the Rx BIN, PCN, Group Number and Member ID to process through the HEMLIBRA Co-pay Program to determine patient responsibility, if any. |  |
 | The HTC pharmacy or specialty pharmacy Collects the patient's co-pay, if any, and the Genentech medicine is shipped to the patient. |
| The HEMLIBRA Co-pay Program reimburses the HTC pharmacy or specialty pharmacy for the patient's out-of-pocket cost, if any, for HEMLIBRA. |  |
*Eligible commercially insured patients who are prescribed HEMLIBRA for an FDA-approved use can receive up to $15,000 in assistance per calendar year. For more information, see full program Terms and Conditions.