Using the Program

There is no physical card that you need to carry. Your hemophilia treatment center (HTC) pharmacy or specialty pharmacy just needs your Rx BIN, PCN, Group Number and Member ID to process your payment.

This information is shown on the screen when you enroll. It is also sent to you in a Welcome Letter.
You might want to hold on to this information, just in case. If you need to find it again, log in to your account. These numbers are shown on your Dashboard.

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.