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Coherus BioSciences

Coherus Biosciences offers the Coherus Complete™ program for patients prescribed Udenyca. Coherus Complete provides patient support services to assist with access.

For more information, search for Udenyca in this Guide, go online, or call 1.844.483.3692.

Oncology-related products: Udenyca^® (pegfilgrastim-cbqv) injection

Reimbursement Assistance

Coherus Complete™

Reimbursement support provided by patient access specialists, include:

• Product-specific benefit verification

• Coverage, coding, and reimbursement

• Prior authorization services

• Product replacement support.

For reimbursement assistance, contact your field reimbursement manager (coheruscomplete.com) or call 1.844.483.3692, Monday through Friday, 8:00 AM to 8:00 PM EST.

Co-Pay Card/Out-Of-Pocket Cost Assistance

Coherus Complete™ Co-Pay Assistance Program

Coherus Complete offers a co-pay assistance program that covers out-of-pocket expenses related to Udenyca for commercially insured patients. Eligible patients qualify for $0 out-of-pocket costs for each Udenyca dose. The program has a 180-day lookback period. The maximum annual benefit is $15,000 per enrollment period. No physical co-pay card is required.

To be eligible for the Co-Pay Assistance Program, patients:

• Must be prescribed Udenyca for a medically appropriate use

• Must have commercial health insurance that covers the medication costs of Udenyca

• Must not be covered by any federal-, state-, or government-funded healthcare program, such as Medicare, Medicaid, Medicare Advantage, Medicare Part D, Veterans Affairs, Department of Defense, or TriCare

• Must not seek reimbursement amount received from Coherus from any third-party payers, including flexible spending accounts or healthcare savings accounts.

To enroll, go online.

For assistance with co-pay claims reimbursement, call the program at 1.844.483.3692, Monday through Friday, 8:00 AM to 8:00 PM EST.

The co-pay program only covers the costs of Udenyca and does not cover any administration or office visit costs. Restrictions may apply and not valid where prohibited by law. Coherus may revise or terminate this program without notice at any time.

Patient Assistance Program

Coherus Complete™ Patient Assistance Program

Patients with no insurance may be eligible for financial support for Udenyca through the patient assistance program. Patient eligibility criteria:

• Uninsured, functionally underinsured, or Medicare patients that demonstrate financial hardship and cannot afford their cost-sharing obligation

• Must meet all eligibility requirements to qualify

• United States resident and must physically reside in the U.S. or U.S. territory

• Be under the care of a U.S. licensed provider with an established practice located in the U.S.

• Do not have any other financial support options

• Diagnosis and dosing must be consistent with FDA-approved prescribing information for Udenyca

• Adjusted annual household income of less than or equal to 500 percent of federal poverty level

• Must receive treatment in an outpatient setting by the physician or physician office.

Underinsured includes patients with health insurance that does not cover an pegfilgrastim product (biosimilar or reference product).

Healthcare providers requesting more than six refills by the program for the same patient will be required to provide written attestation on business letterhead affirming continued program necessity.

If a patient received Udenyxa within the past six months, they may be eligible for retro patient assistance.

To enroll, fax the completed enrollment form to 1.877.226.3670.

For more information, visit the program website or call 1.844.483.3692, Monday through Friday, 8:00 AM to 8:00 PM EST.

Independent Charitable Foundations/Organizations

Coherus Complete™ Referrals

Coherus Complete may also be able to help patients find financial support through charitable foundations. Patient access specialists can research alternative coverage options for patients. When funding becomes available, the healthcare providers' practice will receive email notifications alerting them to available funds from charitable foundations. Patients must be enrolled in Coherus Complete.

To enroll, fax the completed enrollment form to 1.877.226.3670.

For more information, visit the program website or call 1.844.483.3692, Monday through Friday, 8:00 AM to 8:00 PM EST.