PATIENT ASSISTANCE PROGRAM

CoverOne includes a patient assistance program that provides BAVENCIO® (avelumab) 20mg/mL at no charge for patients who meet certain income, insurance (i.e. uninsured), and residency eligibility criteria.

  • To determine eligibility, providers should complete a CoverOne Enrollment Form on the CoverOne Enrollment Portal prior to treatment or fax a form to 1-800-214-7295. Patient assistance is not applied retroactively.
  • A CoverOne representative will notify you as soon as possible with the patient's eligibility determination.

Please include one of the following income documents if applying for the Patient Assistance Program: Most recent Federal or State Tax Return, or W2. If tax return or W2 are not available, please provide the following documentation: Most recent 2 months of Paycheck Stubs, Last 2 months Bank Statements showing income deposits, Social Security Statements, Unemployment Check or Statement.

When BAVENCIO is used in combination with axitinib, questions related to reimbursement and access for axitinib may be referred to Pfizer Oncology TogetherTM.  
Pfizer Oncology TogetherTM provides personalized support and financial assistance resources to help patients access their prescribed axitinib. To learn more, call 1-877-744-5675 (Monday–Friday 8 AM–8 PM ET) or visit Pfizer Oncology Together.

NOTE: The CoverOne patient assistance program is a philanthropic program for patients in need, and is not contingent on any past or future commercial sale.

©2021 Merck KGaA, Darmstadt, Germany or its affiliates. All rights reserved. EMD Serono is the Healthcare business of Merck KGaA, Darmstadt, Germany, in the U.S. and Canada. BAVENCIO is a registered trademark of Merck KGaA, Darmstadt, Germany or its affiliates.

COOKIE SETTINGS

US-AVE-00859     January 2022

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call 1-800-FDA-1088. The health information contained herein is provided for educational purposes only and is not intended to replace discussions with a healthcare provider. All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patient. The product information provided in this site is intended only for residents of the United States. The products discussed herein may have different product labeling in different countries.

You are about to leave the CoverOne website and are being redirected to a non-CoverOne website. Neither EMD Serono nor Pfizer review or control the content of the following website. This redirection does not constitute an endorsement by EMD Serono or Pfizer of the following organization or any information provided by the organization.

Continue