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This form is used to initiate the EFT registration process when the practice chooses not to use check reimbursements. It is a one-time registration completed by the practice.
This form is used when the drug is not clearly identified on the explanation of benefits (EOB). This form can accompany the EOB.
This form is used to initiate a one-time check reimbursement.
This form is used to initiate the check reimbursement process. It is a one-time registration completed by the practice.
This form is used by the practice to give consent to receive fax communications from Genentech, Inc.
OCREVUS is indicated for the treatment of:
OCREVUS is contraindicated in patients with active hepatitis B virus infection and in patients with a history of life-threatening infusion reaction to OCREVUS.
Management recommendations for infusion reactions depend on the type and severity of the reaction. Permanently discontinue OCREVUS if a life-threatening or disabling infusion reaction occurs.
Delay OCREVUS administration in patients with an active infection until the infection is resolved. Vaccination with live-attenuated or live vaccines is not recommended during treatment with OCREVUS and after discontinuation, until B-cell repletion
Reduction in Immunoglobulins:
Monitor the level of immunoglobulins at the beginning of treatment. Monitor during and after discontinuation of treatment with OCREVUS, until B-cell repletion, and especially when recurrent serious infections are suspected. Consider discontinuing OCREVUS in patients with serious opportunistic or recurrent serious infections, and if prolonged hypogammaglobulinemia requires treatment with intravenous immunoglobulins
An increased risk of malignancy, including breast cancer, may exist with OCREVUS
Most Common Adverse Reactions
RMS: The most common adverse reactions (≥10% and >REBIF): upper respiratory tract infections and infusion reactions. PPMS: The most common adverse reactions (≥10% and >placebo): upper respiratory tract infections, infusion reactions, skin infections, and lower respiratory tract infections.