Ocrevus

How to Use the Card

The OCREVUS Co-pay Program for drug or infusion assistance may be used in a community practice, infusion center, or hospital. For drug assistance only, the program may also be used with specialty pharmacies.

Participating practices, institutions or specialty pharmacies must complete a one-time registration so they may process OCREVUS Co-pay Program payments. To register, call (844) MS-COPAY (844-672-6729).

Enrolled patients will receive a welcome letter with one card to cover their drug and infusion costs.*

Administer OCREVUS treatment.

Fax a copy of the detailed explanation of benefits (EOB)^† to (855) MS-COPAY (855-672-6729) or upload it at OCREVUScopay.com

The requirements for reimbursement must include:

Name of insurance company
Facility name
Patient's name
Date of Service (DOS)
Name of drug or J-code
Amount billed, Amount allowed, Patient responsibility, Amount paid to provider

If the EOB does not include any of the above items, additional documentation may be required to process the claim

The OCREVUS Co-pay Program verifies the patient’s information and notifies your practice when the card is loaded with the proper amount.

Collect the patient’s $5 co-pay for drug costs and/or $5 co-pay for infusion costs, then collect the rest of the patient's out-of-pocket costs for drug and/or infusion using the card.

*Multiple payment methods from the OCREVUS Co-pay Program are available. They include the process shown here, as well as reimbursement by check and electronic funds transfer. For more information, please contact your OCREVUS representative.

^†EOBs must be submitted within 545 days from the date of service (DOS) for consideration.

Indication and Important Safety Information

Indications

OCREVUS is indicated for the treatment of:

Relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults
Primary progressive MS, in adults.

Contraindications

OCREVUS is contraindicated in patients with active hepatitis B virus infection and in patients with a history of life-threatening infusion reaction to OCREVUS.

Warnings and Precautions

Infusion reactions:
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.

Infections:
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.

Malignancies:
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.

For additional safety information, please see the full Prescribing Information and Medication Guide.

The OCREVUS Prepaid MasterCard^® is issued by Comerica Bank pursuant to license by MasterCard International. No cash or ATM access. The card can be used only to purchase prescriptions at participating merchant locations where Debit MasterCard is accepted.