Resources to help you get started

Your Patient Navigator is a dedicated resource, providing support and education about your diagnosis and your ZEJULA treatment. They can answer questions about insurance benefits and provide information about programs that might be available to assist with your out-of-pocket costs.

If you need help affording your medication, your Patient Navigator can guide you through our copay and patient assistance programs or explore additional financial resources that may be available to support you.

Your Patient Navigator is here to support you at key moments throughout your ZEJULA treatment journey. You can decide how often you’d like to stay in touch, and they’ll be available to connect with you as much or as little as you prefer.

We want to hear from you! You can tell your Patient Navigator if you have any feedback. Your feedback helps us get better.

Eligible criteria

Patients may be eligible based on the following general eligibility criteria:

• Patient must have a commercial medical or prescription insurance plan.
• Patient is a resident of the US (including the District of Columbia, Puerto Rico, and the US Virgin Islands).
• Patient is not eligible for or enrolled in a government-funded program that provides prescription drug coverage.*

*Patients are not eligible for this program if they are covered by any federal or state prescription insurance program. This includes patients enrolled in Medicare Part B, Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DoD) programs, or TriCare. This may also include state pharmaceutical assistance programs and other federal or state plans not listed. Patients are also ineligible for this program if they are Medicare eligible and enrolled in an employer-sponsored group waiver health plan or government-subsidized prescription drug benefit program for retirees. Patients enrolled in a state or federally funded prescription insurance program may not use this program even if they seek to be processed as an uninsured (cash-paying) patient. Patients enrolled in private indemnity or HMO insurance plans that reimburse them for the entire cost of their prescription drugs are also not eligible.

The ZEJULA Copay Program can provide assistance to eligible patients for their portion of administration fees up to $100 per administration, which counts toward the annual copay program maximum. Residents of Massachusetts and Rhode Island are not eligible for reimbursement of administrative fees. Out-of-pocket responsibilities for other related services, such as office visit copays, are not eligible for copay assistance. Visit the ZEJULA Copay Program site for additional terms and conditions.

To be eligible, the patient must:

• Be enrolled in a commercial (non-public, non-state funded, non-federally funded) prescription insurance plan.
• Be a US resident (including the District of Columbia, Puerto Rico, and the US Virgin Islands).
• Be 18 years of age or older.
• Be prescribed ZEJULA in accordance with the available prescribing information. We will need a valid prescription with approved coverage through the commercial plan.

Patients are not eligible for the ZEJULA Copay Assistance Program if they...

• Have any type of state, federal, or government-funded insurance (e.g., Medicare, Medicaid, TriCare, VA).
• Have insurance that reimburses them for the entire cost of their prescriptions.
• Cash patients and uninsured patients are also ineligible.

The copay program enrollment period ends on December 31 of each calendar year. The program benefit resets each year on January 1.

You can check the eligibility requirements by visiting GSK Patient Assistance for Prescription Medicine | GSKPAF and reviewing the specific income criteria. To determine if you qualify, you need to enroll in Together with ZEJULA.

You can enroll in the GSK PAP program as part of your Together with ZEJULA enrollment.

To enroll, download and complete the Patient section of the enrollment form.

No, enrollment in the support program is not necessary to receive your prescription. Together with ZEJULA is designed to assist patients who already have a prescription for ZEJULA by helping them understand their insurance coverage and savings options, as well as receive personalized support.

If you have a prescription for ZEJULA, you or a caregiver can initiate enrollment in Together with ZEJULA either online or by downloading the enrollment form. While your doctor will need to assist in completing the enrollment, you can start the process yourself.

Once you enroll in Together with ZEJULA, your information will be shared with one of our dedicated Patient Navigators. They will review your information and connect with you via an initial phone call. They’ll also guide you through the next steps in accessing ZEJULA based on your specific needs. The Patient Navigator does not provide medical advice and is not part of your doctor’s care team. Please ask your doctor any questions that you might have about your disease and treatment plan with ZEJULA.