Support Services

Taiho Oncology Patient Support™ is here to help you

Taiho Oncology Patient Support is here to help you obtain access to your Taiho Oncology medicine.

Our program offers a benefits review to confirm coverage, co-pay assistance enrollment,* specialty pharmacy prescription coordination, and personalized nurse support for patients taking LONSURF. Visit TaihoPatientSupport.com to find support now.

Insurance Coverage Support

Benefits investigation
Prior authorization assistance
Appeals assistance
Coordination of prescriptions with pharmacies

Patient Affordability Assistance*

$0 Co-pay program enrollment for eligible commercially insured patients to receive LONSURF Co-pay card
Patient assistance program designed to provide free medication to eligible patients who are uninsured or underinsured
Referrals to third-party foundations for co-pay or other assistance based on eligibility and additional criteria
Referrals to Medicare Part D Low-Income Subsidy (LIS)/Extra Help Program

Personalized Nurse Support^†

One-on-one nurse educational support for patients, available via opt-in

*Visit TaihoPatientSupport.com to see full eligibility criteria.

^†If this option is selected on the Patient Enrollment Form, a Nurse Navigator will be assigned to provide telephone support and will address general inquiries about your patient's Taiho Oncology medicine treatment.

Eligible patients may pay $0 per treatment cycle

Patients may be eligible if they:

Have commercial prescription insurance coverage
Use a specialty pharmacy
Use a hospital outpatient pharmacy
Receive medicine from a doctor’s office

Patients may not be eligible if they:

Are reimbursed under Medicaid, a Medicare drug benefit program, TRICARE, or other state or federal programs
Reside outside of the US, Puerto Rico, or US territories

*Restrictions and eligibility: Offer valid in the US, Puerto Rico, and US territories only. Only valid for patients with private insurance. Offer not valid for prescriptions reimbursed under Medicaid, a Medicare drug benefit plan, TRICARE, or other federal or state programs (such as medical assistance programs). If the patient is eligible for drug benefits under any such program, this offer is not valid and the patient cannot use this offer. By presenting or accepting this benefit, patient and pharmacist agree not to submit claim for reimbursement under the above programs. Patient further agrees to comply with any and all terms of his or her health insurance contract requiring notification to his or her payer of the existence and/or value of this offer. It is illegal to, or to offer to, sell, purchase, or trade this benefit. Maximum reimbursement limits apply; patient out-of-pocket expense may vary. Taiho Oncology, Inc., reserves the right to rescind, revoke, or amend this offer at any time without notice.

How to Enroll

There are 3 convenient ways to enroll in Taiho Oncology Patient Support Services, which is typically handled by the physician's office.

Via HCP Portal

Enroll online, with your healthcare provider through our HCP portal
NOTE: Login required. HCP registration required prior to enrolling.

GO TO HCP PORTAL

Download, Print, and Fax

Download and print the Patient Enrollment Form and fill it in at your doctor's office with your doctor, nurse, or support staff.
Fax the completed form to 1‑844‑287‑2559

DOWNLOAD ENROLLMENT FORM (EN) DOWNLOAD ENROLLMENT FORM (ES)

By Phone

Call 1‑844‑TAIHO‑4U (1‑844‑824‑4648) for help with enrollment.

Indications and Important Safety Information

INDICATIONS

LONSURF is a prescription medicine used:

alone or in combination with the medicine bevacizumab to treat adults with colorectal cancer:
- that has spread to other parts of the body, and
- who have been previously treated with certain chemotherapy medicines
alone to treat adults with a kind of stomach cancer called gastric cancer including adenocarcinoma of the gastroesophageal junction:
- that has spread to other parts of the body, and
- who have been previously treated with at least 2 types of treatment which included certain medicines

It is not known if LONSURF is safe and effective in children.

IMPORTANT SAFETY INFORMATION

LONSURF may cause serious side effects, including:

Low blood counts. Low blood counts are common with LONSURF and can sometimes be severe and life-threatening. LONSURF can cause a decrease in your white blood cells, red blood cells, and platelets. Low white blood cells can make you more likely to get serious infections that could lead to death. Your healthcare provider should do blood tests before you receive LONSURF, at day 15 during treatment with LONSURF, and as needed to check your blood cell counts. Your healthcare provider may lower your dose of LONSURF or stop LONSURF if you have low white blood cell or platelet counts

Tell your healthcare provider right away if you get any of the following signs and symptoms of infection during treatment with LONSURF: fever, chills, or body aches.

Before taking LONSURF, tell your healthcare provider about all of your medical conditions, including if you:

Have kidney or liver problems
Are pregnant or plan to become pregnant. LONSURF can harm your unborn baby
- Females who can become pregnant: Your healthcare provider will do a pregnancy test before you start treatment with LONSURF. You should use effective birth control during and 6 months after the last dose of treatment with LONSURF. Tell your healthcare provider immediately if you become pregnant
- Males, while on treatment and for 3 months after your last dose of LONSURF, you should use a condom during sex with female partners who are able to become pregnant. Tell your healthcare provider right away if your partner becomes pregnant while you are taking LONSURF
Are breastfeeding or plan to breastfeed. It is not known if LONSURF passes into your breast milk. Do not breastfeed during treatment with LONSURF and for 1 day after your last dose of LONSURF

Tell your healthcare provider about all the prescription and over-the-counter medicines, vitamins, and herbal supplements you take.

The most common side effects of LONSURF when used alone include low blood counts, tiredness and weakness, nausea, decreased appetite, diarrhea, vomiting, stomach-area (abdominal) pain, and fever.

The most common side effects of LONSURF when used in combination with bevacizumab include low blood counts, tiredness and weakness, nausea, certain abnormal liver function blood tests, decreased salt (sodium) in your blood, diarrhea, stomach-area (abdominal) pain, and decreased appetite.

Tell your healthcare provider if you have nausea, vomiting, or diarrhea that is severe or that does not go away.

These are not all of the possible side effects of LONSURF. For more information, ask your healthcare provider. Call your doctor for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see accompanying full Prescribing Information.