Taking LONSURF
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WHAT IS
TAIHO ONCOLOGY
PATIENT SUPPORT™?

Taiho Oncology Patient Support Logo

Taiho Oncology Patient Support is your online and on‑call resource center for any questions or needs related to financial help and personal support for your LONSURF® (trifluridine and tipiracil) tablets treatment.

Understanding insurance coverage for LONSURF® (trifluridine and tipiracil) tablets treatment

Insurance Help

Throughout the process including appeals
$0 Co-pay Help for LONSURF® (trifluridine and tipiracil) tablets treatment

$0 Co-Pay*

And other cost help based on your healthcare coverage
Nurse Support for LONSURF® (trifluridine and tipiracil) tablets Treatment

Nurse Support

One-on-one educational guidance

*For commercially insured, eligible patients

HOW TO ENROLL

Find out how you can get help with treatment costs, nurse support, and more.
There are 2 simple ways to enroll:

Download and Print

Download and print the Patient Enrollment Form and fill it in at your doctor's office with your doctor, nurse, or support staff.

By Phone

Call 1-844-TAIHO-4U
(1-844-824-4648) to enroll
by phone.

What happens once you enroll:

  • A Taiho Oncology Patient Support Reimbursement Specialist will call you to:
    • Welcome you to the program
    • Explain your insurance benefits
    • Confirm your insurance coverage for LONSURF or help you apply for financial assistance
  • The specialty pharmacy will call you to discuss payment and shipment, if applicable
  • You will receive LONSURF from the specialty pharmacy, doctor's office, or hospital. Then you'll follow your healthcare provider's instructions for beginning treatment
  • If you have signed up to be paired with a Nurse Navigator, he or she will stay in contact to help you with your treatment plan

Cost Help and $0 Co-pay

MAKING GETTING TREATMENT EASIER

Questions about insurance, costs, or prescriptions? These services are just a phone call away for eligible patients.

Insurance coverage and reimbursement support

Based on your eligibility, we are here to help you:

  • Understand your insurance coverage for LONSURF and your out‑of‑pocket responsibility
  • Determine prior authorization requirements from your insurance company
  • Work with your insurance company if coverage is denied

Co-Pay savings for commercially insured eligible patients

  • You may be eligible to receive a Co-Pay Card to help reduce your out‑of‑pocket costs for LONSURF to $0.
    Ask your healthcare provider or pharmacy for the Taiho Oncology Patient Support Co-Pay Card if you have commercial insurance

Alternate funding support for Medicare/Medicaid‑ or government‑insured

If you are Medicare/Medicaid- or government-insured, we will refer you to third-party organizations that may be able to provide you with co‑pay assistance.

Patient Assistance Program for those unable to afford LONSURF

We may be able to provide LONSURF to you free of charge if you have:

  • No prescription insurance coverage
  • Insufficient prescription insurance coverage
  • Insufficient financial resources

Pharmacy coordination

We will be in contact with your pharmacy and your doctor, and will keep you up to date about your prescription status.

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 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.

SEE ALL INDICATIONS

INDICATIONS

LONSURF is a prescription medicine used to treat adults with

  • colorectal cancer that has spread to other parts of the body and who have been previously treated or cannot receive certain chemotherapy medicines.
  • a kind of stomach cancer called gastric cancer including cancer of the gastroesophageal junction that has spread to other parts of the body and who have been previously treated or cannot receive certain chemotherapy medications.

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

Indications and Important Safety Information

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INDICATIONS

LONSURF is a prescription medicine used to treat adults with

  • colorectal cancer that has spread to other parts of the body and who have been previously treated or cannot receive certain chemotherapy medicines.
  • a kind of stomach cancer called gastric cancer including cancer of the gastroesophageal junction that has spread to other parts of the body and who have been previously treated or cannot receive certain chemotherapy medications.

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 verify your pregnancy status 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 breast-feeding or plan to breast-feed. It is not known if LONSURF passes into your breast milk. Do not breast-feed 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 with LONSURF include tiredness (fatigue, weakness), nausea, decreased appetite, diarrhea, vomiting, abdominal pain, and fever.

Tell your doctor 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.

Please see full Prescribing Information.