For Patients and Caregivers

Help Your Patients Save on Single-Dose XOFLUZA

AT MOST PHARMACIES

As little as

$35 (UP TO $70 OFF)

THE XOFLUZA COUPON

Your patient can present this coupon at their preferred pharmacy. Cost will vary based on their insurance coverage. With the coupon, they can pay as little as $35, up to $70 off. Terms and conditions apply.

Cannot be combined with Government Insurance (Medicare, Medicaid, TRICARE)

HOW TO GET YOUR COUPON

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Have your patients text 
Rx to 96260*


*Message and data rates apply.

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Save PDF


 
xofluza-coupon.pdf

AT SELECT PHARMACIES

Flat fee via self-pay

$50

$50 FLAT FEE

Your patients can choose to self-pay without insurance for $50. They can get their prescription from their preferred pharmacy or have it delivered via select pharmacies. Terms and conditions apply.

Cannot be combined with insurance, including Government insurance (Medicare, Medicaid, TRICARE)

GET IT DELIVERED, ONLY AVAILABLE AT

Same-day delivery may be available via Instacart or pick up in-store. $50 flat fee is available to Costco Members only.

Learn More

Nationwide mail delivery.

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Same-day delivery in select metros.

Learn More

(Shipping & additional fees may apply.)

For Patients:

  1. By using this coupon, you acknowledge that you meet the eligibility criteria and will comply with the terms and conditions.
  2. Present this coupon to your pharmacy along with a valid prescription for XOFLUZA and:
    • You will pay the first $35
    • Genentech can pay up to the next $70 depending on your insurance coverage. Any additional amounts due are your responsibility.
  3. May be used twice between October 1st - September 30th of the following year.
    If you have any questions, call 1-855-XOFLUZA.

For pharmacists:

  1. The processing information on this card can be repeatedly used for all your patients.
  2. When you apply this offer, you are certifying that the patient meets the eligibility criteria, and that you have not submitted and will not submit a claim for reimbursement under any state- or federally funded prescription insurance program for this prescription.
  3. For insured patients, process a coordination of benefits (COB/split bill) claim using the patient’s prescription insurance for the PRIMARY claim. Submit a SECONDARY claim using BIN 610020 and GROUP 99994457. For cash-paying or uninsured patients, submit a PRIMARY claim using BIN 610020 and GROUP 99994457. PCN is not required for processing the claim. For help processing the coupon, please call 1-855-659-9767.

TERMS AND CONDITIONS

  1. This offer is valid for patients receiving a prescription for XOFLUZA for an FDA-approved indication. The offer may be used by those with commercial/private insurance, uninsured patients or those choosing to pay cash (unless otherwise excluded). This offer may not be used for any other product.
  2. This offer may not be used by patients in conjunction with prescription insurance under Medicaid, Medicare, TRICARE or similar federal or state programs. This offer is not health insurance or a benefit plan.
  3. Offer only valid in the United States and U.S. Territories. This offer is not transferable and may not be combined with any other offer.
  4. Offer must be presented along with a valid prescription for XOFLUZA at the time of purchase.
  5. The patient must be 18 years or older to receive coupon benefits or a parent or guardian must redeem this offer on the patient’s behalf.
  6. May be used twice between October 1st - September 30th of the following year.
  7. Coupon program is void where prohibited by law and on the date an AB-rated generic equivalent for XOFLUZA becomes available.
  8. Genentech USA, Inc. reserves the right to rescind, revoke, or amend this offer at any time without notice. It is a violation of federal law to buy, sell, or counterfeit this offer.

$50 FLAT FEE TERMS AND CONDITIONS

Patient Eligibility/Terms and Conditions:

By accepting this offer, you acknowledge that you meet the eligibility criteria and will comply with the terms and conditions.

  1. This offer is available through select pharmacies to patients who have a prescription for XOFLUZA.
  2. For insured patients: The price patients pay under the program through a participating pharmacy may be higher or lower than the price available through their insurance plan. The Program is not available to patients who seek or obtain reimbursement for their XOFLUZA prescription from any third party, including government or private insurance plans or other programs; or who include the payment in any submission for the amount to count toward any deductible, coinsurance, out-of-pocket maximum, or Medicare Part D TrOOP. The dispensing pharmacy and/or Genentech may share this information with Medicare Part D Plans and may deny or reverse payment or charge back amounts if a claim is submitted for product purchased using this offer.
  3. Offer only valid in the United States, U.S. territories and possessions. This offer is not transferable and may not be combined with any other offer.
  4. The offer is void where prohibited by law.
  5. Genentech USA, Inc. reserves the right to rescind, revoke or amend the offer at any time without notice. Providing false information may result in denial or reverse payment or charge back of the cash price.

Frequently
asked
questions

You can direct your patients to the Savings Page of our website, where they can learn about the XOFLUZA Coupon, allowing them to pay as little as $35, up to $70 off (Terms and conditions apply). They can also learn about our $50 self-pay option.

Coverage, patient out-of-pocket cost, copay programs, and sample availability can vary by plan, state, institution, and eligibility criteria.

The complete XOFLUZA prescribing information can be found here. It is also included with the dispensed drug.

You should consult the current FDA-approved US Prescribing Information for complete information on indications, limitations of use, dosing by weight and formulation, contraindications, warnings, adverse reactions, drug or food interactions, use in specific populations, and clinical study data.

Current CDC and local antimicrobial stewardship guidance should also be considered.

No. XOFLUZA is a prescription medication in the US and requires evaluation by a healthcare provider.1

Because XOFLUZA is indicated for the treatment of acute uncomplicated influenza in patients who have been symptomatic for no more than 48 hours, patients with suspected influenza (particularly those at high risk of influenza-related complications) should be evaluated promptly.1 Delayed presentation may place a patient outside the treatment window.

XOFLUZA is given as a single weight-based oral dose.1

The current U.S. Prescribing Information provides specific dose thresholds by body weight.1 You should confirm the exact tablet dose in the Prescribing Information.

IMPORTANT SAFETY INFORMATION & INDICATION

Indication

XOFLUZA is an influenza virus polymerase acidic (PA) endonuclease inhibitor indicated for:

  • Treatment of acute uncomplicated influenza in patients 5 years of age and older who have been symptomatic for no more than 48 hours and who are otherwise healthy or at high risk of developing influenza-related complications.
  • Post-exposure prophylaxis (PEP) of influenza in patients 5 years of age and older following contact with an individual who has influenza.

Limitations of Use
Influenza viruses change over time, and factors such as the virus type or subtype, emergence of resistance, or changes in viral virulence could diminish the clinical benefit of antiviral drugs. Consider available information on drug susceptibility patterns for circulating influenza virus strains when deciding whether to use XOFLUZA.

Important Safety Information

Contraindications
XOFLUZA is contraindicated in patients with a history of hypersensitivity to baloxavir marboxil or any of its ingredients. Serious allergic reactions have included anaphylaxis, angioedema, urticaria, and erythema multiforme.

Warnings and Precautions

Hypersensitivity: Cases of anaphylaxis, urticaria, angioedema, and erythema multiforme have been reported in postmarketing experience with XOFLUZA. Appropriate treatment should be instituted if an allergic-like reaction occurs or is suspected.

Increased Incidence of Treatment-Emergent Resistance in Patients Less Than 5 Years of Age: XOFLUZA is not indicated in patients less than 5 years of age due to increased incidence of treatment-emergent resistance in this age group. In clinical trials, the incidence of virus with treatment-emergent substitutions associated with reduced susceptibility to baloxavir (resistance) was higher in pediatric subjects younger than 5 years of age (40%, 38/96) than in pediatric subjects ≥5 years to <12 years of age (16%, 19/117) or subjects ≥12 years of age (7%, 60/842). The potential for transmission of resistant strains in the community has not been determined.

Risk of bacterial infections: There is no evidence of the efficacy of XOFLUZA in any illness caused by pathogens other than influenza viruses. Serious bacterial infections may begin with influenza-like symptoms or may coexist with, or occur as, a complication of influenza. XOFLUZA has not been shown to prevent such complications. Prescribers should be alert to potential secondary bacterial infections and treat them as appropriate.

Adverse Reactions

  • The most common adverse reactions (≥1%) in adult and adolescent patients (≥12 years of age) in clinical studies for acute uncomplicated influenza were diarrhea (3%), bronchitis (3%), nausea (2%), sinusitis (2%), and headache (1%).
  • The most frequently reported adverse reactions (≥5%) in pediatric patients (5 to <12 years of age) in clinical studies for acute uncomplicated influenza were vomiting (5%) and diarrhea (5%).
  • The safety profile reported in a clinical study for post-exposure prophylaxis was similar in pediatric patients ages 5 to <12 years old as that reported in adults and adolescents 12 years of age and older.

Drug Interactions
Polyvalent cations: Coadministration with polyvalent cation-containing products may decrease plasma concentrations of baloxavir, which may reduce XOFLUZA efficacy. Avoid coadministration of XOFLUZA with dairy products, calcium-fortified beverages, polyvalent cation-containing laxatives, antacids, or oral supplements (eg, calcium, iron, magnesium, selenium, or zinc).

Vaccines: The concurrent use of XOFLUZA with intranasal live attenuated influenza vaccine (LAIV) has not been evaluated. Concurrent administration of antiviral drugs may inhibit viral replication of LAIV and, thereby, decrease the effectiveness of LAIV vaccination. Interactions between inactivated influenza vaccines and XOFLUZA have not been evaluated.

For additional Important Safety Information, please see the XOFLUZA full Prescribing Information.

You are encouraged to report side effects to Genentech by calling 1-888-835-2555 or to the FDA by visiting www.fda.gov/medwatch or calling 1-800-FDA-1088.

    • XOFLUZA. Prescribing information. Genentech, Inc.

      XOFLUZA. Prescribing information. Genentech, Inc.

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