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Compassionate Care

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Helping uninsured, income-eligible patients overcome financial barriers

The Compassionate Care Program is designed to provide eligible patients savings on Gonal-f® (follitropin alfa for injection), Ovidrel® PreFilled Syringe (choriogonadotropin alfa injection), or Cetrotide® (cetrorelix acetate for injection).

Depending on income, eligible patients may save 25%, 50%, or 75% off the self-pay price of medicine or receive a $10 discount per unit, via a mail-in rebate, off their out-of-pocket costs for the following EMD Serono fertility products:


GONAL-F® RFF* Redi-ject (follitropin alfa injection) 300 IU
GONAL-F® RFF* Redi-ject (follitropin alfa injection) 450 IU
GONAL-F® RFF* Redi-ject (follitropin alfa injection) 900 IU
GONAL-F® MULTI-DOSE (follitropin alfa for injection) 450 IU
GONAL-F® MULTI-DOSE (follitropin alfa for injection) 1050 IU
GONAL-F® RFF* (follitropin alfa for injection) 75 IU, single vial pack
GONAL-F® RFF* (follitropin alfa for injection) 75 IU, 10 vial pack


 

OVIDREL® PREFILLED SYRINGE (choriogonadotropin alfa injection)


CETROTIDE® (cetrorelix acetate for injection)


Eligible active military personnel and veterans receive a minimum of 25% off and might be eligible for additional savings up to 50% or 75% off the self-pay price of medication

Eligible patients can use the Compassionate Care Program for multiple cycles each year

Eligibility is based on qualifying annual household gross income and first-time participation in the compassionate Care Program. Program is available only at participating pharmacies. Patients must present a valid prescription for an eligible drug.

Patients must reapply each year

Compassionate Care Program Details

  • Benefit for patients with demonstrated financial need and a valid prescription for Gonal-f® (follitropin alfa for injection), Ovidrel® PreFilled Syringe (choriogonadotropin alfa injection), or Cetrotide® (cetrorelix acetate for injection)
  • Benefit is available at participating pharmacies only
  • Qualifying patients can save 75%, 50%, or 25% off the available self-pay price at the participating pharmacy
  • Eligible active military personnel and veterans receive a minimum of 25% off and might be eligible for additional savings up to 50% or 75% off on select EMD Serono Fertility medication
  • Qualifying patients can receive a $10 discount, via mail-in rebate, off their out-of-pocket costs for the following EMD Serono Fertility products:
    • Gonal-f® (follitropin alfa for injection) $10.00 per 75 IU
    • Ovidrel® PreFilled Syringe (choriogonadotropin alfa injection) $10.00 per 250 mcg
    • Cetrotide® (cetrorelix acetate for injection) $10.00 per
      0.25 mg
    • Patients must reapply each year
    • Patients may not combine this card with any rebate, coupon, free trial, or similar offer
    • Patients must present a valid prescription for an eligible drug at a participating pharmacy
    • EMD Serono reserves the right to rescind, revoke, terminate, or amend the Compassionate Care Card at any time without notice

     

     

    You may also CLICK HERE or call (855) 541-5926 to obtain the Compassionate Care enrollment forms and apply via fax, email or postal mail.

    forma en español

    Send completed enrollment forms to:
    Mail: Compassionate Care Program
             6501 Weston Parkway, Suite 370
             Cary, NC 27513

    Fax: (919) 415-2870

    Email: enrollments@emdcompassionatecare.com

    For active duty and retired military members:
    Offer not valid if any prescriptions or expenses associated with fertility treatment will be paid for by private or public insurance or reimbursed under a federal or state healthcare program, including Medicare, Medicaid, TRICARE, the Department of Veterans Affairs, the Department of Defense, or any other similar state healthcare program, including any state medical pharmaceutical assistance program. If you become insured by any private insurance you must notify the EMD Serono Compassionate Care program by calling 1-855-541-5926.

    For all other patients:
    Offer not valid for prescriptions that may be covered under private or public insurance or reimbursed under a federal or state healthcare program, including Medicare, Medicaid, TRICARE, the Department of Veterans Affairs, the Department of Defense, or any other similar state healthcare program, including any state medical pharmaceutical assistance program. If you become insured by any private or government insurance you must notify the EMD Serono Compassionate Care program by calling 1-855-541-5926.

    Card is not transferable and expires one year after program enrollment, unless earlier terminated by EMD Serono.

    Compassionate Care is not an insurance program.

    IMPORTANT INFORMATION ABOUT THE PROPER USE AND RISKS OF Gonal-f® RFF* Redi-ject™ (follitropin alfa injection):

    Gonal-f® RFF* Redi-ject™ (follitropin alfa injection) is an injection Pen that delivers a prescription medicine containing follicle-stimulating hormone (FSH) used in infertile women to:

    • help healthy ovaries develop (mature) and release an egg
    • cause your ovaries to make multiple (more than 1) eggs as part of an Assisted Reproductive Technology (ART) program

    Do not use the Gonal-f® RFF* Redi-ject™ if you:

    • are allergic to recombinant human FSH or any of the ingredients listed here:  follitropin alfa (r-hFSH), sucrose, meta-cresol, di-sodium hydrogen phosphate dihydrate, sodium dihydrogen phosphate monohydrate, methionine, Poloxamer 188, O-phosphoric acid, sodium hydroxide
    • have ovaries that no longer make eggs (primary ovarian failure)
    • are pregnant or think you may be pregnant
    • have uncontrolled thyroid or adrenal problems
    • have a tumor in your female organs, including your ovaries, breast, or uterus
    • have a tumor in your brain, such as a tumor in your pituitary or hypothalamus
    • have abnormal bleeding from your uterus or vagina
    • have ovarian cysts or large ovaries, not due to polycystic ovary syndrome (PCOS)

    Before you use Gonal-f® RFF* Redi-ject™, tell your healthcare provider if you:

    • have or have had asthma
    • have been told by a healthcare provider that you have an increased risk for blood clots (thrombosis)
    • have ever had a blood clot (thrombosis), or anyone in your family has ever had a blood clot (thrombosis)
    • have had abdominal surgery
    • have had twisting of your ovary (ovarian torsion)
    • had or have a cyst on your ovary
    • have polycystic ovarian disease
    • have any other medical conditions
    • are breastfeeding or plan to breastfeed
    • are taking any