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Understanding the Coverage Process

Here are tips to help you understand the coverage process.

The insurance verification process can be complicated. The VELCADE Reimbursement Assistance Program is here to help. You can contact a dedicated Case Manager from 8:00 am to 8:00 pm EST Monday through Friday at 1-866-VELCADE (835-2233), option 2, who will help you navigate this process.

Four Steps to Access VELCADE® (bortezomib)

Step 1 – Talk to Your Doctor

Discuss any questions you may have regarding treatment and the impact it will have on your out-of-pocket expense with your doctor and the office staff.

Your doctor’s office is a resource for you about what to expect from your treatment and how different treatment regimens may be impacted by your insurance coverage. They can also refer you to other resources that may be useful to you.

You can contact the VELCADE Reimbursement Assistance Program (VRAP) at 1-866-VELCADE (835-2233), option 2, from 8:00 am to 8:00 pm EST, Monday through Friday.

Step 2 – Provide Insurance Information to Your Doctor’s Office

Make sure that your doctor's office has all of your current insurance information so that they can verify your coverage and provide your insurance company with any additional information they need.

Your doctor's office will research your insurance coverage to determine if VELCADE will be covered, if additional documentation will need to be submitted to the insurance company, and how much you will need to pay for your treatment based on your insurance plan.

  • If your insurance company covers VELCADE, you will move on to the payment and scheduling processes outlined in steps 3 and 4
  • If your insurance company requests additional information, then your doctor may need to submit a letter stating the reason(s) why you need to be treated with VELCADE. The insurance company will notify both you and the doctor about their decision. If coverage is approved, you will move on to the payment and scheduling processes outlined in steps 3 and 4
  • If your insurance company requests additional information and does not approve your treatment based on what your doctor has provided, then you may be able to get assistance through the VELCADE Reimbursement Assistance Program (VRAP)
Step 3 – Understand the Payment Process

Depending on the details of your specific insurance coverage, your out-of-pocket expense will vary. It is important to understand these details, and to know where you can go for help.

As a result of the insurance verification process, you and your doctor's office will know whether you have insurance coverage for your VELCADE treatment and how much you will be responsible for paying, according to your insurance policy.

Insured
If your insurance company covers VELCADE and you either have a supplemental policy or can self-pay to cover the co-payment, then treatment will begin as soon as it can be scheduled.

Underinsured
If you are unable to afford your co-payment, then you can apply to a Co-payment Foundation for assistance. You will need to fill out an enrollment form in order to be evaluated for assistance by the foundation. The VELCADE Reimbursement Assistance Program (VRAP) can help you identify the foundations that cover your diagnosis and assist you with the form. Your doctor's office may also be able to help you with this process. If you are approved for assistance from the Co-payment Foundation, they will notify you of the amount they will give you for your treatment. Here is a list of some of the organizations that may be able to offer assistance:

Patient Advocate Foundation
www.patientadvocate.org
Phone: (800) 532-5274

Patient Access Network Foundation
panfoundation.org
Phone: (866) 316-7263

Chronic Disease Fund
www.cdfund.org
Phone: (877) 968-7233

Leukemia and Lymphoma Society
www.lls.org
Phone: (800) 955-4572

HealthWell Foundation
healthwellfoundation.org
Phone: (800) 675-8416

The Assistance Fund
www.theassistancefund.org
Phone: (877) 245-4412

Uninsured
If you have no insurance coverage, then you may be eligible for VRAP. You or your doctor's office can call VRAP and pre-screen to see if you qualify for the program. You and your doctor will have to fill out a one-page form, provide financial documentation and fax the information to VRAP. Within 48 hours, you will know whether you can get free drug for your treatment.

Step 4 – Schedule Your Treatment

Once you have determined how you will be able to pay for VELCADE, contact your doctor's office to schedule your VELCADE treatment.

Once your insurance coverage for VELCADE has been verified, you will set up an appointment to receive your VELCADE therapy. VELCADE is given as a 3- to 5-second IV injection in your doctor’s office or at a hospital out-patient clinic.


Need Additional Resources?

You also have many other resources that can assist you and your family throughout your treatment. These resources can provide assistance with treatment-related costs, help you identify support groups for yourself and other family members, and partner with your doctor and insurance company to get coverage for your treatment.

VELCADE Reimbursement Assistance Program (VRAP)
1-866-VELCADE (835-2233), Option 2
8:00 am to 8:00 pm EST, Monday through Friday

Patient Advocate Foundation
www.patientadvocate.org
Phone: (800) 532-5274

CancerCare
www.cancercare.org
Phone: (800) 813-4673

Patient Access Network Foundation
www.panfoundation.org
Phone: (866) 316-7263

Chronic Disease Fund
www.cdfund.org
Phone: (877) 968-7233

Leukemia & Lymphoma Society
www.lls.org
Phone: (800) 955-4572

Healthwell Foundation
www.healthwellfoundation.org
Phone: (800) 675-8416

VRAP is available to you to provide assistance regarding these and other insurance coverage questions.

NEXT: Questions to Ask Your Doctor’s Office

Reimbursement

The process of paying for healthcare services, supplies, and medications. Insurance plans, the government, and patients reimburse healthcare providers and pharmacies for the services and products they provide

Co-Payment

Fixed amount of money a patient is responsible for at each doctor’s visit, at the hospital or emergency room, or when a prescription is filled at a pharmacy (i.e. $10, $20, etc.). Amounts defined by the patient’s insurance benefit structure.

IV Injection

Intravenous injection; a method of administering drugs or fluids using a needle or a thin tube inserted in a vein; IV push denotes that the process happens quickly, within seconds, while the IV infusion may take many hours


Important Safety Information

What is VELCADE® (bortezomib) used for?

VELCADE is approved for the treatment of patients with multiple myeloma (a cancer of the plasma cells). VELCADE is also approved for the treatment of patients with mantle cell lymphoma (a cancer of the lymph nodes) who have already received other treatments.

How is VELCADE administered?

VELCADE is prescribed by a physician experienced in the use of medications to treat cancer. It is administered by a healthcare professional as an injection into your vein (intravenously, or IV) or under your skin (subcutaneously). VELCADE must not be administered into your spinal fluid (intrathecally).

Who should not receive VELCADE?

Before you receive treatment with VELCADE, tell your doctor about all of your medical conditions. You should not receive VELCADE if you are allergic to bortezomib, boron, or mannitol.

What are the possible side effects of VELCADE?

VELCADE can cause serious side effects, including:

  • Peripheral neuropathy. VELCADE can cause damage to the nerves, a condition called peripheral neuropathy. You may feel muscle weakness, tingling, burning, pain, and loss of feeling in your hands and feet, any of which can be severe. Tell your doctor if you notice any of these symptoms. Your doctor may change the dose and/or schedule of VELCADE, or stop it altogether. If you have peripheral neuropathy before starting VELCADE, your doctor could consider giving you VELCADE subcutaneously.
  • Low blood pressure. VELCADE can cause a drop in blood pressure. Tell your doctor if you have low blood pressure, feel dizzy, or feel as though you might faint. If you are taking drugs that lower blood pressure, your medications might need to be adjusted. If you are not drinking enough liquids, your doctor may need to administer IV fluids.
  • Heart problems. Treatment with VELCADE can cause or worsen heart rhythm problems and heart failure. Your doctor may closely monitor you if you have, or are at risk for, heart disease. Tell your doctor if you experience chest pressure or pain, palpitations, swelling of your ankles or feet, or shortness of breath.
  • Lung disorders. There have been reports of lung disorders in patients receiving VELCADE. Some of these events have been fatal. Tell your doctor if you experience any cough, shortness of breath, wheezing, or difficulty breathing.
  • Liver disease. If you have liver problems, it can be harder for your body to get rid of VELCADE. VELCADE has caused sudden liver failure in patients who were taking many medications or had other serious medical conditions. Symptoms of liver problems include a yellow discoloration of the eyes and skin (jaundice) and changes in liver enzymes measured in blood tests. Your doctor will closely monitor you if you have liver disease. In patients with moderate or severe liver disease, VELCADE should be started at a lower dose. Additional dose adjustments may be made based on your tolerance of the drug.
  • Gastrointestinal problems. VELCADE treatment can cause nausea, vomiting, diarrhea, and constipation. If your symptoms are severe, your doctor may recommend IV fluids and/or medications.
  • Neutropenia (low levels of neutrophils, a type of white blood cell) and thrombocytopenia (low levels of platelets). VELCADE can cause low levels of white blood cells (infection-fighting cells) and/or platelets (clot-forming cells). You will have regular blood tests to check your cell counts during your treatment with VELCADE. If the number of these cells is very low, your doctor may change the dose and/or schedule of VELCADE. If your white blood cells become low, you can be at higher risk for infections. Tell your doctor if you develop a fever or believe you have an infection. If platelets become very low, there is an increased risk of bleeding. Your doctor may recommend a platelet transfusion. There have been cases of bleeding in the stomach, bowels, and brain during treatment with VELCADE.
  • Tumor lysis syndrome (TLS). TLS can occur with cancer treatments, and your doctor will be monitoring your blood and urine for any signs of this syndrome. If you develop TLS, your doctor will take appropriate steps to treat it.
  • Reversible posterior leukoencephalopathy syndrome (RPLS). There have been reports of a rare, reversible condition involving the brain, called RPLS, in patients treated with VELCADE. Patients with RPLS can have seizures, high blood pressure, headaches, tiredness, confusion, blindness, or other vision problems. Treatment with VELCADE should be stopped in cases of RPLS.

More than 30% of patients receiving VELCADE have experienced the following side effects: thrombocytopenia, neutropenia, nausea, peripheral neuropathy, neuralgia (nerve pain), pyrexia (fever), diarrhea, anemia, leukopenia (low levels of white blood cells), decreased appetite, fatigue, constipation, vomiting, dehydration, dyspnea (difficulty breathing), cough, asthenia (low energy), insomnia (trouble sleeping), peripheral edema (swelling of the limbs), and headache.

What other information should you discuss with your doctor?

Women should avoid becoming pregnant or breastfeeding while being treated with VELCADE. Discuss with your doctor when it is safe to restart breastfeeding after finishing your treatment.

You should also tell your doctor if you:

  • Have kidney disease. If you are on dialysis, your doctor will administer VELCADE after the dialysis procedure.
  • Are taking medication for diabetes. VELCADE can affect your blood glucose levels. Your doctor may require close monitoring of your blood glucose levels and change the dose of your diabetes medicine while you are being treated with VELCADE.
  • Have liver disease.
  • Are using medicines like ketoconazole (an antifungal), ritonavir (an antiviral), and rifampin (an antibiotic), which will require close monitoring during treatment with VELCADE.
  • Are using any other medications (including over-the-counter drugs), herbal or dietary supplements, or holistic treatments. St. John’s Wort should be avoided.
  • Develop a rash of any type while receiving VELCADE.

The side effects of VELCADE may impair your ability to drive or operate machinery.

These are not all of the possible side effects with VELCADE. It is important to always contact your doctor if you experience any side effects while on VELCADE. If you have any questions about VELCADE, contact your doctor.

Please click here for the full Prescribing Information for VELCADE, including Warnings and Precautions.

Page last updated 1/23/2012

Learn what to expect from treatment with VELCADE.
Important Safety Information
What is VELCADE® (bortezomib) used for?

VELCADE is approved for the treatment of patients with multiple myeloma (a cancer of the plasma cells). VELCADE is also approved for the treatment of patients with mantle cell lymphoma (a cancer of the lymph nodes) who have already received other treatments.

How is VELCADE administered?

VELCADE is prescribed by a physician experienced in the use of medications to treat cancer. It is administered by a healthcare professional as an injection into your vein (intravenously, or IV) or under your skin (subcutaneously). VELCADE must not be administered into your spinal fluid (intrathecally).

Who should not receive VELCADE?

Before you receive treatment with VELCADE, tell your doctor about all of your medical conditions. You should not receive VELCADE if you are allergic to bortezomib, boron, or mannitol.

What are the possible side effects of VELCADE?

VELCADE can cause serious side effects, including:

  • Peripheral neuropathy. VELCADE can cause damage to the nerves, a condition called peripheral neuropathy. You may feel muscle weakness, tingling, burning, pain, and loss of feeling in your hands and feet, any of which can be severe. Tell your doctor if you notice any of these symptoms. Your doctor may change the dose and/or schedule of VELCADE, or stop it altogether. If you have peripheral neuropathy before starting VELCADE, your doctor could consider giving you VELCADE subcutaneously.
  • Low blood pressure. VELCADE can cause a drop in blood pressure. Tell your doctor if you have low blood pressure, feel dizzy, or feel as though you might faint. If you are taking drugs that lower blood pressure, your medications might need to be adjusted. If you are not drinking enough liquids, your doctor may need to administer IV fluids.
  • Heart problems. Treatment with VELCADE can cause or worsen heart rhythm problems and heart failure. Your doctor may closely monitor you if you have, or are at risk for, heart disease. Tell your doctor if you experience chest pressure or pain, palpitations, swelling of your ankles or feet, or shortness of breath.
  • Lung disorders. There have been reports of lung disorders in patients receiving VELCADE. Some of these events have been fatal. Tell your doctor if you experience any cough, shortness of breath, wheezing, or difficulty breathing.
  • Liver disease. If you have liver problems, it can be harder for your body to get rid of VELCADE. VELCADE has caused sudden liver failure in patients who were taking many medications or had other serious medical conditions. Symptoms of liver problems include a yellow discoloration of the eyes and skin (jaundice) and changes in liver enzymes measured in blood tests. Your doctor will closely monitor you if you have liver disease. In patients with moderate or severe liver disease, VELCADE should be started at a lower dose. Additional dose adjustments may be made based on your tolerance of the drug.
  • Gastrointestinal problems. VELCADE treatment can cause nausea, vomiting, diarrhea, and constipation. If your symptoms are severe, your doctor may recommend IV fluids and/or medications.
  • Neutropenia (low levels of neutrophils, a type of white blood cell) and thrombocytopenia (low levels of platelets). VELCADE can cause low levels of white blood cells (infection-fighting cells) and/or platelets (clot-forming cells). You will have regular blood tests to check your cell counts during your treatment with VELCADE. If the number of these cells is very low, your doctor may change the dose and/or schedule of VELCADE. If your white blood cells become low, you can be at higher risk for infections. Tell your doctor if you develop a fever or believe you have an infection. If platelets become very low, there is an increased risk of bleeding. Your doctor may recommend a platelet transfusion. There have been cases of bleeding in the stomach, bowels, and brain during treatment with VELCADE.
  • Tumor lysis syndrome (TLS). TLS can occur with cancer treatments, and your doctor will be monitoring your blood and urine for any signs of this syndrome. If you develop TLS, your doctor will take appropriate steps to treat it.
  • Reversible posterior leukoencephalopathy syndrome (RPLS). There have been reports of a rare, reversible condition involving the brain, called RPLS, in patients treated with VELCADE. Patients with RPLS can have seizures, high blood pressure, headaches, tiredness, confusion, blindness, or other vision problems. Treatment with VELCADE should be stopped in cases of RPLS.

More than 30% of patients receiving VELCADE have experienced the following side effects: thrombocytopenia, neutropenia, nausea, peripheral neuropathy, neuralgia (nerve pain), pyrexia (fever), diarrhea, anemia, leukopenia (low levels of white blood cells), decreased appetite, fatigue, constipation, vomiting, dehydration, dyspnea (difficulty breathing), cough, asthenia (low energy), insomnia (trouble sleeping), peripheral edema (swelling of the limbs), and headache.

What other information should you discuss with your doctor?

Women should avoid becoming pregnant or breastfeeding while being treated with VELCADE. Discuss with your doctor when it is safe to restart breastfeeding after finishing your treatment.

You should also tell your doctor if you:

  • Have kidney disease. If you are on dialysis, your doctor will administer VELCADE after the dialysis procedure.
  • Are taking medication for diabetes. VELCADE can affect your blood glucose levels. Your doctor may require close monitoring of your blood glucose levels and change the dose of your diabetes medicine while you are being treated with VELCADE.
  • Have liver disease.
  • Are using medicines like ketoconazole (an antifungal), ritonavir (an antiviral), and rifampin (an antibiotic), which will require close monitoring during treatment with VELCADE.
  • Are using any other medications (including over-the-counter drugs), herbal or dietary supplements, or holistic treatments. St. John’s Wort should be avoided.
  • Develop a rash of any type while receiving VELCADE.

The side effects of VELCADE may impair your ability to drive or operate machinery.

These are not all of the possible side effects with VELCADE. It is important to always contact your doctor if you experience any side effects while on VELCADE. If you have any questions about VELCADE, contact your doctor.

Please click here for the full Prescribing Information for VELCADE, including Warnings and Precautions.