TERMS & CONDITIONS FOR THE pharma& QUICKSTART PROGRAM


Eligibility Criteria

  • RUBRACA (rucaparib) must be prescribed on-label by an appropriately licensed health care professional (HCP), and the HCP must certify that based on his/her independent medical judgment, RUBRACA is a medically appropriate treatment option for the patient
  • Patient must have either commercial or government insurance
  • Patient must reside in the US or US Territories and be 18 years old or older
  • Patient must be new to RUBRACA treatment – existing RUBRACA patients are not eligible
  • Patient must request a coverage determination from their insurer and must experience a coverage delay of more than 5 days
Terms & Conditions
  • Patient may be eligible for free RUBRACA for up to 60 days of therapy. Quick Start product will end the earlier of (1) the patient receiving a coverage determination, or (2) 60 days
  • Not available to uninsured patients
  • Patients and participating prescribers agree not to seek reimbursement for all, or any, part of the benefit
  • Product will be shipped approximately every 15 days
  • Patients are eligible for Quick Start once per lifetime
  • This program is not health insurance. This program may not be combined with any other financial assistance program, free trial, discount, rebate, coupon, or other offer
  • pharma& reserves the right to make eligibility determinations and to rescind, revoke, or amend the program and discontinue support at any time without notice

TERMS & CONDITIONS FOR THE pharma& COVERAGE LINK BRIDGE PROGRAM

Eligibility Criteria

  • RUBRACA (rucaparib) must be prescribed on-label by an appropriately licensed health care professional (HCP), and the HCP must certify that based on his/her independent medical judgment, RUBRACA is a medically appropriate treatment option for the patient
  • Patient must have either commercial or government insurance
  • Patient must reside in the US or US Territories and be 18 years old or older
  • Patient must be an existing RUBRACA patient who has had a change in insurance and is experiencing a delay in obtaining insurance coverage from their new insurer
  • Patient must request a coverage determination from their new insurer and must experience a coverage delay of more than 5 days
Terms & Conditions
  • Patient may be eligible for free RUBRACA for up to 60 days of therapy. Coverage Link product will end the earlier of (1) the patient receiving a coverage determination, or (2) 60 days
  • Not available to uninsured patients
  • Patients and participating prescribers agree not to seek reimbursement for all, or any, part of the benefit
  • Product will be shipped approximately every 15 days
  • This program is not health insurance. This program may not be combined with any other financial assistance program, free trial, discount, rebate, coupon, or other offer
  • pharma& reserves the right to make eligibility determinations and to rescind, revoke, or amend the program and discontinue support at any time without notice

TERMS & CONDITIONS FOR THE pharma& CO-PAY PROGRAM

Patient Instructions 

If you are an eligible, commercially insured patient, the RUBRACA co-pay card will reduce your out-of-pocket costs up to the copay program annual limitation. If you reach the maximum annual limit, you will be responsible for any additional cost.

When you use this card, you are certifying that you understand and agree to comply with the program Terms & Conditions below.

Terms & Conditions

  • This offer is only available to patients with commercial insurance. The program is not available for patients who receive reimbursement under any federal, state or government-funded insurance programs, including patients who: (i) are enrolled in Medicare, Medicare Advantage, Medigap, Medicaid, TRICARE, VA, DoD, or any other federal or state health care program; (ii) are not using insurance coverage at all; (iii) are enrolled in an insurance plan that reimburses for the entire cost of the drug; or (iv) where product is not covered by patient’s insurance
  • The value of this program is exclusively for the benefit of patients and is intended to be credited toward patient out-of-pocket obligations, including applicable copayments, coinsurance, and deductibles
  • Co-pay maximizers are programs in which the amount of your out-of-pocket costs is increased to reflect the availability of support offered by a manufacturer assistance program. Except where prohibited by applicable state law, if your insurance company or health plan implements either an accumulator adjustment or co-pay maximizer program, you will not be eligible for, and agree not to use, co-pay assistance because these programs are inconsistent with our agreed intent that this program is solely for your benefit. You also agree that you are personally responsible for paying any amount of co-pay required after the savings card is applied. Any out-of-pocket costs remaining after the application of the savings card may not be paid by your health plan, pharmacy benefit programs, or any other program
  • If you learn your insurance company or health plan has implemented either an accumulator adjustment program or a co-pay maximizer program, you agree to inform pharma& of this fact by calling 1-844-779-7707 to discuss alternative options that may be available to support you. Since you may be unaware whether you are subject to a co-pay maximizer program when you enroll in the copay assistance program, Pharma& will monitor program utilization data and reserves the right to discontinue co-pay assistance at any time if pharma& determines that you are subject to a co-pay maximizer program. If your health plan removes RUBRACA from a co-pay maximizer program, you will return to eligibility for co-pay assistance up to the maximum annual benefit
  • Proof of purchase may be required
  • Patient may not seek reimbursement for the value received from this program from other parties, including any health insurance program or plan, flexible spending account, or health care savings account
  • Patient is responsible for complying with any applicable limitations and requirements of his/her health plan related to the use of the program. The program may not be used if prohibited by a patient’s health insurer
  • Program is not valid where prohibited by law. Valid only in the United States and US Territories: American Samoa, Guam, Northern Mariana Island, Puerto Rico and US Virgin Islands
  • This program is not health insurance. This program may not be combined with any other financial assistance program, free trial, discount, rebate, coupon, or other offer
  • pharma& reserves the right to make eligibility determinations and to rescind, revoke, or amend the program and discontinue support at any time without notice
  • For complete information about the terms & conditions of this program, including the limitations on use and the amount of assistance, call 844-779-7707

TERMS & CONDITIONS FOR THE pharma& PATIENT ASSISTANCE PROGRAM

Eligibility Criteria

  • RUBRACA (rucaparib) must be prescribed on-label by an appropriately licensed health care professional (HCP), and the HCP must certify that based on his/her independent medical judgment, RUBRACA is a medically appropriate treatment option for the patient
  • Patient must be either uninsured or insured without coverage for RUBRACA after completing any available appeals process
  • Patient must reside in the US or US Territories and be 18 years old or older
  • Patient must have gross annual household income at or below 300% of the current Federal Poverty Level (FPL) (FPL Guidelines available at https://aspe.hhs.gov/poverty-guidelines). Below are the 300% 2024 FPL limits based on household size:
Household Size Annual Income*
1 $45,180 or less
2 $61,320 or less
3 $77,460 or less
4 $93,600 or less
If your household has more than four members, please add $16,140* for each additional dependent member.
*Subject to change in 2025, as the FPL is updated annually by the U.S. government.

Terms & Conditions

  • Patient may be asked to submit documentation (e.g., federal tax returns; IRS forms such as W-2, 1099, 4506T; Social Security statement/checks/benefit letter; pension or disability benefit statement/letter; unemployment compensation statement; pay stubs) to validate levels of income
  • pharma& will review all submitted documentation, including the pharma& Patient Assistance Program eligibility form and all substantiating information, prior to approving a patient for eligibility under the pharma& Patient Assistance Program
  • Both the patient and prescriber must sign and date all submitted documentation to attest to the accuracy of the information
  • Uninsured patients, commercially insured patients, and federal healthcare program beneficiaries who qualify for the pharma& Patient Assistance Program are enrolled for the entire calendar year. However, pharma& reserves the right to reassess eligibility for uninsured patients and patients with commercial insurance during the calendar year
  • The pharma& Patient Assistance Program is not insurance
  • Provision of free product under this program is not contingent upon future purchase or prescribing of RUBRACA
  • No patient, pharmacy, payer, or other third party may be billed for the free product provided through the pharma& Patient Assistance Program.
  • Patients and providers agree not to submit any claims for reimbursement for all or any part of the free product provided through the pharma& Patient Assistance Program. If the HCP or pharmacy receives any payments for products provided under this program, they agree to return such payments to the applicable payer or patient
  • Patient, pharmacist, and prescriber agree to not sell, purchase, trade, or offer to sell, purchase, or trade any free product received through the pharma& Patient Assistance Program
  • Patient cannot apply the value of the free product received through the pharma& Patient Assistance Program toward any insurance benefit out-of-pocket spending calculations
  • pharma& retains the right to make the final decision regarding any pharma& Patient Assistance Program product request. All product requests are subject to review at pharma&’s sole discretion, and all decisions by pharma& are final
  • pharma& requires that you re-apply every year
  • pharma& reserves the right to modify or revoke this program at any time without notice

These Terms & Conditions are effective as of 01/01/2025.

Tap for safety information

INDICATION AND IMPORTANT SAFETY INFORMATION

INDICATION

RUBRACA® (rucaparib) is indicated for the treatment of adult patients with a deleterious BRCA mutation (germline and/or somatic)-associated metastatic castration-resistant prostate cancer (mCRPC) who have been treated with androgen receptor-directed therapy and a taxane-based chemotherapy. Select patients for therapy based on an FDA-approved companion diagnostic for RUBRACA. 

This indication is approved under accelerated approval based on objective response rate and duration of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials. 

SELECT IMPORTANT SAFETY INFORMATION

Myelodysplastic Syndrome (MDS)/Acute Myeloid Leukemia (AML) occur in patients treated with RUBRACA, and are potentially fatal adverse reactions. In 1594 treated patients with ovarian cancer, MDS/AML occurred in 32 patients (2%), including those in long term follow-up. Of these, 14 occurred during treatment or during the 28-day safety follow-up (0.9%). The duration of RUBRACA treatment prior to the diagnosis of MDS/AML ranged from < 2 months to approximately 72 months. The cases were typical of secondary MDS/cancer therapy-related AML; in all cases, patients had received previous platinum-containing chemotherapy regimens and/or other DNA damaging agents. 

In ARIEL3, of patients with a germline and/or somatic BRCA mutation treated with RUBRACA, MDS/AML occurred in 9 out of 129 (7%) patients treated with RUBRACA and 4 out of 66 (6%) patients treated with placebo. The duration of therapy with RUBRACA in patients who developed secondary MDS/cancer therapy-related AML varied from 1.2 to 4.7 years.

In TRITON2, MDS/AML was not observed in patients with mCRPC (n=209) regardless of homologous recombination deficiency (HRD) mutation.  
Do not start RUBRACA until patients have recovered from hematological toxicity caused by previous chemotherapy (≤ Grade 1). Monitor complete blood counts for cytopenia at baseline and monthly thereafter for clinically significant changes during treatment. For prolonged hematological toxicities (> 4 weeks), interrupt RUBRACA or reduce dose and monitor blood counts weekly until recovery. If the levels have not recovered to Grade 1 or less after 4 weeks or if MDS/AML is suspected, refer the patient to a hematologist for further investigations, including bone marrow analysis and blood sample for cytogenetics. If MDS/AML is confirmed, discontinue RUBRACA.  
Based on findings from genetic toxicity and animal reproduction studies, RUBRACA can cause fetal harm. Advise male patients with female partners of reproductive potential or who are pregnant to use effective methods of contraception during treatment and for 3 months following last dose of RUBRACA. Advise male patients not to donate sperm during therapy and for 3 months following the last dose of RUBRACA. 

Most common adverse reactions of patients with BRCA-mutated mCRPC in TRITON2 (≥ 20%; Grade 1-4) were fatigue/asthenia (62%), nausea (52%), anemia (43%), AST/ALT elevation (33%), decreased appetite (28%), rash (27%), constipation (27%), thrombocytopenia (25%), vomiting (22%), and diarrhea (20%).  

Concomitant administration of RUBRACA with CYP1A2, CYP3A, CYP2C9, or CYP2C19 substrates can increase the systemic exposure of these substrates, which may increase the frequency or severity of adverse reactions of these substrates. If concomitant administration is unavoidable between RUBRACA and substrates of these enzymes where minimal concentration changes may lead to serious adverse reactions, decrease the substrate dosage in accordance with the approved prescribing information.  
If concomitant administration with warfarin (a CYP2C9 substrate) cannot be avoided, consider increasing the frequency of international normalized ratio (INR) monitoring.  
For medical information inquiries within the U.S., contact pharma& at medinfo.us@pharmaand.com. 
You may report adverse events to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Alternatively, to report an adverse event or reaction, contact pharma& by calling 1-800-506-8501 or emailing pv@pharmaand.com.
To report a product complaint, contact pharma& at complaints@pharmaand.com. 
Please see full Prescribing Information for RUBRACA.

The information contained in this website is intended for US healthcare professionals only.

By clicking the button below, you acknowledge that you are a US healthcare professional.

I am a US healthcare professional
Cancel

YOU ARE NOW LEAVING RubracaProstateHCP.com

Are you sure you want to leave?

Continue
Cancel and stay
Skip to content
Rubraca® HCP
Powered by  GDPR Cookie Compliance
Privacy Overview

This website uses cookies so that we can provide you with the best user experience possible. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful.