ZEJULA Co-pay Program

Together with GSK Oncology Co-pay Program may help eligible commercially-insured patients* with their out-of pocket medication costs for Zejula

If approved, patients may pay as little as $0 for out-of-pocket costs for Zejula up to $26,000 for 12-months.

Eligibility criteria
Patients may be eligible based on general eligibility criteria below:

Patient has a commercial prescription insurance plan; or
Patient is uninsured;
AND
Patient is a resident of the US (including the District of Columbia, Puerto Rico, and the US Virgin Islands); and
Not eligible for or enrolled in a government funded program that provides prescription drug coverage*

To get started please indicate whether you are a

I am a
Patient

I am a
Healthcare
Provider

*Eligibility restrictions and program maximums apply. Patients are not eligible for this program if they are covered by any federal or state prescription insurance program. This includes patients enrolled in Medicare Part B, Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DoD) programs or TriCare. This may also include state pharmaceutical assistance programs and other federal or state plans not listed. Patients are also ineligible for this program if they are Medicare eligible and enrolled in an employer-sponsored group waiver health plan or government-subsidized prescription drug benefit program for retirees. Patients enrolled in a state or federally funded prescription insurance program may not use this program even if they elect to be processed as an uninsured (cash paying) patient. Those on Medicare Part D, even if in the coverage gap, are not eligible.

Additional program rules apply visit togetherwithgskoncology.com for complete Program Terms and Conditions.

For questions regarding the Together with GSK Oncology Co-pay Program for ZEJULA call
1-844-4GSK-ONC (1-844-447-5662)
(8am – 8pm EST, Monday–Friday)