Skip To Main Content
For Patients and Caregivers

Helpful Resources for Your Practice

Genentech Ophthalmology Access Solutions offers a range of access and reimbursement resources for your patients and practice after VABYSMO is prescribed, including help with benefits investigations (BIs), resources for prior authorizations (PAs), sample billing and coding information, resources for denials and appeals, information about distribution and referrals to potential financial assistance options.

Quick Links

Help with Coverage (BIs and PAs)
Reimbursement (Billing, Coding and Appeals)
Online Patient Enrollment
VABYSMO Distribution

Coverage

Get help understanding insurance benefits and coverage, such as with benefits investigations and prior authorization resources.

Benefits Investigations

Genentech Ophthalmology Access Solutions can conduct a benefits investigation (BI) which can determine:

  • If treatment is covered
  • If treatment is denied
  • If a prior authorization or pre-determination is required*
  • If your patient's insurance plan has a mandated or preferred specialty pharmacy


*If your patient’s request for a prior authorization is not granted, your Genentech Ophthalmology Access Solutions specialist can work with you to determine your next steps.

Get started with enrollment by following the steps below.

Option 1: Submit online

If your practice has a registered account for My Patient Solutions, you can get started by logging into your account.

Don't have an account?

Your patient is required to complete the Patient Consent Form. You can either upload their Patient Consent Form as part of your application or have your patient submit the form via fax, text or e-submit.

  • An online tool to help you enroll patients in Genentech Ophthalmology Access Solutions and manage your service requests at your convenience.

Option 2: Print & fax or text

Step 1: Print one of the Patient Consent Forms below for your patient to complete.

Step 2: Print and complete the Prescriber Service Form below.

Step 3: Submit the completed forms via fax or text.

Both forms are required. We must have both the Patient Consent Form and the Prescriber Service Form before we can help you.

What to expect next:

  • The request will be processed within five business days upon receipt of both required forms.
  • Your office will be contacted to discuss any next steps.

The completion and submission of coverage- or reimbursement-related documentation are the responsibility of the patient and healthcare provider. Genentech makes no representation or guarantee concerning coverage or reimbursement for any service or item.

VABYSMO Case Managers

A Case Manager may assist during your patient's treatment with coverage, reimbursement and financial assistance support

Learn more about VABYSMO Case Managers

VABYSMO Benefits Reverification

When a medical treatment is authorized by the patient’s insurance plan for a limited period of time, it will generally require reverification of coverage for continued treatment. Genentech Ophthalmology Access Solutions can help you obtain reverification for your patients. 

If the patient’s health insurance plan denies the request for reverification, your practice may file an appeal on behalf of your patient.

Reimbursement

Sample coding information and resources for denials and appeals

VABYSMO Sample Coding

This coding information may assist you as you complete the payer forms for VABYSMO. These tables are provided for informational purposes only. Please visit CMS.gov or other payers’ websites to obtain additional guidance on their processes related to billing and coding.

Sample Coding: Diabetic Macular Edema (DME)

Correct coding is the responsibility of the provider submitting the claim for the item or service. Please check with the payer to verify codes and special billing requirements. Genentech does not make any representation or guarantee concerning reimbursement or coverage for any service or item.

Appeals

If your patient’s health insurance plan has issued a denial, your Genentech Ophthalmology Access Solutions specialist can provide resources as you prepare an appeal submission, as per your patient’s plan requirements. 

If a plan issues a denial: 

  1. The denial should be reviewed, along with the health insurance plan’s guidelines to determine what to include in your patient’s appeal submission.
  2. Your Genentech Ophthalmology Access Solutions specialist has local payer coverage expertise and can help you determine specific requirements for your patient.

A sample appeal letter and additional considerations are available on the Practice Forms & Documents page.

Appeals cannot be completed or submitted by Genentech on your behalf.

Online Patient Enrollment

My Patient Solutions is an online tool to help you enroll patients in Genentech Ophthalmology Access Solutions and manage your service requests, all through one portal. It allows you the flexibility to work with Genentech Ophthalmology Access Solutions when it’s convenient for you.

With My Patient Solutions, you can:

  • Enroll and re-enroll patients in Genentech Ophthalmology Access Solutions and/or the Genentech Patient Foundation
  • View Genentech Patient Foundation eligibility and coordinate shipment
  • Communicate with your Genentech Ophthalmology Access Solutions specialist
  • Easily identify next steps for service requests
  • View Benefits Investigation reports for all your enrolled patients
  • Follow up on prior authorizations or appeals
  • Request benefits reverification

How to register

Account registration can be completed by one person for the entire practice and for multiple practice locations. For help with registration or if you have questions, call us at 877-GENENTECH (877-436-3683) (6AM-5PM PST, Monday through Friday).

Register for My Patient Solutions

VABYSMO Distribution

Genentech has contracted with authorized specialty distributors and specialty pharmacies to service practices choosing to prescribe VABYSMO. 

These partners have made a commitment to product integrity and have agreed to distribute only products purchased directly from Genentech and not to distribute VABYSMO through secondary channels.

Authorized Distributors

For a full list of authorized distributors, please visit the Genentech Access Solutions website or contact Genentech Ophthalmology Access Solutions at (833) EYE-GENE/(833) 393-4363.

About Buy and Bill

With Buy and Bill, the practice purchases the medication in advance, then bills the patient's health insurance plan for reimbursement. The practice is responsible for storing and handling the drug as well as collecting the patient's co-pay for both the drug and its administration. With Buy and Bill, practices can maintain a stock of the drug, giving them the flexibility to treat patients when clinically appropriate.

About Specialty Pharmacies

Genentech Ophthalmology Access Solutions works with specialty pharmacies (SPs) to help patients receive their prescribed Genentech medicines.

In addition to distributing medicines, an SP may provide the following services:

  • Reimbursement resources
  • Clinical services to support patients throughout their treatment
  • The ability to manage the specialty handling and shipping needs linked with many specialty therapies

You can work with your preferred SP or contact Genentech Ophthalmology Access Solutions to learn which SP the patient’s health insurance plan mandates or prefers.

For a full list of in-network specialty pharmacies, please visit the Genentech Access Solutions website or contact Genentech Ophthalmology Access Solutions at (833) EYE-GENE/(833) 393-4363.

Genentech does not influence or advocate the use of any one specialty distributor or specialty pharmacy. We make no representation or guarantee of service or coverage of any item. For any product-specific distribution questions, call Genentech Ophthalmology Access Solutions at (833) EYE-GENE/(833) 393-4363 (6AM-5PM PST, Monday through Friday).

Product Issues

We are serious about patient safety. If your Genentech product is spoiled, expired or damaged, we may be able to help you replace it.

Need more help? Click here to find the latest information.

Please contact Genentech Customer Service at 800-551-2231 for any order or return-related questions.

Contact Us

Need more help? Contact Genentech Ophthalmology Access Solutions

Call (833) EYE-GENE/(833) 393-4363 (Mon.–Fri., 6AM–5PM PST), except major holidays

Financial Support

Find the right financial resources option for your patients.

Learn more
NEXT: Practice Forms & Documents

  • We are open from 6AM-5PM PST, Mon. through Fri., except for the following holidays:

    • New Year’s Day
    • Martin Luther King, Jr. Day
    • Memorial Day
    • Juneteenth
    • Independence Day
    • Labor Day
    • Thanksgiving Holiday (Thursday and Friday)
    • Christmas Day

Important Safety Information & Indications


INDICATIONS
VABYSMO (faricimab-svoa) is a vascular endothelial growth factor (VEGF) inhibitor and angiopoietin-2 (Ang-2) inhibitor indicated for the treatment of patients with Neovascular (Wet) Age-Related Macular Degeneration (nAMD), Diabetic Macular Edema (DME), and Macular Edema following Retinal Vein Occlusion (RVO).


IMPORTANT SAFETY INFORMATION

Contraindications
VABYSMO is contraindicated in patients with ocular or periocular infection, in patients with active intraocular inflammation, and in patients with known hypersensitivity to faricimab or any of the excipients in VABYSMO. Hypersensitivity reactions may manifest as rash, pruritus, urticaria, erythema, or severe intraocular inflammation.

Warnings and Precautions
Endophthalmitis and Retinal Detachments
Intravitreal injections have been associated with endophthalmitis and retinal detachments. Proper aseptic injection techniques must always be used when administering VABYSMO. Patients should be instructed to report any symptoms suggestive of endophthalmitis or retinal detachment without delay, to permit prompt and appropriate management.

Increase in Intraocular Pressure
Transient increases in intraocular pressure (IOP) have been seen within 60 minutes of intravitreal injection, including with VABYSMO. IOP and the perfusion of the optic nerve head should be monitored and managed appropriately.

Thromboembolic Events
Although there was a low rate of arterial thromboembolic events (ATEs) observed in the VABYSMO clinical trials, there is a potential risk of ATEs following intravitreal use of VEGF inhibitors. ATEs are defined as nonfatal stroke, nonfatal myocardial infarction, or vascular death (including deaths of unknown cause).

The incidence of reported ATEs in the nAMD studies during the first year was 1% (7 out of 664) in patients treated with VABYSMO compared with 1% (6 out of 662) in patients treated with aflibercept.

The incidence of reported ATEs in the DME studies from baseline to week 100 was 5% (64 out of 1,262) in patients treated with VABYSMO compared with 5% (32 out of 625) in patients treated with aflibercept.

The incidence of reported ATEs in the RVO studies during the first 6 months was 1.1% (7 out of 641) in patients treated with VABYSMO compared with 1.4% (9 out of 635) in patients treated with aflibercept.

Retinal Vasculitis and/or Retinal Vascular Occlusion
Retinal vasculitis and/or retinal vascular occlusion, typically in the presence of intraocular inflammation, have been reported with the use of VABYSMO. Healthcare providers should discontinue treatment with VABYSMO in patients who develop these events. Patients should be instructed to report any change in vision without delay.

Adverse Reactions
The most common adverse reactions (≥5%) reported in patients receiving VABYSMO were cataract (15%) and conjunctival hemorrhage (8%).

Pregnancy, Lactation, Females and Males of Reproductive Potential
Based on the mechanism of action of VEGF and Ang-2 inhibitors, there is a potential risk to female reproductive capacity, and to embryo-fetal development. VABYSMO should not be used during pregnancy unless the potential benefit to the patient outweighs the potential risk to the fetus. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for VABYSMO and any potential adverse effects on the breastfed child from VABYSMO. Females of reproductive potential are advised to use effective contraception prior to the initial dose, during treatment and for at least 3 months following the last dose of VABYSMO.

You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835-2555.

Please see additional Important Safety Information in the full VABYSMO Prescribing Information.

    • VABYSMO [package insert]. South San Francisco, CA: Genentech, Inc; 2024.

      VABYSMO [package insert]. South San Francisco, CA: Genentech, Inc; 2024.

    • Data on file. South San Francisco, CA: Genentech, Inc.

      Data on file. South San Francisco, CA: Genentech, Inc.

    • Baumal CR, et al. Presented at American Academy of Ophthalmology (AAO) 2022. Sep 30–Oct 03 2022.

      Baumal CR, et al. Presented at American Academy of Ophthalmology (AAO) 2022. Sep 30–Oct 03 2022.

    • Tadayoni R, et al. Presented at Angiogenesis, Exudation, and Degeneration 2023. Feb 10–11 2023.

      Tadayoni R, et al. Presented at Angiogenesis, Exudation, and Degeneration 2023. Feb 10–11 2023.

    • Regula JT, et al. EMBO Mol Med. 2016;8:1265–1288.

      Regula JT, et al. EMBO Mol Med. 2016;8:1265–1288.

    • Saharinen P, et al. Nat Rev Drug Discov. 2017;16:635–661.

      Saharinen P, et al. Nat Rev Drug Discov. 2017;16:635–661.

    • Warmke N, et al. J Diabetes Complications. 2016;30:1643-1650.

      Warmke N, et al. J Diabetes Complications. 2016;30:1643-1650.

    • Fiedler U, et al. Trends Immunol. 2006;27(12):552–558.

      Fiedler U, et al. Trends Immunol. 2006;27(12):552–558.

    • Avery RL, et al. Presented at American Association of Ophthalmology (AAO) 2022. Sept 30–Oct 03 2022.

      Avery RL, et al. Presented at American Association of Ophthalmology (AAO) 2022. Sept 30–Oct 03 2022.

    • Heier J, et al. Lancet. 2022;399(10326):729–740.

      Heier J, et al. Lancet. 2022;399(10326):729–740.

    • Guymer R, et al. Presented at Angiogenesis, Exudation, and Degeneration 2022. Feb 11–12 2022.

      Guymer R, et al. Presented at Angiogenesis, Exudation, and Degeneration 2022. Feb 11–12 2022.

    • Tadayoni R, et al. Presented at Angiogenesis, Exudation, and Degeneration 2024. Feb 03 2024.

      Tadayoni R, et al. Presented at Angiogenesis, Exudation, and Degeneration 2024. Feb 03 2024.

    • Khanani AM, et al. JAMA Ophthalmol. 2020;138(9):964–972.

      Khanani AM, et al. JAMA Ophthalmol. 2020;138(9):964–972.

    • Sahni J, et al. Ophthalmology. 2019;126(8):1155–1170.

      Sahni J, et al. Ophthalmology. 2019;126(8):1155–1170.

    • Wykoff C, et al. Lancet. 2022;399(10326):741–755.

      Wykoff C, et al. Lancet. 2022;399(10326):741–755.

    • Heier JS, et al. Presented at American Academy of Ophthalmology Retina Subspecialty Day (AAO-SSD) 2021. Nov 12–13 2021.

      Heier JS, et al. Presented at American Academy of Ophthalmology Retina Subspecialty Day (AAO-SSD) 2021. Nov 12–13 2021.

    • Goldberg R, et al. Presented at the Association for Research in Vision and Ophthalmology (ARVO) 2023. April 23–27 2023.

      Goldberg R, et al. Presented at the Association for Research in Vision and Ophthalmology (ARVO) 2023. April 23–27 2023.

    • Baumal CR, et al. Presented at the Association for Research in Vision and Ophthalmology (ARVO) 2022. May 1–4 2022.

      Baumal CR, et al. Presented at the Association for Research in Vision and Ophthalmology (ARVO) 2022. May 1–4 2022.