Celgene Patient Support^®
A single source for access support

At Celgene, we believe nothing should come between you and your medicine

That’s why Celgene Patient Support^® is ready to help answer questions about the insurance approval process. And you may need help paying for REVLIMID. Celgene Patient Support^® can help you and your loved ones understand the programs and services available to you.

Our Specialists are ready to help you and your family with:

Understanding your insurance plan
Learning about financial assistance that may help you pay for REVLIMID
Obtaining information about organizations that may assist you with travel costs to and from your doctor’s office

Financial Assistance

What type of insurance do you have?

Programs that help with the cost of REVLIMID differ by the type of insurance you have. Even if you don’t have insurance or enough coverage to pay for your medicine, financial help may be available.

Commercial insurance

If you have commercial insurance, you may qualify for the Celgene Commercial Co-pay Program.

If you qualify, your out-of-pocket co-pay responsibility will be $25 for REVLIMID.
This program provides up to $10,000 per calendar year to help meet co-pay/co-insurance costs.

Eligibility criteria include*

Gross annual household income of $100,000 or less^†
Commercial or private insurance (including healthcare exchanges) that does not cover the full cost of the prescribed Celgene medicine
Residence in the United States or US territory
Patients with government healthcare insurance (for example, Medicaid, Medicare, Medigap, TriCare) are not eligible

Medicare, Medicaid, or other government-sponsored insurance

Your Specialist can provide you with information about independent third-party organizations^‡ that may be able to help with the cost of your:

Deductibles
Co-payments/co-insurance
Insurance premiums

I do not have health insurance or enough coverage to pay for REVLIMID

If you do not have health insurance or enough coverage to pay for your medicine, you may qualify for the Celgene Patient Assistance Program (PAP)^§

To qualify, you must meet certain financial criteria. Your Specialist can tell you if you qualify.

Celgene Patient Support^® can also provide information about insurance coverage or other programs you may qualify for

Other eligibility requirements and restrictions apply. Please see full Terms and Conditions

^†

Patients may be subject to a random audit to verify income.

^‡

Financial and medical eligibility requirements vary by organization

^§

Patients must meet specified financial and eligibility requirements to qualify for assistance.

Eligibility

PATIENTS MUST MEET THE FOLLOWING CRITERIA TO ENROLL:

Covered by commercial or private insurance
Reside in the United States or a US territory
Not participating in a federal or state-funded healthcare program, including, but not limited to, Medicare or Medicaid, Medigap, CHAMPUS, VA, DOD, or Tricare
Gross annual household income must not exceed $100,000
- – Gross household income is the total income before income tax deductions from all people living in your household. Gross income refers not only to the salaries and benefits received, but also to receipts from any personal business, investments, dividends, and other income

PROGRAM BENEFITS

For Celgene oral hematology products, Celgene provides assistance to reduce the co-pay of eligible patients to $25 per prescription with a maximum benefit of $10,000 per enrollment period
For Celgene IV products, the Program will cover the co-pay for each prescription of a Celgene product up to a maximum of $10,000 per enrollment period
In order to receive the Program benefits for a Celgene IV product, patients or their providers must submit an Explanation of Benefits (EOB) form
Patients are responsible for any costs that exceed the Program’s $10,000 maximum
The Program will not cover, and shall not be applied toward, the cost of any dosing procedure, any other healthcare provider service or supply charges or other treatment costs, or any costs associated with a hospital stay

PROGRAM TIMING

If eligible, patients will be enrolled from the date of enrollment through the end of the then current calendar year

ADDITIONAL TERMS AND CONDITIONS OF THE
CELGENE COMMERCIAL CO-PAY PROGRAM

Patients, pharmacists, and healthcare providers must not seek reimbursement from health insurance or any third party for any part of the benefit received by the patient through this Program. Patients must not seek reimbursement from any health savings, flexible spending, or other healthcare reimbursement accounts for the amount of assistance received from the Program
Acceptance of this offer confirms that this offer is consistent with your insurance and that you will report the value of the co-pay assistance you receive, as may be required by your insurance provider
Only valid in the United States and US territories; this offer is void where prohibited by law, taxed or restricted. Absent a change in Massachusetts law, effective July 1, 2019, Massachusetts residents will no longer be eligible to participate in this Program
The Program benefits are nontransferable
Acceptance of this Program is not conditioned on any past, present, or future purchase, including additional doses
The Program cannot be combined with any other coupon, rebate, voucher, free trial, or similar offer
The Program is not insurance
Celgene reserves the right to rescind, revoke, or amend this Program at any time without notice

NEXT: Your resources

REVLIMID^® (lenalidomide) is a prescription medicine, used to treat people with mantle cell lymphoma (MCL) when the disease comes back or becomes worse after treatment with two prior medicines, one of which included bortezomib. MCL is a cancer of a type of white blood cell called lymphocytes that are in the lymph nodes

REVLIMID should not be used to treat people who have chronic lymphocytic leukemia (CLL) unless they are participants in a controlled clinical trial

It is not known if REVLIMID is safe and effective in children

Please see full Prescribing Information, including Boxed WARNINGS and Medication Guide

Indication

REVLIMID should not be used to treat people who have chronic lymphocytic leukemia (CLL) unless they are participants in a controlled clinical trial

It is not known if REVLIMID is safe and effective in children

Important Safety Information

What is the most important information I should know about REVLIMID?

Before you begin taking REVLIMID, you must read and agree to all of the instructions in the REVLIMID REMS^® program. Before prescribing REVLIMID, your healthcare provider will explain the REVLIMID REMS program to you and have you sign the Patient-Physician Agreement Form

REVLIMID may cause serious side effects; including:

Possible birth defects (deformed babies) or death of an unborn baby. Females who are pregnant or who plan to become pregnant must not take REVLIMID
- REVLIMID is similar to the medicine thalidomide which is known to cause severe life-threatening birth defects. REVLIMID has not been tested in pregnant females. REVLIMID has harmed unborn animals in animal testing
- Females must not get pregnant:
  - For at least 4 weeks before starting REVLIMID
  - While taking REVLIMID
  - During any breaks (interruptions) in your treatment with REVLIMID
  - For at least 4 weeks after stopping REVLIMID
- Females who can become pregnant:
  - Must have pregnancy tests weekly for 4 weeks, then every 4 weeks if your menstrual cycle is regular, or every 2 weeks if your menstrual cycle is irregular. If you miss your period or have unusual bleeding, you will need to have a pregnancy test and receive counseling
  - Must agree to use 2 different forms of effective birth control at the same time, for at least 4 weeks before, while taking, during any breaks (interruptions) in your treatment, and for at least 4 weeks after stopping REVLIMID. Talk with your healthcare provider to find out about options for effective forms of birth control that you may use to prevent pregnancy
  - If you had unprotected sex or if you think your birth control has failed, stop taking REVLIMID immediately and call your healthcare provider right away
- If you become pregnant while taking REVLIMID, stop taking it right away and call your healthcare provider. If your healthcare provider is not available, you can call Celgene Customer Care Center at 1-888-423-5436. Healthcare providers and patients should report all cases of pregnancy to FDA MedWatch at 1-800-FDA-1088, and Celgene Corporation at 1-888-423-5436. There is a pregnancy exposure registry that monitors the outcomes of females who take REVLIMID during pregnancy, or if their male partner takes REVLIMID and they are exposed during pregnancy. You can enroll in this registry by calling Celgene Corporation at the phone number listed above
- REVLIMID can pass into human semen. Males, including those who have had a vasectomy, must always use a latex or synthetic condom during any sexual contact with a pregnant female or a female that can become pregnant while taking REVLIMID, during any breaks (interruptions) in your treatment with REVLIMID, and for up to 4 weeks after stopping REVLIMID
  - If a female becomes pregnant with your sperm, you should call your HCP right away. The baby may be exposed to REVLIMID and may be born with birth defects
  - Do not have unprotected sexual contact with a female who is or could become pregnant. Tell your healthcare provider if you do have unprotected sexual contact with a female who is or could become pregnant
  - Do not donate sperm while taking REVLIMID, during any breaks (interruptions) in your treatment, and for 4 weeks after stopping REVLIMID
Low white blood cells (neutropenia) and low platelets (thrombocytopenia). REVLIMID causes low white blood cells and low platelets in most people. You may need a blood transfusion or certain medicines if your blood counts drop too low. Your healthcare provider should check your blood counts often especially during the first several months of treatment with REVLIMID, and then at least monthly. Tell your healthcare provider if you develop any bleeding or bruising, during treatment with REVLIMID
Blood clots. Blood clots in the arteries, veins, and lungs happen more often in people who take REVLIMID. This risk is even higher for people with multiple myeloma who take the medicine dexamethasone with REVLIMID. Heart attacks and strokes also happen more often in people who take REVLIMID with dexamethasone. To reduce this increased risk, most people who take REVLIMID will also take a blood thinner medicine

Before taking REVLIMID, tell your healthcare provider:
- If you have had a blood clot in the past
- If you have high blood pressure, smoke, or if you have been told you have a high level of fat in your blood (hyperlipidemia)
- About all the medicines you take. Certain other medicines can also increase your risk for blood clots
Call your healthcare provider or get medical help right away if you get any of the following during treatment with REVLIMID:
- Signs or symptoms of a blood clot in the lung, arm, or leg may include: shortness of breath, chest pain, or arm or leg swelling
- Signs or symptoms of a heart attack may include: chest pain that may spread to the arms, neck, jaw, back, or stomach area (abdomen), feeling sweaty, shortness of breath, feeling sick or vomiting
- Signs or symptoms of stroke may include: sudden numbness or weakness, especially on one side of the body, severe headache or confusion, or problems with vision, speech, or balance

Who should not take REVLIMID?

Do not take REVLIMID if you are pregnant, plan to become pregnant, or become pregnant during treatment with REVLIMID. See "What is the most important information I should know about REVLIMID?"
Do not take REVLIMID if you are allergic to lenalidomide or any of the ingredients in REVLIMID. See the Medication Guide for a complete list of ingredients in REVLIMID

What should I tell my healthcare provider before taking REVLIMID?

Before you take REVLIMID, tell your healthcare provider about all of your medical conditions, including if you:

have liver problems
have kidney problems or receive kidney dialysis treatment
have thyroid problems
have had a serious skin rash with thalidomide treatment. You should not take REVLIMID
are lactose intolerant. REVLIMID contains lactose
are breastfeeding. REVLIMID must not be used by females who are breastfeeding. It is not known if REVLIMID passes into your breast milk and can harm your baby

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. REVLIMID and other medicines may affect each other, causing serious side effects. Talk with your healthcare provider before taking any new medicines. Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist

How should I take REVLIMID?

Take REVLIMID exactly as prescribed and follow all the instructions of the REVLIMID REMS program

Swallow REVLIMID capsules whole with water 1 time a day. Do not open, break, or chew your capsules
REVLIMID may be taken with or without food
Take REVLIMID at about the same time each day
Do not open the REVLIMID capsules or handle them any more than needed. If you touch a broken REVLIMID capsule or the medicine in the capsule, wash the area of your body right away with soap and water
If you miss a dose of REVLIMID and it has been less than 12 hours since your regular time, take it as soon as you remember. If it has been more than 12 hours, just skip your missed dose. Do not take 2 doses at the same time
If you take too much REVLIMID, call your healthcare provider right away
Do not share REVLIMID with other people. It may cause birth defects and other serious problems

What should I avoid while taking REVLIMID?

See “What is the most important information I should know about REVLIMID?”
Females: Do not get pregnant and do not breastfeed while taking REVLIMID
Males: Do not donate sperm
Do not donate blood while you take REVLIMID, during any breaks (interruptions) in your treatment, and for 4 weeks after stopping REVLIMID. If someone who is pregnant gets your donated blood, her baby may be exposed to REVLIMID and may be born with birth defects

What are the possible side effects of REVLIMID?

REVLIMID can cause serious side effects, including:

See "What is the most important information I should know about REVLIMID?"
Increased risk of death in people who have chronic lymphocytic leukemia (CLL). People with CLL who take REVLIMID have an increased risk of death compared with people who take the medicine chlorambucil. REVLIMID may cause you to have serious heart problems that can lead to death, including atrial fibrillation, heart attack, or heart failure. You should not take REVLIMID if you have CLL unless you are participating in a controlled clinical trial
Risk of new cancers (malignancies). An increase in new (second) cancers has happened in patients who received REVLIMID and melphalan, or a blood stem cell transplant, including certain blood cancers, such as acute myelogenous leukemia (AML), and myelodysplastic syndrome (MDS) and certain other types of cancers of the skin and other organs. Talk with your healthcare provider about your risk of developing new cancers if you take REVLIMID. Your healthcare provider will check you for new cancers during your treatment with REVLIMID
Severe liver problems, including liver failure and death. Your healthcare provider should do blood tests to check your liver function during your treatment with REVLIMID. Tell your healthcare provider right away if you develop any of the following symptoms of liver problems:
- yellowing of your skin or the white part of your
  eyes (jaundice)
- dark or brown (tea-colored) urine
- pain on the upper right side of your stomach
  area (abdomen)
- bleeding or bruising more easily than normal
- feeling very tired
Severe skin reactions including severe allergic reactions can happen with REVLIMID and may cause death. Call your healthcare provider right away if you develop any of these signs or symptoms of a severe allergic reaction or severe skin reaction during treatment with REVLIMID:
- swelling of your face, eyes, lips, tongue, throat
- trouble swallowing
- trouble breathing
- skin rash, hives, or peeling of your skin
- blisters
- rash with fever and or swollen glands
Tumor lysis syndrome (TLS). TLS is caused by the fast breakdown of cancer cells. TLS can cause kidney failure and the need for dialysis treatment, abnormal heart rhythm, seizure and sometimes death. Your healthcare provider may do blood tests to check you for TLS
Worsening of your tumor (tumor flare reaction). Tell your healthcare provider if you get any of these symptoms of tumor flare reaction while taking REVLIMID: tender swollen lymph nodes, low grade fever, pain, or rash
Thyroid problems. Your healthcare provider may check your thyroid function before you start taking REVLIMID and during treatment with REVLIMID
Risk of Early Death in MCL. In people who have Mantle Cell Lymphoma (MCL), there may be a risk of dying sooner (early death) when taking REVLIMID. Talk with your healthcare provider about any concerns and possible risk factors

The most common side effects of REVLIMID include:

diarrhea
rash
nausea

constipation
tiredness
fever

itching
swelling of the limbs and skin
cough

These are not all the possible side effects of REVLIMID. Your healthcare provider may tell you to decrease your dose, temporarily stop or permanently stop taking REVLIMID if you develop certain serious side effects during treatment with REVLIMID. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088

Please see full Prescribing Information, including Boxed WARNINGS and Medication Guide