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logo_emdserono_without_taglineCompassionate Care from EMD Serono

Committed to helping eligible patients overcome financial barriers, the Compassionate Care Program may provide significant savings on EMD Serono medications for uninsured, income-eligible patients.

Eligibility is based on qualifying annual household gross income and first-time participation in the Compassionate Care program
More patients can now save on Gonal-f® (follitropin alfa for injection), Ovidrel® PreFilled Syringe (choriogonadotropin alfa injection), or Cetrotide® (cetrorelix acetate for injection).

Eligible patients can use the Compassionate Care Program for multiple cycles within each year*

*Patients must reapply each year.


 

Patient Enrollment Process

Complete the Compassionate Care enrollment forms, patient authorization forms, and include the required income verification documents. Patients can submit completed documents for review by Mail, Fax or Email.

Compassionate Care Forms

Compassionate Care Application NYFS

Compassionate Care Authorization

Mail 
Compassionate Care Program
6501 Weston Parkway,
Suite 370
Cary, ​NC 27513

Fax 

Please fax completed forms to (919) 415-2870

Email

Please email completed forms to enrollments@emdcompassionatecare.com
Eligible patients will receive an e-mail and subsequent mailing with their Compassionate Care redemption card. Present card along with prescription to a participating pharmacy and receive a discount off the cash price available at that pharmacy for the select medications

Compassionate Care Program Details

Benefit for patients with demonstrated financial need and a valid prescription for Gonal-f® (follitropin alfa for injection), Ovidrel® PreFilled Syringe (choriogonadotropin alfa injection), or Cetrotide® (cetrorelix acetate for injection)

Benefit is available at participating pharmacies only

  • Patients can save 50% or 75% off the available self-pay price at the participating pharmacy
  • The Compassionate Care Program is available for multiple cycles within each year.
  • Patients must reapply each year
  • Patients may not combine this card with any rebate, coupon, free trial, or similar offer
  • Patients must present a valid prescription for an eligible drug at a participating pharmacy
  • EMD Serono reserves the right to rescind, revoke, terminate, or amend the Compassionate Care Card at any time without notice
  • Covers the following products:

Gonal-f® RFF Redi-jectTM 300 IU (follitropin alfa injection)
Gonal-f® RFF Redi-jectTM 450 IU (follitropin alfa injection)
Gonal-f® RFF Redi-jectTM 900 IU (follitropin alfa injection)
Gonal-f® Multi-Dose 450 IU (follitropin alfa for injection)
Gonal-f® Multi-Dose 1050 IU (follitropin alfa for injection)
Gonal-f® RFF 75 IU (follitropin alfa for injection)
Cetrotide® .25 mg (cetrorelix acetate for injection)
Ovidrel® PreFilled Syringe 250 mcg (choriogonadotropin alfa injection)

Offer not valid for prescriptions that may be covered under private or public insurance or reimbursed under a federal or state healthcare program, including Medicare, Medicaid, or any other similar state healthcare program, including any state medical pharmaceutical assistance program. If you become insured by any private or government insurance you must notify the EMD Serono Compassionate Care program by calling 1-855-541-5926

Card is not transferable and expires one year after program enrollment, unless earlier terminated by EMD Serono

Compassionate Care is not an insurance program.