Insurance Reimbursement

If you are undergoing enzyme treatment, you will most likely need to understand how your insurance plan works. Some insurance plans may cover Cerezyme® (imiglucerase for injection) as an outpatient service, a physician service, or under a prescription plan. Additionally, it may be necessary for the doctor to get written confirmation of coverage before treatment begins.

Genzyme is committed to ensuring that people who are prescribed Cerezyme therapy will have access to it. To help you and your doctor through the reimbursement process, you can call Genzyme Treatment Support at 800-745-4447. A case management specialist will assist you in reviewing your current insurance coverage and, if necessary, try to obtain and maintain the insurance coverage you may need for long-term enzyme replacement therapy. This service is voluntary and the information required to perform this service will be maintained as confidential by Genzyme.

A case management specialist may assist in many ways:

Educating third party payers about Type 1 Gaucher disease and the benefits of Cerezyme therapy

Educating individuals about available health insurance and helping them review their policies

Coordinating the exchange of information between physicians, third party payers, and patients to obtain coverage approval for enzyme replacement therapy

Serving as a resource to patients and their families who are seeking alternative funding options

Here is a list of events when your health insurance benefits may change, and you may want to call on Genzyme Treatment Support:

Job changes

Current insurance policy changes

Marriage or divorce

Graduation from high school/college

Change in treatment venue

Move

Vacation

Cerezyme Charitable Access Program

The Cerezyme Charitable Access Program has been established in the United States through the Genzyme Charitable Foundation, Inc. The program provides treatment for people with Gaucher disease who have medical need, are uninsured, and cannot afford to purchase Cerezyme therapy.

To be considered for the program, you will be asked to provide:

A physician referral for Cerezyme therapy based on medical need

A completed program application

Current financial information

Tax returns

W-2 forms

Bank statements

All of these materials must be submitted before an application can be reviewed. Everything you provide to the Cerezyme Charitable Access Committee will be maintained as confidential. The committee meets monthly, and your materials will be reviewed as soon as possible.

Please note that the Cerezyme Charitable Access Program is considered a temporary funding program. Patients and their families are expected to continue exploring alternative funding options with the assistance of the case management specialist. These may include:

Private insurance

Governmental programs

Charitable sources

If you have questions about Genzyme Treatment Support, the role of the case management specialist, or the Cerezyme Charitable Access Program, please call 800-745-4447. To request a comprehensive brochure about Genzyme Treatment Support, please click here.

Important Safety Information

Side effects related to Cerezyme® (imiglucerase for injection) administration have been reported in less than 15% of patients. Each of the following events occurred in less than 2% of the total patient population. Reported side effects include nausea, vomiting, abdominal pain, diarrhea, rash, fatigue, headache, fever, dizziness, chills, backache, and rapid heart rate. Because Cerezyme® therapy is administered by intravenous infusion, reactions at the site of injection may occur: discomfort, itching, burning, swelling or uninfected abscess. Symptoms suggestive of allergic reaction include anaphylactoid reaction (a serious allergic reaction), itching, flushing, hives, an accumulation of fluid under the skin, chest discomfort, shortness of breath, coughing, cyanosis (a bluish discoloration of the skin due to diminished oxygen), and low blood pressure. Approximately 15% of patients have developed immune responses (antibodies); periodic monitoring by your physician is suggested. Patients should notify their physician immediately if they experience any side effects with treatment. Cerezyme is available by prescription only. For more information, consult your physician. To learn more, please see the full product information (PDF) or contact Genzyme at 1-800-745-4447.