Actemra (tocilizumab)
Patient Assistance Program Guide — Genentech Patient Foundation
Do You Qualify?
Income
Up to $75,300 for a single person
Insurance
Uninsured, underinsured (drug not covered), or meeting specific criteria for government-funded coverage (e.g., Medicare Part B/D) if financial need is demonstrated.
Residency
U.S. resident with a valid U.S. address
Income Limits (500% FPL)
Calculated based on 500% of 2025 FPL; Genentech also considers total household income versus cost of living in some cases.
Based on 2025 HHS Federal Poverty Level guidelines.
# Getting Actemra (Tocilizumab) Through the Genentech Patient Foundation: A Complete Guide
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Who Qualifies for the Genentech Patient Foundation?
If you need Actemra (tocilizumab) but cannot afford it, you may be able to get it at no cost through the Genentech Patient Foundation. This program is designed specifically for patients who are uninsured, underinsured, or who have government-funded insurance and can demonstrate financial need. For a single-person household, the maximum annual income to qualify is $75,300. Your insurance status matters, too — you generally need to be uninsured, have coverage that does not pay for Actemra, or meet specific criteria if you are on Medicare. The program covers multiple conditions and does not require perfect financial circumstances, just documented need within the program's guidelines.
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About Actemra (Tocilizumab)
Actemra is an FDA-approved prescription biologic medication manufactured by Genentech. It belongs to a class of drugs called interleukin-6 (IL-6) receptor antagonists. It is approved to treat several serious conditions, including Rheumatoid Arthritis, Giant Cell Arteritis, Polyarticular Juvenile Idiopathic Arthritis (pJIA), Systemic Juvenile Idiopathic Arthritis (sJIA), and Cytokine Release Syndrome. Because Actemra is a biologic — meaning it is derived from living cells and requires specialized manufacturing — it carries a high list price that can reach tens of thousands of dollars per year without insurance or assistance. This cost places it out of reach for many patients, making programs like the Genentech Patient Foundation an important resource.
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Income Eligibility: Full Breakdown
The Genentech Patient Foundation uses income thresholds set at approximately 500% of the 2025 Federal Poverty Level (FPL). Here is how that breaks down by household size:
| Household Size | Maximum Annual Income |
|---|---|
| 1 person | $75,300 |
| 2 persons | $102,200 |
| 3 persons | $129,100 |
| 4 persons | $156,000 |
Your household size includes anyone who lives with you and whose income contributes to your household finances. If your income is above these limits, you may not automatically be disqualified. Genentech has been known to consider your cost of living relative to your total income in certain situations, so it can still be worth applying if you are close to the limit.
Income is typically verified using your most recent federal tax return, a W-2, or three months of recent pay stubs. If your income has changed significantly from last year — for example, due to job loss — you can typically use current pay stubs rather than last year's tax return to better reflect your situation. Make sure whatever documents you submit are legible, complete, and show your full name.
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Insurance Requirements Explained
Your current insurance status plays a key role in your eligibility. Here is how different situations are handled:
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Step-by-Step: How to Apply
Follow these steps to apply for Actemra through the Genentech Patient Foundation:
1. Gather your documents first. You will need proof of income (tax return, W-2, or three months of pay stubs), a valid prescription for Actemra from a U.S.-licensed prescriber, and a completed application form signed by both you and your doctor.
2. Get the application form. Visit the official program page at https://www.genentech-access.com/patient/genentech-patient-foundation.html to download or complete the form online.
3. Have your doctor complete their section. Your prescriber must sign the application. Many offices are familiar with this process — ask your doctor's office staff to help coordinate.
4. Choose your submission method. You can apply online at the link above, call the program at (888) 941-2431 for assistance, or fax your completed paperwork to (877) 231-5077.
5. Submit your income documentation. Attach your proof of income to the application before submitting.
6. Wait for confirmation. Processing typically takes about 2 business days after your complete application is received.
7. Follow up if needed. If you have not heard back within a few business days, call (888) 941-2431 to check your application status.
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What to Expect: Timeline and Delivery
Once your completed application is submitted, you can typically expect a decision within 2 business days. Genentech will notify you and your prescriber of the outcome. If approved, Actemra can be delivered either directly to your home or to your prescriber's office, depending on your treatment setup and how you receive your infusions or injections. If you receive Actemra as an infusion at a clinic, the medication will usually be sent to the prescribing office or infusion center. Ask your care team whether you need to arrange anything at the delivery location. Approval through the program lasts for one year, after which you will need to reauthorize annually by submitting updated income documentation and a renewed application.
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Alternatives If You Don't Qualify
If you do not qualify for the Genentech Patient Foundation, you still have options:
1. Biosimilar alternatives: Ask your doctor whether Tyenne (tocilizumab-aazg) or Tofidence (tocilizumab-bavi) — both FDA-approved biosimilars of Actemra — might be appropriate for your treatment. These may carry lower list prices or different assistance programs.
2. Savings card for insured patients: If you have commercial insurance, Genentech offers a co-pay savings card for Actemra. Visit https://www.actemra-copay.com/ to see if you are eligible and to enroll. This will not make the drug free, but it can significantly reduce your out-of-pocket costs.
3. State Pharmaceutical Assistance Programs (SPAPs): Many states offer their own drug assistance programs, especially for seniors or people with disabilities. Search for your state's program through your state health department website.
4. NeedyMeds.org: This free, nonprofit database lists hundreds of patient assistance programs and drug discount options. Visit https://www.needymeds.org and search by drug name or condition to find additional resources that may fit your situation.
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*This guide is for informational purposes only and does not constitute medical or legal advice. Eligibility determinations are made solely by Genentech. Program terms may change — verify current requirements at [https://www.genentech-access.com/patient/brands/actemra.html](https://www.genentech-access.com/patient/brands/actemra.html) before applying.*
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Documents You'll Need
If You Don't Qualify for the Assistance Program
Biosimilar / Generic Alternatives
FDA-approved alternatives to Actemra: Tyenne (tocilizumab-aazg), Tofidence (tocilizumab-bavi). Ask your prescriber if one of these is clinically appropriate for your condition.
Manufacturer Savings Card (for insured patients)
Genentech offers a savings card that may reduce your out-of-pocket cost if you have commercial insurance. Ask your prescriber or pharmacist for current savings card details.
Common Questions
Most complete applications are processed within 2 business days. Make sure your application includes all required documents — proof of income, a valid prescription, and signatures from both you and your prescriber — to avoid delays.
Yes, in many cases. Unlike some assistance programs, the Genentech Patient Foundation considers Medicare Part B and Part D patients who can demonstrate financial need. Call (888) 941-2431 to discuss your specific Medicare situation before applying.
Yes. Approval through the Genentech Patient Foundation lasts for one year. You will need to complete a reauthorization process annually, which typically involves submitting updated income documentation and a new application signed by you and your prescriber.
It may still be worth applying. Genentech considers cost of living relative to total income in some cases. If your situation involves high housing, medical, or other expenses, those factors could be taken into account. Contact the program at (888) 941-2431 for guidance.
No. The Actemra co-pay savings card at actemra-copay.com is typically only available to patients with commercial (private) insurance. Federal law generally prohibits the use of manufacturer savings cards for patients covered by Medicare, Medicaid, or other government-funded programs.
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