How to Use the Card

The OCREVUS Co-pay Program for drug or infusion assistance may be used in a community practice, infusion center, or hospital. For drug assistance only, the program may also be used with specialty pharmacies.

Participating practices, institutions or specialty pharmacies must complete a onetime registration so they may process OCREVUS Co-pay Program payments. To register, call (844) MS-COPAY (844-672-6729).

Administer OCREVUS treatment and collect the patient's $5 co-pay for drug costs and/or $5 co-pay for infusion costs.
Fax a copy of the detailed Explanation of Benefits (EOB) and the completed claim form (eg, CMS-1500) to (855) MS-COPAY (855-672-6729)
The OCREVUS Co-pay Program verifies the patient's information and notifies your practice when the card is loaded with the proper amount.
Collect the rest of the patient's out-of-pocket costs for drug and/or infusion using the card.
Indication and Important Safety Information

Indication:

OCREVUS is indicated for the treatment of adult patients with relapsing or primary progressive forms of multiple sclerosis

Contraindications

OCREVUS is contraindicated in patients with active hepatitis B virus infection and/or a in patients with a history of life threatening infusion reaction to OCREVUS.

Warnings and Precautions

Infusion-related reactions:
Management recommendations for infusion reactions depend on the type and severity of the reaction. Permanently discontinue OCREVUS if a life-threatening or disabling infusion reaction occurs

Infections:
Delay OCREVUS administration in patients with an active infection until the infection is resolved. Vaccination with live-attenuated or live vaccines is not recommended during treatment with OCREVUS and after discontinuation, until B-cell repletion

Malignancies:
An increased risk of malignancy, including breast cancer, may exist with OCREVUS.

Most Common Adverse Reactions

RMS: The most common adverse reactions (≥10% and >REBIF): upper respiratory tract infections and infusion reactions
PPMS: The most common adverse reactions (≥10% and >placebo): upper respiratory tract infections, infusion reactions, skin infections, and lower respiratory track infections

For additional safety information, please see the full Prescribing Information and Medication Guide.

The OCREVUS Prepaid MasterCard® is issued by Comerica Bank pursuant to license by MasterCard International. No cash or ATM access. The card can be used only to purchase prescriptions at participating merchant locations where Debit MasterCard is accepted.