Lonsurf Patient assistance program
Complete a free online enrollment application to find out if you’re eligible to pay only $49 per month for your Lonsurf medication.Get started today
- Secure: Your personal and medical information is safe with us
- Convenient: We manage the whole process and we’re here to assist you
- Ongoing refills: We request your medication refills on your behalf
NiceRx works with your healthcare provider to help you access affordable medications directly from U.S. pharmaceutical companies.
An introduction to NiceRx(01:52)
Next steps after qualifying(00:38)
Uploading documents and billing(00:50)
SSN & billing information(00:33)
Medication delivery time(00:41)
How it works
Get started by filling out the online enrollment application to find out if you are eligible.
NiceRx verifies your eligibility for medication assistance and notifies you if you are qualified.
You may be required to submit further information and documents required by the pharmaceutical company which can be securely uploaded online.
Your application is created and sent to your doctor for signature. At this stage, you will be billed $49 and will not be billed again until you receive your first medication delivery.
Your application is sent to the pharmaceutical company. You will be billed again once you receive your medication. We handle the entire ordering process including requesting ongoing refills.
Your monthly Lonsurf cost savings if eligible
With our assistance, you could access the Lonsurf patient assistance program and obtain your medication for free. We only charge a flat monthly fee of $49 per medication for our services.
Am I eligible for Lonsurf patient assistance?
We review each Lonsurf enrollment application individually to determine if you are eligible. Each assistance program has its own eligibility criteria and the factors considered by most programs are:
- I am a permanent, legal resident of the United States or Puerto Rico
- I am uninsured or my insurance doesn’t cover my medication
- I meet certain income eligibility requirements
How do I apply for the Lonsurf patient assistance program?
Our process makes it as easy as possible to apply for the Lonsurf patient assistance program. Begin by completing the enrollment application form on our website. Tell us about any medications that you are taking, including Lonsurf, your healthcare provider, your insurance plan, and your household income. This information is required by the pharmaceutical manufacturers who will supply the medication, so it is important to make sure this information is accurate and up to date.
We will review the information that you have provided to determine whether you are eligible for patient assistance. If we can pre-qualify you for assistance, NiceRx will handle the full enrollment process on your behalf. If you are approved by the pharmaceutical company, you will typically start receiving your medication in 6 – 8 weeks.
Is NiceRx a Lonsurf coupons provider?
NiceRx is not a Lonsurf coupon, Lonsurf discount card, or Lonsurf copay card provider. We do not offer Lonsurf manufacturer coupons, Lonsurf discounts, rebates, Lonsurf savings cards, trial offers, or free Lonsurf samples. We are a service provider that helps eligible individuals access their medication directly from the U.S. pharmaceutical company.
Can NiceRx help me if I have insurance?
NiceRx may be able to help you if:
- You have a high copay or coinsurance responsibility for Lonsurf
- Your insurance company will not pay for your Lonsurf prescription
- Your healthcare plan does not cover your medication
- You do not have insurance
Please apply online to find out if we can help you.
How much does Lonsurf cost without insurance?
Without insurance, Lonsurf costs will vary depending on where you buy the medication as prices will vary by retailer. As a guide, Lonsurf oral tablets (6.14 mg-15 mg) will cost around $3,750 for 20 tablets.
How much does Lonsurf cost with insurance?
The copay for Lonsurf will depend on the terms of your healthcare plan. Your healthcare provider or pharmacist will be able to calculate your copay with your current insurance. Contact them to find out more.
What is Lonsurf?
Lonsurf is an FDA (Food and Drug Administration) approved medication manufactured by Taiho Oncology, Inc.
It is a combination of trifluridine, a nucleoside metabolic inhibitor, and tipiracil, a thymidine phosphorylase inhibitor. It is used for the treatment of adult patients with:
- Advanced metastatic colorectal cancer (MCRC) who have been previously treated with fluoropyrimidine, oxaliplatin, and irinotecan-based chemotherapy, an anti-VEGF biological therapy, and if RAS wild-type, an anti-EGFR therapy
- Metastatic gastric cancer (cancer that has spread to other parts of the body) or gastroesophageal junction adenocarcinoma already treated with at least two prior lines of chemotherapy that included a fluoropyrimidine, platinum, either a taxane or irinotecan and if appropriate, HER2/neu-targeted therapy
What doses of Lonsurf are available?
Lonsurf is available in tablet form, in the following doses: 15 mg trifluridine/6.14 mg tipiracil, 20 mg trifluridine/8.19 mg tipiracil
The recommended dosage is 35 mg/m2 /dose orally twice daily with food on Days 1 through 5 and Days 8 through 12 of each 28-day cycle. Until disease progression or unacceptable toxicity.
The tablets should be taken within 1 hour of completion of morning and evening meals. The dose should be rounded to the nearest 5 mg increment. Do not start a treatment cycle of this drug until absolute neutrophil count (ANC) is 1,500/mm3 or greater or febrile neutropenia has been resolved, platelets are 75,000/mm3 or greater, and Grade 3 or 4 non-hematological adverse reactions are resolved to Grade 0 or 1.
You will need blood tests before and while you are receiving treatment. The timing of these tests is very important.
Always speak with your healthcare provider about any changes to your dose so they can monitor and evaluate your condition.
Lonsurf active ingredients
The active ingredients of Lonsurf are trifluridine and tipiracil is anti-cancer (“antineoplastic” or “cytotoxic”) chemotherapy drugs.
Lonsurf contains the thymidine-based nucleoside analog, trifluridine, and the thymidine phosphorylase inhibitor, tipiracil. Tipiracil inhibits trifluridine metabolism by the enzyme thymidine phosphorylase. Once in the cancer cells, trifluridine is bound into DNA, interferes with DNA production, and inhibits cell proliferation (growth).
Lonsurf side effects
The most common side effects of Lonsurf in clinical trials include:
- Asthenia (feeling abnormally weak)
- Decreased appetite, diarrhea, vomiting
- Abdominal pain, loss of appetite
In rare instances, Lonsurf can cause more serious adverse reactions. These can include:
- Severe myelosuppression – obtain complete blood counts before and on Day 15 of each cycle
- Low levels of platelets in your blood – easy bruising, unusual bleeding, purple or red spots under your skin
- Anemia (low red blood cells) – pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet
- Neutropenia low white blood cell counts – fever, mouth sores, skin sores, sore throat, cough, problems breathing
Your doctor will assess the benefits of using Lonsurf against your risk of side effects.
Patients are encouraged to report negative side effects or adverse reactions of Lonsurf to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Lonsurf drug interactions
Lonsurf can interact with other medications. These include:
- Live vaccines – BCG, measles, mumps, rubella, smallpox, varicella-zoster
- Fingolimod, ozanimod, siponimod
- Leflunomide, teriflunomide
This list is not exhaustive and other drugs may interact with Lonsurf.
You should not use Lonsurf if you:
- Are allergic to the active ingredient trifluridine and tipiracil
- Are allergic to any of the other ingredients in Lonsurf
- Are pregnant or are planning to become pregnant due to Embryo-fetal toxicity. Females of reproductive potential are advised to use effective contraception. Tipiracil hydrochloride and trifluridine can harm an unborn baby. Do not use Lonsurf if you are a pregnant woman
- Are breastfeeding or are planning to breastfeed – you should not breastfeed while using this medicine, and for at least 24 hours after your last dose
Talk to your doctor before using Lonsurf if you:
- Are taking any of the medications that could interact with Lonsurf
- Have kidney disease
- Have liver disease
Lonsurf is the trademark brand name for trifluridine and tipiracil manufactured by Taiho Oncology, Inc. A generic version of trifluridine and tipiracil is not available. Generic drugs are generally cheaper than brand-name drugs, but you can still find Lonsurf savings through NiceRx.
*Qualifying persons may obtain medications directly from patient assistance programs without any out-of-pocket cost (or for less than $49 per medication). However, our monthly flat rate of just $49 per medication spares you the hassle of tracking down the different programs and filling out all the required paperwork for each program.
Enrollees enjoy a full-service solution, as NiceRx assists them and their physicians with the entire process. We prepare all required documents for the physician to sign, help enrollees manage all prescription refills, monitor eligibility criteria, and maintain enrollment.
**If you do not receive medications because you were determined to be ineligible for the prescription assistance by the applicable pharmaceutical companies and you have a letter of denial, we will refund any fees you paid toward medications for which you did not qualify to receive prescription assistance (“Refund”).
To receive a refund, you must send the letter of denial to us by fax to 888-517-7444, or by e-mail to [email protected] within 30 days of your receipt of such letter. The Refund is your sole and exclusive remedy for any fees you may wish to dispute.