Supporting Patients

Transfers of Value

In accordance with our Code of Practice for the Pharmaceutical Industry, Roche is committed to transparency in all interactions with patient organisations, healthcare organisations and healthcare professionals.

Visit www.transferofvalue.ie for more information regarding disclosure of transfers of value and our methodological note.

Transfers of value to patient organisation for the following years are linked here: 2025, 2024, and 2023.

Requests for Support

Roche is committed to advancing research and creating value for Irish patients. In line with this commitment, Roche supports medical and educational activities organised by healthcare organisations/entities and by patient organisations to enhance and maintain patient care and advance research. This includes financial and in-kind support for research, medical education, information and patient initiatives.

To request support for your organisation, please fully complete the form below.

Full Name *

Email Address *

Telephone No. *

Roche contact person *

Organisation Name *

Organisation Type *

Healthcare Organisation/Entity

Patient Organisation

Organisation Full Address *

Website

Company/Charity Registration No.

Position of Person Submitting the Request *

This person has the authority to request support on behalf of the Organisation *

Yes

No

Title of Support Request *

Start Date of Support *

End Date of Support *

Venue (if not applicable, please enter N/A) *

Outline how this activity will directly benefit patient care at this Organisation *

Please provide a detailed description and rationale for this initiative. Proposals will be strengthened by providing relevant details as applicable (e.g. objective or predicted outcomes, scope and benefit to audience, impact on patients, how Roche’s contribution with be used and/or recognised). Note: if you are requesting support for a meeting, an agenda must be included in this section (a draft agenda may be submitted if the programme is not yet finalised). Please also include if there will be any benefit to Roche at the meeting (e.g. stand, symposium, etc.)

Description: *

Total Amount Requested from Roche (€), please include VAT if applicable. *

Full Cost Breakdown of the Amount Requested (€) If a full breakdown is not provided, assessment of your request will be delayed. *

Has funding been sought from other sources? If yes, please specify *

Name(s) of Signatory for Support Agreement (if request approved) *

Email Address of Signatory for Support Agreement (if request approved) *

Name(s) of Financial Controller (or similar) for signing Support Agreement (if request approved) *

Email Address of Financial Controller (or similar) for Support Agreement (if request approved) *

By submitting this request, I confirm that I have read the Roche Privacy Policy.

By submitting this request, I agree that if my request is approved, I will provide evidence that the support was used for that stated purpose.

Please note if approved, we will require bank details of the Organisation in order to process the payment

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