Phone: (800) 222-6885 for uninsured or underinsured assistance
Fax: (866) 250-2803
Application: http://www.needymeds.org/papforms/abbhum0323.pdf
Etanercept (Enbrel)
The ENBREL Support™ Copay Program lowers costs for eligible patients. The program may offer 6 months at no copay cost to you and $10 or less copay per month thereafter. This program is not open to uninsured patients or for patients whose prescriptions are reimbursed under Medicare, Medicaid, or similar federal or state programs or private insurance in the Commonwealth of Massachusetts.
Program provides up to $750 of assistance per patient per month for months 1-12. Patient is responsible for costs above these amounts. Financial support is available to you each time you fill your ENBREL prescription and you may renew your participation in the ENBREL Support copay program every 12 months.
Phone: (888) 4-ENBREL or (888) 436-2735 for reimbursement assistance
Program website: http://enbrelsupport.com/
If you have no insurance coverage or are underinsured, you may be referred to the ENcourage Foundation Patient Assistance Program, a nonprofit foundation support by Amgen and Wyeth. If you are insured but still need more financial assistance, you may be referred to an independent foundation.
ENcourage Foundation, P.O. Box 4133, Gaithersburg, MD 20879-7808
Phone: (800) 282-7752 for uninsured or underinsured assistance
Fax: (888) 508-8083
Application: http://www.needymeds.org/papforms/encour0284.pdf
Infliximab (Remicade), Tramadol (Ultram, Ultram-ER)
Tramadol with acetaminophen (Ultracet)
Janssen Ortho Patient Assistance Foundation Program
P.O. Box 221857, Charlotte, NC 28222-1857
Phone: (800) 652-6227
Fax: (888) 526-5168
Application: http://www.needymeds.org/papforms/johnso0996.pdf
Infliximab (Remicade)
Phone: (888) ACCESS-1 or (888) 222-3771 for reimbursement assistance
Or call (866) 489-5957 and select option 1
Program website: http://www.remicade.com (select “getting support”)
Program website: http://www.remicade.com/remicade/global/index.html
Rituximab (Rituxan)
Rituxan Access Solutions
Phone: (866) 681-3261 for reimbursement assistance.
Phone: (866) 681-3320 for uninsured or underinsured assistance
Program website: http://www.RituxanAccessSolutions.com/
Patient Enrollment Form: http://www.needymeds.org/papforms/genave0079.pdf
Patient Authorization Form: http://www.needymeds.org/papforms/genave0079.pdf
Program website: http://www.genentechaccesssolutions.com/rituxanRA/patient/index.jsp
Fax: (866) 681-3288
Anakinra (Kineret)
The Kineret Reimbursement Support Program helps to verify insurance coverage and provides temporary product assistance to financially needy patients who meet predetermined eligibility criteria. To receive free product, the prescriber and patient must complete a Kineret Patient Assistance Program Application.
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