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This program provides brand name medications at no or low cost.
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| Pharmaceutical Company |
Acorda Therapeutics |
| Program Name |
Zanaflex Uninsured Individual Program |
| Program Address |
P.O. Box 1968
Danbury, CT 06810
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| Phone Number |
800-999-6673
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| Fax Number |
203-798-2964 |
| Medications on Program |
Zanaflex Capsules 2mg, 4mg, 6mg ()
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| Application Forms |
Not Applicable |
On-line Application
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No on-line application available at this time |
| Web Site |
No link available. |
| Eligibility Guidelines and Notes |
The patient must be uninsured and meet income guidelines that are not disclosed. The patient must be diagnosed with Spasticity. The patient must also be a US resident. Patient must call this program first to be prescreened. Then the program refers the call to NORD and NORD sends out the application and makes the decision. The prescription must be for the brand name Zanaflex Capsules only.
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| Application Process |
The patient must call for a prescreening. The application is sent to the patient within 2 weeks. The completed application must be mailed back.
The estimated timeline is 3-5 business days.
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| Application Requirements |
The doctor must fill out a section, sign the application and attach a prescription. The patient must fill out a section, sign the application and attach proof of income.
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| Program Details |
Up to a 90-day supply is sent to the doctor's office or the patient's home. The company automatically sends out refills. The company will contact the patient regarding reapplication.
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| Last Updated |
June 03, 2010 |
