|
This program provides brand name medications at no or low cost.
|
| Pharmaceutical Company |
Reckitt Benckiser Pharmaceuticals, Inc. |
| Program Name |
Suboxone Here To Help Patient Assistance Program |
| Program Address |
PO Box 220281
Charlotte, NC 28222-0281 |
| Phone Number |
888-898-4818
|
| Fax Number |
888-407-9788 |
| Medications on Program |
Suboxone 2mg/0.5mg, 8mg/2mg (buprenorphine/naloxone)
|
| Application Forms |
Not Applicable |
On-line Application
|
No on-line application available at this time |
| Web Site |
No link available. |
| Eligibility Guidelines and Notes |
The patient can have no public or private prescription insurance and have an income at or below 250% of the Federal Poverty Level. The patient must have medical diagnosis of opioid dependence The patient must also be a US resident. The patient must be 16 years or older.
A doctor can only have three patients on the program at a time.
Enrolled patients are eligible for only one year of assistance.
Eligible patients receive a card in the mail. Patients must take the card and
a valid prescription to a participating community pharmacy. The card is valid
for up to 12 months.
|
| Application Process |
The patient or doctor should call for an application. The enrollment form is faxed out. The completed application can be faxed or mailed back.
The doctor is notified of acceptance or denial.
|
| Application Requirements |
The doctor must fill out a section and sign the application. The patient must fill out a section, sign the application and attach proof of income.
|
| Program Details |
Not applicable.
|
| Last Updated |
July 14, 2010 |
