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This program provides brand name medications at no or low cost.
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| Pharmaceutical Company |
Alaven Pharmaceutical |
| Program Name |
Alaven Patient Assistance Program |
| Program Address |
PO Box 5836
Somerset, NJ 08875 |
| Phone Number |
800-593-7923
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| Fax Number |
732-507-7624 |
| Medications on Program |
Anadrol-50 Tablets 50mg (oxymetholone)
Rowasa Enema (mesalamine)
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| Application Forms |
Alaven Patient Assistance Program
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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 have no prescription coverage for any medications and have an income at or below 200% of the Federal Poverty Level. Medical diagnosis necessary for this program is not specified. The patient must also be a US citizen being treated by a US doctor. Annual household income limits do apply but each case is reviewed on an individual basis. The medication is only sent to the doctors DEA registered address.
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| Application Process |
The doctor or patient can call to request an application. The application will be faxed out. The completed application can be faxed or mailed back.
The doctor is notified of acceptance or denial. The medication is shipped within 10 business days.
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| Application Requirements |
The doctor must fill out and sign the enrollment form. The patient must fill out a section, sign the application and attach proof of income.
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| Program Details |
The medication is sent to the doctor's office. A copy of the same application with new dates is needed for refills. Every 6 months financial documentation is needed.
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| Last Updated |
August 17, 2009 |
