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This program provides brand name medications at no or low cost.
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| Pharmaceutical Company |
Accredo Therapeutics |
| Program Name |
Flolan Patient Assistance Program |
| Program Address |
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| Phone Number |
877-772-2001
724-778-3980
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| Fax Number |
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| Medications on Program |
Flolan IV (epoprostenol)
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| Application Forms |
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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 the requested medication and have an income at or below 500% of the Federal Poverty Level. The patient must also be taking the medication for an on-label diagnosis. The patient must also be a US resident. In order for new patients to access the program, their physician needs to initiate the process by sending a referral form to Acreedo. Patients may not be eligible for Medicare, Medicaid or have commercial insurance coverage for Flolan. Upon receipt of the referral an application will be sent to the patient. Patient needs to send documentation showing
that they have submitted applications for Medicare, Medicaid and SS Disability. Once the application is returned with the documentation the information will be verified and the program will then call the patient.
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| Application Process |
The patient's physician needs to initiate the process by sending a referral form to the program. The application is sent to the patient. Once the application is returned and the information verified, the program contact will call the patient. The completed application must be mailed back.
Once all the needed documentation is received the decision is usually made within a week.
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| 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 and any insurance information.
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| Program Details |
The medication is sent to the patient's home. The company contacts the patient to arrange for refills.
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| Last Updated |
May 12, 2010 |