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This program provides brand name medications at no or low cost.
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| Pharmaceutical Company |
Abbott |
| Program Name |
Abbott Patient Assistance Foundation (HUMIRA) |
| Program Address |
PO Box 789
San Bruno, CA 94066 |
| Phone Number |
800-222-6885
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| Fax Number |
866-250-2803 |
| Medications on Program |
Humira Injection (adalimumab)
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| Application Forms |
Abbott Patient Assistance Foundation (HUMIRA)
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On-line Application
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No on-line application available at this time |
| Web Site |
Click to go to program's web site |
| Eligibility Guidelines and Notes |
The patient must not have any private nor public insurance and meet income guidelines that are not disclosed. Medical diagnosis necessary for this program is not specified. US residency requirements are
not specified. Patients with prescription drug coverage, including enrollment in a Medicare Part D Prescription Drug Plan, who have difficulty accessing their Abbott medications may be eligible for assistance by obtaining a Pharmaceutical Assistance Program exception based on health-related expenditures and household income.
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| Application Process |
The patient or doctor should call for an application. The application can be either faxed or mailed out upon request. The completed application can be faxed or mailed back.
Both the patient and doctor are notified of acceptance into the program. The decision is usually made within 24-48 hours. The medication is shipped within 3-5 business days.
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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 |
Up to a 90-day supply is sent to the doctor's office or the patient's home. The patient or doctor must contact the company for refills. Once a year a new application with financial documentation is needed.
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| Last Updated |
August 13, 2009 |
