Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  

Aptevo Therapeutics Reimbursement and Patient Assistance Program

This program provides brand name medications at no or low cost

Provided by: Aptevo Therapeutics

PO Box 1041
Morristown, NJ 07962

TEL: Program Closed

ALT PHONE: 973-656-2626
FAX: 973-644-2361
Languages Spoken:



Patient Assistance Applications


Generic Name


Eligibility Requirements   

Insurance Status Must have no prescription coverage for the requested medication, be ineligible for federal or state programs
Those with Part D Eligible? No, must be ineligible
Income At or below 200% of FPL
Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
US Residency Required? Must be treated by US licensed healthcare provider


Obtaining Call or download
Receiving Faxed or mailed
Returning Fax or mail
Doctor's Action Complete section, sign, attach required documents
Applicant's Action Complete section, sign, attach required documents
Decision Communicated Health care provider notified via fax
Decision Timeframe Not specified


Amount/Supply Varies
Sent To Doctor's office
Delivery Time Within a week
Refill Process New application process required
Limit Not specified
Re-application Every 3 months new application required

Additional Information

Program Closed

Updated February 28, 2018