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

Otrexup Injector Disposal Program

Provided by: Antares Pharma, Inc.


TEL: 855-687-3987


FAX: 855-820-9608
Languages Spoken:

English

Program Website

 

Patient Assistance Applications

Otrexup Injector Disposal Program Request Form

 

Brand Name Medications Covered

 
  • Otrexup Container disposal container
 

Generic Name

 
  • container for otrexup sharps disposal container
 

Eligibility Requirements   

Insurance Status Not applicable
Those with Part D Eligible? Not applicable
Income Not applicable
Diagnosis/Medical Criteria Not specified
US Residency Required? Must reside in the US
   

Application

Obtaining Call, download or apply online
Receiving Complete online or by phone
Returning Fax or submit online
Doctor's Action Not applicable
Applicant's Action Call or enroll online
Decision Communicated Not specified
Decision Timeframe Not specified
   

Medication

Amount/Supply 1 Container
Sent To Patient's home
Delivery Time Not specified
Refill Process Not applicable
Limit Contact the program for details
Re-application Not specified
   

Additional Information


Updated July 28, 2017