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

AbbVie Patient Assistance Program for Viekira and Technivie

This program provides brand name medications at no or low cost

Provided by: AbbVie

PO Box 4280
Gaithersburg, MD 20885

TEL: 855-765-0504


ALT PHONE: 855-687-7503
FAX: 855-886-2481
Languages Spoken:

English

Program Website

 

Patient Assistance Applications

AbbVie Patient Assistance Foundation for Viekira XR Application

AbbVie Patient Assistance Foundation for Technivie: Contact program

 

Brand Name Medications Covered

 
  • Technivie
  • Viekira XR
 

Generic Name

 
  • dasabuvir/ombitasvir/paritaprevir/ritonavir
  • ribavirin
  • ombitasvir-paritaprevir-ritonavir
 

Eligibility Requirements   

Insurance Status Must be uninsured
Those with Part D Eligible? No
Income Not disclosed
Diagnosis/Medical Criteria FDA-approved diagnosis
US Residency Required? Must be treated by US Doctor
   

Application

Obtaining Call or download
Receiving Faxed or downloaded from website
Returning Fax
Doctor's Action Complete section, sign, attach required documents
Applicant's Action Complete section, sign, attach required documents
Decision Communicated Not specified
Decision Timeframe Not specified
   

Medication

Amount/Supply 28 day supply
Sent To Doctor's office or patient's home
Delivery Time Not specified
Refill Process Not specified
Limit Not specified
Re-application Not specified
   

Additional Information

Contact the program for more details (1-855-765-0504).

This program also provides copay assistance.

ProCeed assists with resources and tools for TECHNIVIE. ProCeed is a personalized program.


Updated August 11, 2017