Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Updated May 27, 2015
 

AndroGel

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AbbVie Patient Assistance Foundation for Androgel and Creon

This program provides brand name medications at no or low cost.

Provided by: AbbVie

PO Box 270
Somerville, NJ 08876

TEL: 800-222-6885


FAX: 800-276-9901
Languages Spoken:

English, Spanish, Others By Translation Service

Program Website

 

Patient Assistance Applications

AbbVie Patient Assistance Foundation Application for Androgel

AbbVie Patient Assistance Foundation Application for Creon

AbbVie Patient Assistance Foundation Medicare D Attestation Form for Androgel

AbbVie Patient Assistance Foundation Medicare D Attestation Form for Creon

 

Medications

  • AndroGel Gel 1.62% (testosterone)
  • Androgel Pump Topical 1.62% (testosterone topical)
 

Eligibility Requirements   

Insurance Status Must have no prescription coverage
Those with Part D Eligible? Considered on exception basis
Income Not disclosed
Diagnosis/Medical Criteria Not specified
US Residency Required? Yes
   

Application

Obtaining Call or download
Receiving Faxed or mailed
Returning Fax or mail from Doctor's office
Doctor's Action Complete section, sign, attach prescription
Applicant's Action Complete section, sign, attach a copy of proof of income
Decision Communicated Patient notified in writing
Decision Timeframe 7-10 business days
   

Medication

Amount/Supply Up to 90 day supply
Sent To Doctor's office or patient's home
Delivery Time Not specified
Refill Process Patient or Doctor must contact company
Limit None
Re-application New application, new documentation yearly
   

Additional Information

Exceptions to guidelines considered.