|
This program provides brand name medications at no or low cost.
|
| Pharmaceutical Company |
Roche Diagnotic Corporation |
| Program Name |
Roche Diagnostic Corporation Patient Assistance Program |
| Program Address |
PO Box 18740
Louisville, KY 40261 |
| Phone Number |
866-441-4090
|
| Fax Number |
866-441-4091 |
| Medications on Program |
Accu-Chek (glucose test strips)
|
| Application Forms |
Roche Diagnostic Patient Assistance Program
|
On-line Application
|
No on-line application available at this time |
| Web Site |
Click to go to program's web site |
| Eligibility Guidelines and Notes |
The patient can have no public or private prescription insurance and meet income guidelines that are not disclosed. Medical diagnosis necessary for this program is not specified. The patient must also be a US citizen. A limit of 300 test strips will be sent out per 90-day supply.
|
| Application Process |
The patient or doctor should call for an application. The application can be faxed, mailed out or downloaded from website. The completed application must be mailed back.
The patient is notified of eligibility for the program.
|
| Application Requirements |
The doctor must fill out a section, sign the application and attach a prescription. The patient must fill out a section, sign the application and attach proof of income.
|
| Program Details |
Up to a 90-day supply is sent to the doctor's office or the patient's home. The patient must contact the company to arrange for refills. Every year a new application is needed.
|
| Last Updated |
November 17, 2009 |
