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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