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Program 1 of 3 Scroll down to see them all.

This program provides brand name medications at no or low cost.
Pharmaceutical Company Bayer HealthCare Pharmaceuticals
Program Name Betaseron Patient Assistance Program
Program Address PO Box 221349
Charlotte, NC 28222-1349
Phone Number

877-836-5724
Fax Number 877-744-5615
Medications on Program Betaseron SC Injection 0.25mg (1cc) (interferon beta 1b)
Application Forms Betaseron Patient Assistance Program
Betaseron Patient Assistance Program Spanish
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 must meet insurance and financial guidelines that are not disclosed. meet income guidelines that are not disclosed. The patient must also have MS. The patient must also be a US resident. The support program is very detailed, including registered nurse counselors who are available 24 hours a day, seven days a week. They also provide training if needed.

Application Process

The doctor or patient can call to request an application. The application can be either faxed or mailed out upon request. The completed application can be faxed or mailed back.    
Application Requirements

The doctor needs to complete an application, sign it and attach a prescription. The patient needs to complete an application, sign it, and attach proof of income and other requested documentation.
Program Details

A 90-day supply is sent to the patient's home. The patient needs to communicate with the program's pharmacy to arrange for refills. Once a year a new application with documentation is needed.
Last Updated August 12, 2010


                                         

Program 2 of 3 Scroll down to see them all.

This program provides help in applying for assistance with the cost of this drug.
Pharmaceutical Company Diplomat Specialty Pharmacy
Program Name Diplomat's Co-Pay Assistance Navigator Program
Program Address Attn: Funding Department
2029 S. Elms Rd., Suite D,
Swartz Creek, MI 48473
Phone Number

877-977-9118 ext. 10184
Fax Number 866-418-2650
Medications on Program Betaseron SC Injection 0.25mg (1cc) (interferon beta 1b)
Application Forms Not Applicable
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

Individual eligibility and level of financial support is determined on a case by case basis.  Medical diagnosis necessary for this program is not specified. US residency requirements are not specified. The Co-Pay Navigator is a full service program to help patients seek funding assistance for the co-pay portion of their required medications. There is no charge for this service. Physicians/physicians' offices may submit an application online at the website indicated above, or fax information as directed below.

Application Process

The physician/physician's office should fax the prescription, diagnosis, patient demographics and any insurance information to 866-418-2650 Attn: Sandy/Funding.  A Patient Care Coordinator will contact the patient within 24-48 business hours.     
Application Requirements

Will be discussed with the patient and physician after the initial request to the program is received. 
Program Details

Not applicable.
Last Updated May 07, 2010


                                         

Program 3 of 3.

This company does not offer a patient assistance program.
Pharmaceutical Company Xubex Pharmaceuticals
Program Name Xubex Copay Assistance Program
Program Address PO Box 1244
Winter Park, Fl 32790-1244
Phone Number

866-699-8239
Fax Number 407-671-7960
Medications on Program Betaseron  Injection 0.3mg (interferon beta 1b)
Application Forms Xubex Copay 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

 This program does not have income limitations. Medical diagnosis is not necessary This program is not valid in Massachusetts, so MA residents are not eligible. This is a copay assistance program that covers all or part of the applicant's copay for the medication. The amount of the copay assistance varies by medication, check the program's website for the exact amount. The application does not require a HCP signature, however the applicant must send the prescription(s) in with the application.
Application Process

Anyone requesting assistance can call the above number to request an application be mailed or faxed out or download it from the website. The application can be either faxed or mailed out upon request. The completed application can be faxed or mailed back.    
Application Requirements

Not applicable.
Program Details

The medication is sent to the patient's home.  
Last Updated August 03, 2010