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This program provides brand name medications at no or low cost.
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| 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
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| Fax Number |
877-744-5615 |
| Medications on Program |
Betaseron SC Injection 0.25mg (1cc) (interferon beta 1b)
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| Application Forms |
Betaseron Patient Assistance Program
Betaseron Patient Assistance Program Spanish
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On-line Application
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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.
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| 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.
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| 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.
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| 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.
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| Last Updated |
August 12, 2010 |