800-221-4025

The patient cannot have prescription insurance, be ineligible for any federal or state programs and have an income at or below 250% of the Federal Poverty Level. Medical diagnosis necessary for this program is not specified. The patient must be a US citizen or legal resident. Patients with Medicare Part D are not eligible, however, if they have Part D and are still having problems affording the medication, they may apply. Sanofi Aventis may help patients in the donut hole. They will initially deny patient but submit an appeal and state that patient is in the DH and has no coverage.

With the patient's permission, anyone concerned can call for an application. The application can be either faxed or mailed out upon request. The completed application can be faxed or mailed back.  Both the patient and health care professional are notified of acceptance into the program.  The medication is shipped within 10 business days.

The doctor must fill out a section, sign the application and attach a brand name prescription. The patient must fill out a section and sign the application.

Up to a 90-day supply is sent to the doctor's office. Refills may be requested by calling an automated refill system. Faxed and phoned in refills are also available. Once a year a new application with financial documentation is needed.

866-699-8239

Applicants may have individual or employer sponsored prescription insurance. Those with Medicare, Medicaid or other state or federal funded are not eligible. 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.

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.    

Not applicable.

The medication is sent to the patient's home.