Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
 

Daraprim

Daraprim Direct Program

For Healthcare Professionals Only.

Provided by: Turing Pharmaceuticals LLC


TEL: 844-267-3323


ALT PHONE: 800-222-4991
FAX: 877-241-1365
Languages Spoken:

Program Website

 

Program Applications and Forms

Daraprim Prescription & Enrollment Form

 

Medications

  • Daraprim tablet (pyrimethamine)
 

Eligibility Requirements   

Insurance Status Determined case by case
Those with Part D Eligible? Not specified
Income Not disclosed
Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
US Residency Required? Not specified
   

Application

Obtaining Call or download
Receiving Faxed or downloaded from website
Returning Fax from Doctor's office
Doctor's Action Complete section, sign, attach required documents
Applicant's Action Inform Doctor that he/she is in need
Decision Communicated Patient and Doctor are notified
Decision Timeframe Not specified
   

Medication

Amount/Supply Not specified
Sent To Not specified
Delivery Time Not specified
Refill Process Not specified
Limit Not specified
Re-application Not specified
   

Additional Information

Resources for HEALTHCARE PROFESSIONALS ONLY.

This program provides delivery, reimbursement and support services.


Updated April 20, 2016