Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Updated March 13, 2015
 

Mestinon

Valeant Patient Assistance Program

This program provides brand name medications at no or low cost.

Provided by: Valeant Pharmaceuticals, Inc.

PO Box 836
Somervile, NJ 08876

TEL: 866-268-7325


ALT PHONE:
FAX: 866-217-7164
Languages Spoken:

English

Program Website

 

Patient Assistance Applications

Valeant Patient Assistance Program Enrollment Form

 

Medications

  • Mestinon Syrup 60mg (pyridostigmine bromide)
  • Mestinon Tablet; Timespan 60mg, 180mg (pyridostigmine bromide)
 

Eligibility Requirements   

Insurance Status Must have no prescription coverage
Those with Part D Eligible? No
Income At or below 200% of FPL
Diagnosis/Medical Criteria Not required
US Residency Required? Must be citizen or legal resident
   

Application

Obtaining Call
Receiving Faxed or mailed
Returning Fax or mail
Doctor's Action Complete section, sign, attach prescription
Applicant's Action Complete section and sign
Decision Communicated If accepted, medication sent to Dr office. If denied, Dr office is informed
Decision Timeframe Within 2-3 days
   

Medication

Amount/Supply Up to 90 day supply
Sent To Doctor's office
Delivery Time Within 5-7 business days
Refill Process Copy of application with new doctor signature
Limit Not specified
Re-application New application yearly
   

Additional Information

Wellbutrin XL IS NOT AVAILABLE FOR NEW PATIENTS.

Call for information on the most recent medications as the list is subject to change .