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Program 1 of 1.  Updated March 29, 2013 Back | Print Page

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

Valeant Patient Assistance Program

Provided by:


Valeant Pharmaceuticals, Inc.
P.O. Box 836
Somervile, NJ 08876


TEL: 866-268-7325


ALT PHONE:
FAX: 866-217-7164
 Program Website

Languages Spoken: English

Patient assistance
applications

 

Medications

  • Mestinon  Syrup 60mg (pyridostigmine bromide)
  • Mestinon  Timespan Tablets 180mg (pyridostigmine bromide)

Eligibility Requirements

APPLICATION

MEDICATION
Insurance Status Must have no prescription coverage
Those with Part D Eligible? No
Income Based on FPL
Diagnosis/Medical Criteria Not required
US Residency Required? Must be citizen or legal resident
Obtaining Call
Receiving Faxed or mailed
Returning Mail or fax
Doctor's Action Complete section, sign, attach prescription
Applicant's Action Complete section, sign
Decision Communicated If accepted, medication sent to Dr office. If denied, Dr office is informed
Decision Timeframe Within 2-3 days
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.



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