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This program provides brand name medications at no or low cost.
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| Pharmaceutical Company |
Glenwood |
| Program Name |
Glenwood Compassionate Drug Program |
| Program Address |
Glenwood LLC
111 Cedar Lane
Englewood NJ, 07631
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| Phone Number |
800-542-0772, ext 1
201-569-0050
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| Fax Number |
201-569-0250 |
| Medications on Program |
Potaba Tablets 0.5gram (potassium p-aminobenzoate)
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| Application Forms |
Not Applicable |
On-line Application
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No on-line application available at this time |
| Web Site |
No link available. |
| Eligibility Guidelines and Notes |
This is an informal program; decisions are made on a case-by-case basis. meet income guidelines that are not disclosed. Medical diagnosis necessary for this program is not specified. US residency requirements are
not specified. The company limits to only 20 patients nationwide at any given time but rarely have 20 people on the program.
The company will only accept applications sent in from the doctor.
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| Application Process |
The doctor/doctor's office should call for an application. The application is faxed to the doctor's office. The completed application must be faxed or mailed from the doctor's office.
The doctor is notified of acceptance or denial. The decision is made within 5-7 business days. The medication is shipped the same day.
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| Application Requirements |
The doctor must fill out a section, sign the application and attach a copy of the DEA or State License number. The patient must fill out a section, sign the application and attach proof of income.
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| Program Details |
Up to a 90-day supply is sent to the doctor's office. The doctor/doctor's office must contact the company to arrange refills. If the patient stops taking the medication for more than 3 months, then a new application is needed.
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| Last Updated |
March 04, 2010 |
