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This program provides brand name medications at no or low cost.
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| Pharmaceutical Company |
EUSA Pharma |
| Program Name |
EUSA Pharma Community Access Patient Program |
| Program Address |
AccessMED
6900 College Blvd. Ste. 1000
Overland Park, KS 66211 |
| Phone Number |
888-837-4397
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| Fax Number |
866-287-3036 |
| Medications on Program |
Quadramet single dose vial for Injection 150mci (samarium sm 153 lexdronam)
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| Application Forms |
EUSA Community Access Patient Program
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On-line Application
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No on-line application available at this time |
| Web Site |
Click to go to program's web site |
| Eligibility Guidelines and Notes |
The patient must be uninsured or underinsured and and have an income at or below 200% of the Federal Poverty Level, adjusted for family size. Medical diagnosis is not necessary The patient must be a US citizen or possess a valid greencard to be eligible for this program
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| Application Process |
Anyone can call to get an application faxed out. Blank applications can be mailed, faxed, or emailed; Applications pre-populated with patient specific information must be faxed or mailed. The completed application can be faxed or mailed back.
The decision is usually made within 2-3 business days. The medication is shipped within 2 business days.
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| Application Requirements |
The doctor must fill out a section and sign the application. The patient must fill out a section and sign the application.
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| Program Details |
The medication is sent to either the doctor's office, or a specific site (clinic, hospital, infusion site etc.)
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| Last Updated |
August 05, 2010 |
