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This company does not offer a patient assistance program.
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| Pharmaceutical Company |
Xubex Pharmaceuticals |
| Program Name |
Xubex Copay Assistance Program |
| Program Address |
PO Box 1244
Winter Park, Fl 32790-1244 |
| Phone Number |
866-699-8239
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| Fax Number |
407-671-7960 |
| Medications on Program |
Sanctura XR Extended Release Tablets 60mg (trosplum choride)
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| Application Forms |
Xubex Copay 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 |
This program does not have income limitations. Medical diagnosis is not necessary This program is not valid in Massachusetts, so MA residents are not eligible. This is a copay assistance program that covers all or part of the applicant's copay for the medication. The amount of the copay assistance varies by medication, check the program's website for the exact amount. The application does not require a HCP signature, however the applicant must send the prescription(s) in with the application.
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| Application Process |
Anyone requesting assistance can call the above number to request an application be mailed or faxed out or download it from the website. The application can be either faxed or mailed out upon request. The completed application can be faxed or mailed back.
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| Application Requirements |
Not applicable.
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| Program Details |
The medication is sent to the patient's home.
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| Last Updated |
August 03, 2010 |
