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This program provides brand name medications at no or low cost.
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| Pharmaceutical Company |
Novartis Pharmaceuticals |
| Program Name |
Novartis Patient Assistance Program for Specialty Medicines |
| Program Address |
PO Box 66531
St Louis, MO 63166 |
| Phone Number |
800-277-2254
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| Fax Number |
866-470-1750 |
| Medications on Program |
Sandimmune Gelatin Capsules 25mg (cyclosporine)
Sandimmune Injection 250mg/5ml (cyclosporine injectable)
Sandimmune Oral Solution 100mg/ml (cyclosporine oral solution)
Sandimmune Soft Gelatin Capsules 25mg, 100mg (cyclosporine)
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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 |
Click to go to program's web site |
| Eligibility Guidelines and Notes |
The patient must have no prescription coverage for the requested medication and meet income guidelines that are not disclosed. Medical diagnosis necessary for this program is not specified. The patient must also be a US resident.
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| Application Process |
The doctor, patient, social worker or patient advocate must call for a prescreening. The application can be either faxed or mailed out upon request. The completed application can be faxed or mailed back.
The patient is notified of eligibility for the program.
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| Application Requirements |
The doctor must fill out a section, sign the application and attach a prescription for 90 days. The patient must fill out a section, sign the application and attach proof of income.
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| Program Details |
The medication is sent to the patient's home. Once a year the application process must be repeated.
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| Last Updated |
July 10, 2009 |
