Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Program 1 of 4.
Scroll down to see them all.
Updated August 21, 2009
 

Tysabri

Tysabri Patient Assistance Program

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

Provided by: Biogen Idec and Elan Pharmaceuticals


TEL: 888-489-7227


ALT PHONE: 800-456-2255
FAX:
Languages Spoken:

English

Program Website

 

Patient Assistance Applications

 

Medications

  • Tysabri Vial; Single-Use 300mg (natalizumab)
 

Eligibility Requirements   

Insurance Status Must be uninsured or underinsured
Those with Part D Eligible? Yes, if not enrolled
Income Not disclosed
Diagnosis/Medical Criteria Must have MS
US Residency Required? Yes
   

Application

Obtaining Applicant must call for prescreening
Receiving
Returning
Doctor's Action
Applicant's Action
Decision Communicated
Decision Timeframe
   

Medication

Amount/Supply
Sent To Doctor's office
Delivery Time
Refill Process
Limit
Re-application
   

Additional Information

Patients will be referred to a financial counselor to determine assistance. Those with Medicare Part D may eligible. Decisions made on a case by case basis. There is no application. Some income documentation may be requested.


Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Program 2 of 4.
Scroll down to see them all.
Updated December 10, 2014
 

Tysabri

Biogen Idec Copay Assistance Program

This is a copay assistance program.

Provided by: Biogen Idec

5000 Davis Drive
PO Box 13919
Research Triangle Park
Morrisville, NC 27709

TEL: 800-456-2255


ALT PHONE:
FAX:
Languages Spoken:

Program Website

 

Patient Assistance Applications

 Biogen Idec Copay Assistance Program: Contact program

 

Medications

  • Tysabri Vial; Single-Use dosage varies (natalizumab)
 

Eligibility Requirements   

Insurance Status Must not have public insurance, may have private insurance
Those with Part D Eligible? No
Income No limits
Diagnosis/Medical Criteria Relapsing form of MS
US Residency Required? Must reside in the US
   

Application

Obtaining Applicant must call for prescreening
Receiving There is no application
Returning Not applicable
Doctor's Action Fax in prescription
Applicant's Action Provide information and proof of income
Decision Communicated Decision made during phone screening
Decision Timeframe Decision made during phone screening
   

Medication

Amount/Supply Not specified
Sent To Not applicable
Delivery Time Not specified
Refill Process Pharmacy contacts patient
Limit None
Re-application New application yearly
   

Additional Information

Patients will be referred to a financial assistance counselor. Decisions made on a case by case basis. There may be an annual cap that limits the amount of assistance that you can receive over one year, based on income. For Avonex, Tecfidera and Plegridy: up to a 90-day supply is sent to the doctor's office or the patient's home. For Tysabri: a one month supply is sent to the doctor's office or site of care for administration of the infusion. During conditional approval, medication will be covered as per program guidelines.

Insurance benefits, claims assistance and/or other reimbursement help is offered.


Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Program 3 of 4.
Scroll down to see them all.
Updated October 17, 2014
 

Tysabri

Patient Access Network Foundation (PAN)

This is a copay assistance program.

Provided by: Patient Access Network Foundation

PO Box 221858
Charlotte, NC 28222-1858

TEL: 866-316-7263


ALT PHONE:
FAX: 866-316-7261
Languages Spoken:

English, Spanish, Others By Translation Service

Program Website

 

Patient Assistance Applications

PAN Brochure

PAN Eligibility Criteria and Benefit Cap Information

PAN Proof of Expenditure Form

 

Medications

  • Tysabri Vial; Single-Use 300mg (natalizumab)
 

Eligibility Requirements   

Insurance Status Must have insurance
Those with Part D Eligible? Determined case by case
Income At or below 500% of FPL
Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
US Residency Required? Must reside and receive treatment in US
   

Application

Obtaining Call or complete online
Receiving Sent out or may be completed online
Returning Fax, mail or submit online
Doctor's Action Will be discussed with patient and Doctor after request is received
Applicant's Action Complete section and sign
Decision Communicated Patient and Doctor notified in writing
Decision Timeframe Within 48 hours
   

Medication

Amount/Supply Not applicable
Sent To Patient sent card to be used at pharmacy
Delivery Time Once approved; shipped same day
Refill Process Patient presents voucher/card to pharmacy for each refill
Limit None
Re-application New application every 12 months
   

Additional Information

Call for most recent medications as the list is subject to change and the medication for which you are seeking assistance must treat the disease directly.


Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Program 4 of 4. Updated December 10, 2014
 

Tysabri

The Free Drug Program

This program provides medication at no cost.

Provided by: Biogen Idec

5000 Davis Drive
PO Box 13919
Research Triangle Park
Morrisville, NC 27709

TEL: 800-456-2255


ALT PHONE:
FAX:
Languages Spoken:

English

Program Website

 

Patient Assistance Applications

 The Free Drug Program: Contact program

 

Medications

  • Tysabri Vial; Single-Use 300mg (natalizumab)
 

Eligibility Requirements   

Insurance Status Must be uninsured or underinsured
Those with Part D Eligible? Yes
Income Not disclosed
Diagnosis/Medical Criteria Relapsing form of MS
US Residency Required? Must reside in the US
   

Application

Obtaining Applicant must call for prescreening
Receiving There is no application
Returning Not specified
Doctor's Action Fax in prescription
Applicant's Action Provide information and proof of income
Decision Communicated Decision made during phone screening
Decision Timeframe Not specified
   

Medication

Amount/Supply Not specified
Sent To Not applicable
Delivery Time Not specified
Refill Process Company contacts patient to arrange
Limit None
Re-application Company contacts patient about reapplying
   

Additional Information

Patients will be referred to a financial assistance counselor. Decisions made on a case by case basis. Program assistance can range from a temporary need up to a 1 year enrollment period. For Avonex, Tecfidera and Plegridy: up to a 90-day supply is sent to the doctor's office or the patient's home. For Tysabri: a one month supply is sent to the doctor's office or site of care for administration of the infusion.

Insurance benefits, claims assistance and/or other reimbursement help is offered.