Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
 

Wellbutrin XL

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Wellbutrin XL Guarantee Program

Provided by: Valeant Pharmaceuticals, Inc.

Direct Success Pharmacy
PO Box 279
Sea Girt, NJ 08750

TEL: 800-520-3185


Languages Spoken:

English

 

Program Applications and Forms

 Wellbutrin XL Enrollment Form: Contact program

 

Medications

  • Wellbutrin XL tablet; extended release (bupropion)
 

Eligibility Requirements   

Insurance Status Determined case by case
Those with Part D Eligible? No
Income Not disclosed
Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
US Residency Required? Must be treated by US licensed healthcare provider
   

Application

Obtaining Call
Receiving Not specified
Returning Not specified
Doctor's Action Not specified
Applicant's Action Call
Decision Communicated Not specified
Decision Timeframe Not specified
   

Medication

Amount/Supply Not specified
Sent To Not specified
Delivery Time Not specified
Refill Process Not specified
Limit Not specified
Re-application Not specified
   

Additional Information

Eligibility determined on a case-by-case basis. Contact program for details.


Updated March 16, 2016