Program

Program 1 of 3 Scroll down to see them all.

This program provides brand name medications at no or low cost.
Pharmaceutical Company	Abbott
Program Name	Abbott Patient Assistance Foundation
Program Address	P.O. Box 270 Somerset, NJ 08876
Phone Number	800-222-6885
Fax Number	866-898-1473
Medications on Program	Gengraf Capsules 25mg, 100mg (cyclosporine)
Application Forms	Abbott Patient Assistance Foundation
On-line Application	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 not have any private nor public insurance and meet income guidelines that are not disclosed. Medical diagnosis necessary for this program is not specified. US residency requirements are not specified. Patients with prescription drug coverage, including enrollment in a Medicare Part D Prescription Drug Plan, who have difficulty accessing their Abbott medications may be eligible for assistance by obtaining a Pharmaceutical Assistance Program exception based on health-related expenditures and household income.
Application Process	The doctor or patient can call to request an application. The application can be either faxed or mailed out upon request. The completed application can be faxed or mailed back. The doctor is notified of acceptance or denial. The decision is made within 5-7 business days. The medication is shipped out within 5-7 business days.
Application Requirements	The doctor must fill out a section and sign the application. The patient must fill out a section, sign the application and attach proof of income.
Program Details	Up to a 90-day supply is sent to the doctor's office. The doctor/doctor's office must contact the company to arrange refills. Once a year a new application with financial documentation is needed.
Last Updated	August 13, 2009

Program 2 of 3 Scroll down to see them all.

This program provides brand name medications at no or low cost.
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
Fax Number	866-470-1750
Medications on Program	Neoral Capsules 25mg, 100mg (cyclosporine) Sandimmune Gelatin Capsules 25mg (cyclosporine) Sandimmune Soft Gelatin Capsules 25mg, 100mg (cyclosporine)
Application Forms	Not Applicable
On-line Application	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.
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.
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.
Program Details	The medication is sent to the patient's home. Once a year the application process must be repeated.
Last Updated	July 10, 2009

Program 3 of 3.

This program provides brand name medications at no or low cost.
Pharmaceutical Company	TEVA Pharmaceuticals
Program Name	TEVA Assistance Program
Program Address	PO Box 52028 Phoenix, AZ 85072-9937
Phone Number	877-254-1039
Fax Number	888-782-6157
Medications on Program	Cyclosporine Capsules 1 (cyclosporine) Cyclosporine Oral Solution 1 (cyclosporine)
Application Forms	Teva Assistance Program
On-line Application	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 insurance. have an income at or below 200% of the Federal Poverty Level. Medical diagnosis necessary for this program is not specified. The patient must also be a US resident. Discount cards are not considered insurance. If patient has reached her/his cap s/he should still apply because s/he may still be eligible. Purinethol is not available to new applicants. There are two new medications on the program: paclitaxel and epirubicin, but they are not listed on the most current application.
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 is sent to the patient. The completed application can be faxed or mailed back. Both the doctor and patient are notified or acceptance or denial.
Application Requirements	The doctor must fill out a section and sign the application. The patient must fill out a section and sign the application.
Program Details	The medication is sent to the doctor's office. Every 6 months a new application is needed.
Last Updated	November 20, 2009