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This program provides brand name medications at no or low cost.
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| Pharmaceutical Company |
Stiefel Laboratories |
| Program Name |
StiefelCare Program |
| Program Address |
PO Box 259
Acworth, GA 30101 |
| Phone Number |
800-572-3225
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| Fax Number |
866-468-2420 |
| Medications on Program |
Soriatane Capsules 10mg (acitretin)
Soriatane CK Capsules 25mg (acitretin)
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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 can have no public or private prescription insurance and have an income at or below 200% of the Federal Poverty Level. Medical diagnosis necessary for this program is not specified. The patient must be a US citizen or legal resident.
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| Application Process |
The patient or doctor needs to call for a prescreening. The application is faxed to the doctor's office. The completed application can be faxed or mailed back.
Both the doctor and patient are notified or acceptance or denial.
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| Application Requirements |
The doctor must fill out a section, sign the application, and attach a prescription and include the DEA or State License number. The patient must fill out a section and sign the application.
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| Program Details |
Up to a 90-day supply is sent to the doctor's office. A copy of the application with new signatures and a new prescription is needed for refills. Every 6 months a new application is needed.
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| Last Updated |
September 22, 2009 |
