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This program provides brand name medications at no or low cost.
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| Pharmaceutical Company |
Amylin Pharmaceuticals |
| Program Name |
Amylin Reimbursement Hotline |
| Program Address |
PO Box 8435
Gaithersburg, MD 20898 |
| Phone Number |
800-330-7647
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| Fax Number |
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| Medications on Program |
Byetta Injection 5mcg, 10mcg (exenatide)
Symlin Injection 5ml (pramlintide)
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| Application Forms |
Amylin Pharmaceuticals Patient Assistance for Byetta
Amylin Pharmaceuticals Patient Assistance for Symlin
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On-line Application
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| Web Site |
Click to go to program's web site |
| Eligibility Guidelines and Notes |
The patient must have no insurance and meet income guidelines that are not disclosed. For Byetta, the patient must have a diagnosis of Type 2 Diabetes and for Symlin the patient must be taking insulin for control of Diabetes The patient must also be a US resident. If the patient is eligible for Part D but does not enroll then s/he may still be eligible for this program. Patients who are enrolled in Medicare Part D, but in the Donut Hole are not eligible for this program.
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| Application Process |
The patient or doctor needs to call for a prescreening. The application is sent to either the doctor or the patient. The completed application must be mailed back.
Both the patient and doctor are notified of acceptance into the program. The decision is usually made within 2 weeks.
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| Application Requirements |
The doctor needs to provide a prescription to the patient. The patient must fill out a section, sign the application and attach proof of income.
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| Program Details |
The patient is sent a pharmacy card. Every 6 months a new application is needed.
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| Last Updated |
October 05, 2009 |
