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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 |
P.O. Box 42886
Cincinnati, Ohio 45232 |
| Phone Number |
800-330-7647
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| Fax Number |
800-330-7718 |
| Medications on Program |
Byetta Injection 5mcg, 10mcg (exenatide)
SymlinPen 60mcg, 120mcg (pramlintide acetate)
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| Application Forms |
Amylin Pharmaceuticals Patient Assistance for Byetta and 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 meet insurance and financial guidelines that are not disclosed. The patient must also be a US resident.
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| 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 either the doctor or the patient. The completed application must be mailed back.
The patient is notified of eligibility for 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 and proof of residency.
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| Program Details |
The patient is sent a pharmacy card. Every 3 months a new application is needed.
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| Last Updated |
July 21, 2010 |
