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This program provides brand name medications at no or low cost.
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| Pharmaceutical Company |
Organogenesis Inc. |
| Program Name |
Apligraf Patient Assistance Program |
| Program Address |
150 Dan Road
Canton, MA 02021 |
| Phone Number |
888-432-5232, opt 3
|
| Fax Number |
866-212-2888 |
| Medications on Program |
Apligraf 44sq cm (bi-layered skin substitute)
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| Application Forms |
Apligraf Patient Assistance Program
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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. Medical diagnosis necessary for this program is not specified. The patient must also be a US resident.
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| Application Process |
The doctor/doctor's office should call for an application. The application can be either faxed or mailed out upon request. The completed application must be faxed back.
The doctor is notified of acceptance or denial. The decision is usually made within 2-3 business days. The product will be shipped within 2 business days.
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| 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.
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| Program Details |
The product is sent to the doctor's office. Refills are determined on a case-by-case basis; the patient or doctor must contact the company.
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| Last Updated |
November 13, 2009 |
