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This program provides brand name medications at no or low cost.
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| Pharmaceutical Company |
Eli Lilly & Company |
| Program Name |
Access for Humatrope |
| Program Address |
Humatrope Reimbursement Center
100 Grandview Rd., Suite 210
Braintree, MA 02184 |
| Phone Number |
800-642-2340
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| Fax Number |
317-779-0961 |
| Medications on Program |
Humatrope Injection 5 vial (somatropin (recombinant))
HumatroPen Injection 6mg, 12mg, 24mg cartridge (somatropin (recombinant))
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| Application Forms |
Access for Humatrope
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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 |
This program is based on guidelines that are not disclosed. meet income guidelines that are not disclosed. Medical diagnosis necessary for this program is not specified. The patient must also be under treatment from a US doctor. This program starts with an insurance verification process. If the patient is eligible for any coverage than they are not eligible for this program.
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| Application Process |
The doctor/doctor's office starts the process by filling out the Statement of Medical Necessity Form. The completed application must be faxed or mailed from the doctor's office.
Both the patient and doctor are notified of acceptance into the program.
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| Application Requirements |
The doctor must fill out a section and sign the application. The company will contact the patient for the needed information and documentation.
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| Program Details |
Up to a 90-day supply is sent to the patient's home. The company contacts the patient to arrange for refills. The company will contact the patient regarding reapplication.
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| Last Updated |
August 09, 2009 |
