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This program provides brand name medications at no or low cost.
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| Pharmaceutical Company |
Baxter Healthcare Corporation |
| Program Name |
Gammagard Insurance Assistance Program |
| Program Address |
PAREXEL
5870 Trinity Parkway
Suite 600
Centreville, VA 20120 |
| Phone Number |
800-447-3435
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| Fax Number |
888-750-1243 |
| Medications on Program |
Gammagard Injection 0.5g (immune globulin intravenous (human))
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| Application Forms |
Not Applicable |
On-line Application
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| Web Site |
Click to go to program's web site |
| Eligibility Guidelines and Notes |
Individual eligibility and level of financial support is determined on a case by case basis. meet income guidelines that are not disclosed. Medical diagnosis necessary for this program is not specified. US residency requirements are
not specified. Program does not provide co-pay assistance, patient must be uninsured to qualify. Medication will be shipped to a qualified Baxter provider.
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| Application Process |
The patient or doctor should call for an application. The completed application can be faxed or mailed back.
The patient is notified of eligibility for the program. The decision is usually made within 24-48 hours. The medication is shipped within 3-5 business days.
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| Application Requirements |
The doctor must fill out a section and sign the application. The patient needs to complete an application, sign it, and attach proof of income and other requested documentation.
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| Program Details |
The medication is sent to either the doctor's office, or a specific site (clinic, hospital, infusion site etc.) There is a limit of 720 grams per lifetime
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| Last Updated |
May 04, 2010 |
