Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
 

Valeant Patient Assistance Program for Salix Pharmaceuticals Products

This program provides brand name medications at no or low cost

Provided by: Valeant Pharmaceuticals, Inc.

PO Box 429303
Cincinnati, OH 45242-9303

TEL: 833-862-8727


FAX: 866-777-5705
Languages Spoken:

English

 

Patient Assistance Applications

 

Generic Name

 
 

Eligibility Requirements   

Insurance Status Must have no prescription coverage
Those with Part D Eligible? Determined case by case
Income Not disclosed
Diagnosis/Medical Criteria Medication must be for outpatient use only
US Residency Required? Must be a US resident and treated by a US licensed healthcare provider
   

Application

Obtaining Call or download
Receiving Faxed or downloaded from website
Returning Fax or mail
Doctor's Action Complete section, sign, attach required documents
Applicant's Action Complete section, sign, attach required documents
Decision Communicated Not specified
Decision Timeframe 2 business days, once application process is complete
   

Medication

Amount/Supply Varies
Sent To Varies
Delivery Time Not specified
Refill Process Not specified
Limit One year
Re-application New application yearly
   

Additional Information

Hardship appeals for patients residing in Puerto Rico will be reviewed on a case-by-case basis.

Call for information on the most recent medications as the list is subject to change.


Updated February 28, 2018