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

BMS3assist Co-Pay Assist for Atripla, Evotaz, Reyataz and Sustiva

This is a copay assistance program

Provided by: Bristol-Myers Squibb Company

BMS3assist
PO Box 221430
Charlotte, NC 28222

TEL: 888-281-8981


FAX: 888-281-8985
Languages Spoken:

English

Program Website

 

Patient Assistance Applications

BMS3assist Co-Pay Assist for Atripla, Evotaz, Reyataz and Sustiva: Contact Program

 

Brand Name Medications Covered

 
  • Atripla tablet
  • Reyataz
  • Evotaz
  • Sustiva
 

Generic Name

 
  • atazanavir sulfate
  • efavirenz
  • atazanavir sulfate/cobicistat
  • efavirenz/emtricitabine/tenofovir disoproxil fumarate tablet
 

Eligibility Requirements   

Insurance Status Must have insurance
Those with Part D Eligible? No
Income No limits
Diagnosis/Medical Criteria Not specified
US Residency Required? Must reside in the US, Puerto Rico or the USVI
   

Application

Obtaining Call
Receiving There is no application
Returning Not applicable
Doctor's Action Not specified
Applicant's Action Request card online or by phone
Decision Communicated Patient notified
Decision Timeframe Decision made during phone screening
   

Medication

Amount/Supply Not applicable
Sent To Varies
Delivery Time ID number given over the phone or card shipped within 7-10 business days
Refill Process Not applicable
Limit Up to one year
Re-application Must re-enroll at end of calendar year
   

Additional Information

Eligible patients may be able to save up to $7,500 per year with no monthly limit.

Patient Assistance Program also available; Contact program for details.


Updated August 16, 2017