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

This program provides medication at no cost.

Provided by: Amgen, Inc.

PO Box 18769
Louisville, KY 40261-7821

TEL: 888-762-6436


FAX: 866-549-7239
Languages Spoken:

English

Program Website

 

Patient Assistance Applications

Amgen Safety Net Foundation: Contact program

 

Brand Name Medications Covered

 
  • Aranesp vial
  • Neupogen vial
  • Blincyto injection
  • Nplate injectable; subcutaneous
  • Corlanor tablet
  • Parsabiv
  • Enbrel
  • Prolia injectable; subcutaneous
  • Epogen injection (for dialysis only)
  • Repatha
  • Imlygic
  • Sensipar tablet
  • Kyprolis injection
  • Vectibix
  • Neulasta syringe
  • Xgeva
 

Generic Name

 
  • blinatumomab injection
  • etelcalcetide
  • carfilzomib injection
  • evolocumab
  • cinacalcet tablet
  • filgrastim vial
  • darbepoetin alfa vial
  • ivabradine tablet
  • denosumab
  • panitumumab
  • denosumab injectable; subcutaneous
  • pegfilgrastim syringe
  • epoetin alfa injection (for dialysis only)
  • romiplostim injectable; subcutaneous
  • etanercept
  • talimogene laherparepvec
 

Eligibility Requirements   

Insurance Status Must be uninsured or underinsured
Those with Part D Eligible? Varies
Income At or below 500% of FPL
Diagnosis/Medical Criteria *See Additional Information section below
US Residency Required? Yes, must have lived in the US or its territories for 6 months or longer.
   

Application

Obtaining Call or download from Programs website
Receiving Mailed or downloaded from website
Returning Fax or mail from Doctor's office
Doctor's Action Complete section, sign, attach required documents
Applicant's Action Complete section and sign
Decision Communicated Patient and Doctor are notified
Decision Timeframe Varies
   

Medication

Amount/Supply Amount requested is sent
Sent To Address of shipment varies by medication
Delivery Time Varies
Refill Process Determined on a case by case basis
Limit Not specified
Re-application Varies
   

Additional Information

Please visit www.SafetyNetFoundation.com for more information or visit www.AmgenAssist360.com for product information.

* Diagnosis is required if patient has insurance.


Updated May 31, 2017