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

View Coupon View Coupon

Organon Connect

For Healthcare Professionals Only

Provided by: Organon


TEL: 844-674-3200


Languages Spoken:

English, Others By Translation Service

Program Website

 

Program Applications and Forms

Organon Connect Product Information: Contact program

 

Medications

  • Follistim AQ Cartridge injection; subcutaneous (follitropin alpha/beta)
 

Eligibility Requirements   

Insurance Status Determined case by case
Those with Part D Eligible? Determined case by case
Income Not disclosed
Diagnosis/Medical Criteria Medically Necessary as determined by a Doctor
US Residency Required? Must be treated by US licensed healthcare provider
   

Application

Obtaining Not specified
Receiving Not specified
Returning Not specified
Doctor's Action Enroll in the program
Applicant's Action Not applicable
Decision Communicated Not specified
Decision Timeframe Not specified
   

Medication

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

Additional Information

Resources for HEALTHCARE PROFESSIONALS ONLY.

The Physician must register to access tools and materials for patient support, product sample requests, and up-to-date professional resources.

Updated September 30, 2021