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

EpiPen 2-Pak

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Viatris EpiPen Patient Assistance Program

This program provides both brand name and generic name

Provided by: Viatris Inc.


TEL: 800-796-9526


Languages Spoken:

English, Spanish

Program Website

 

Program Applications and Forms

Viatris EpiPen Patient Assistance Program: Contact program

 

Medications

  • EpiPen 2-Pak injection (epinephrine)
 

Eligibility Requirements   

Insurance Status Contact program for details.
Those with Part D Eligible? No
Income Based on FPL
Diagnosis/Medical Criteria Medically Necessary as determined by a Doctor
US Residency Required? Must be citizen or legal resident
   

Application

Obtaining Call or download
Receiving Faxed or downloaded from website
Returning Fax from Doctor's office
Doctor's Action Complete section, sign, attach required documents
Applicant's Action Inform Doctor that he/she is in need
Decision Communicated Doctor notified
Decision Timeframe Varies
   

Medication

Amount/Supply Varies
Sent To Doctor's office
Delivery Time Varies
Refill Process Contact program for details.
Limit Not specified
Re-application Varies
   

Additional Information

Co-payment assistance and patient assistance programs are available for eligible patients.

Updated June 07, 2021