Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Program 1 of 3.
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Bristol Myers Squibb (BMS) Patient Support Program (Expanded: COVID-19)

This program provides brand name medications at no or low cost

Provided by: Bristol-Myers Squibb Company


TEL: 800-721-8909


Languages Spoken:

English, Others By Translation Service

Program Website

 

Program Applications and Forms

Bristol Myers Squibb (BMS) Patient Support Program (Expanded: COVID-19): Contact program

 

Medications

  • abatacept injection; iv (Orencia) Injection; IV
 

Eligibility Requirements   

Insurance Status Determined case by case
Those with Part D Eligible? Determined case by case
Income Not disclosed
Diagnosis/Medical Criteria FDA-approved diagnosis
US Residency Required? Must reside in the US
   

Application

Obtaining Call
Receiving Not specified
Returning Not specified
Doctor's Action Not specified
Applicant's Action Call for information or inform doctor that he/she is in need
Decision Communicated Call for decision
Decision Timeframe Varies
   

Medication

Amount/Supply Varies
Sent To Varies
Delivery Time Varies
Refill Process Contact program for details.
Limit Contact the program for details
Re-application Determined case by case
   

Additional Information

Eligibility determined on a case-by-case basis. Contact program for details: 1-800-721-8909

Updated August 01, 2022


Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Program 2 of 3.
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Bristol-Myers Squibb Patient Assistance Foundation (BMSPAF)

This program provides brand name medications at no or low cost

Provided by: Bristol-Myers Squibb Company

PO Box 220769
Charlotte, NC 28222-0769

TEL: 800-736-0003


FAX: 800-736-1611
Languages Spoken:

English, Spanish, Others By Translation Service

Program Website

 

Program Applications and Forms

Bristol-Myers Squibb Patient Assistance Foundation Application

Bristol-Myers Squibb Patient Assistance Foundation Application (Zeposia)

 

Medications

  • abatacept injection; iv (Orencia)
 

Eligibility Requirements   

Insurance Status Must have no prescription coverage for needed medication
Those with Part D Eligible? Determined case by case
Income Varies
Diagnosis/Medical Criteria Medication must be for outpatient use only
US Residency Required? Must reside in the US, Puerto Rico or the USVI
   

Application

Obtaining Call or download
Receiving Faxed
Returning Fax or mail
Doctor's Action Complete section, sign, attach required documents
Applicant's Action Complete section, sign, attach required documents
Decision Communicated Patient and Doctor are notified
Decision Timeframe Within a week
   

Medication

Amount/Supply Varies
Sent To Doctor's office
Delivery Time Varies
Refill Process Doctor/Doctor's office must contact the Program
Limit Contact the program for details
Re-application New application yearly
   

Additional Information


Updated September 13, 2022


Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Program 3 of 3.
 

Patient Access Network Foundation (PAN)

This is a copay assistance program

Provided by: Patient Access Network Foundation


TEL: 866-316-7263


FAX: 866-316-7261
Languages Spoken:

English, Spanish, Others By Translation Service

Program Website

 

Program Applications and Forms

Patient Access Network Foundation (PAN) Application: Contact program

 

Medications

  • abatacept injection; iv (Orencia)
 

Eligibility Requirements   

Insurance Status *See Additional Information section below
Those with Part D Eligible? Determined case by case
Income Between 400-500% of FPL
Diagnosis/Medical Criteria FDA Approved Diagnosis - See Program Website for Details
US Residency Required? Must reside and receive treatment in US
   

Application

Obtaining Call or complete online
Receiving Complete online or by phone
Returning Not applicable
Doctor's Action Varies
Applicant's Action Call for information or inform doctor that he/she is in need
Decision Communicated Patient and Doctor are notified
Decision Timeframe Within 48 hours
   

Medication

Amount/Supply Not applicable
Sent To Patient is sent savings card to be used at pharmacy
Delivery Time Once approved; shipped same day
Refill Process Patient presents voucher/card to pharmacy for each refill
Limit None
Re-application New application every 12 months
   

Additional Information

*Patients must have health insurance and their insurance must cover the qualifying medication for which they seek assistance.

Call for most recent medications as the list is subject to change and the medication for which you are seeking assistance must treat the disease directly.

Note: All new enrollment is now done electronically or over the phone. Contact program for details.

Updated November 28, 2022