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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Catalyst Pathways

This program provides brand name medications at no or low cost

Provided by: Catalyst Pharmaceuticals, Inc.

c/o AnovoRx Manufacturer Services, LLC
1710 N. Shelby Oaks Drive #3
Memphis, TN 38134

TEL: 833-422-8259


FAX: 833-422-8260
Languages Spoken:

English, Spanish, Others By Translation Service

Program Website

 

Program Applications and Forms

Catalyst Pathways Enrollment Form

Catalyst Pathways Enrollment Form Instructions

 

Medications

  • amifampridine tablet (Firdapse) Tablet
 

Eligibility Requirements   

Insurance Status Determined case by case
Those with Part D Eligible? Determined case by case
Income Based on FPL
Diagnosis/Medical Criteria Medically Necessary as determined by a Doctor
US Residency Required? Must reside in the US
   

Application

Obtaining Call or download
Receiving Faxed or downloaded from website
Returning Fax
Doctor's Action Complete section and sign
Applicant's Action Complete section and sign
Decision Communicated Patient and Doctor are notified
Decision Timeframe Within 72 hours
   

Medication

Amount/Supply Up to 1 month supply
Sent To Patient's home, unless otherwise noted
Delivery Time Varies
Refill Process Pharmacy contacts patient
Limit Varies
Re-application Must re-enroll at end of calendar year
   

Additional Information

This program also provides co-pay and reimbursement assistance.

Updated August 20, 2020


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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Ruzurgi Patient Assistance

This program provides patient support assistance

Provided by: Jacobus Pharmaceutical Company, Inc.

Attn: PANTHERx Specialty Pharmacy

TEL: 844-789-8744


FAX: 877-203-8844
Languages Spoken:

English

Program Website

 

Program Applications and Forms

Ruzurgi Patient Assistance Treatment Form

 

Medications

  • amifampridine tablet (Ruzurgi) Tablet
 

Eligibility Requirements   

Insurance Status Contact program for details.
Those with Part D Eligible? Contact program for details.
Income Not disclosed
Diagnosis/Medical Criteria Not specified
US Residency Required? Not specified
   

Application

Obtaining Call or download
Receiving Downloaded from website
Returning Fax from Doctor's office
Doctor's Action Complete section and sign
Applicant's Action Complete section and sign
Decision Communicated Not specified
Decision Timeframe Not specified
   

Medication

Amount/Supply Contact the program for more details.
Sent To Varies
Delivery Time Contact Program for Details
Refill Process Contact program for details.
Limit Contact the program for details
Re-application Contact program for details.
   

Additional Information

This program provides copay assistance.

Updated September 11, 2020


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

HealthWell Foundation Copay Program

This is a copay assistance program

Provided by: HealthWell Foundation

PO Box 489
Buckeystown, MD 21717

TEL: 800-675-8416


FAX: 800-282-7692
Languages Spoken:

English, Others By Translation Service

Program Website

 

Program Applications and Forms

HealthWell Foundation Copay Program Enrollment: Contact program

HealthWell Foundation COVID-19 Ancillary Costs: Contact program

 

Medications

  • amifampridine tablet (Ruzurgi) Tablet
 

Eligibility Requirements   

Insurance Status May have insurance
Those with Part D Eligible? Yes
Income Varies
Diagnosis/Medical Criteria FDA Approved Diagnosis - See Program Website for Details
US Residency Required? Must reside in the US
   

Application

Obtaining Call or complete online
Receiving Sent out or may be completed online
Returning Mail
Doctor's Action Complete section and sign
Applicant's Action Complete section, sign, attach a copy of proof of income
Decision Communicated Patient notified in writing
Decision Timeframe 3-5 business days
   

Medication

Amount/Supply Not applicable
Sent To Varies
Delivery Time Not specified
Refill Process Good for one year
Limit Not specified
Re-application New application every 12 months
   

Additional Information

This program provides financial assistance to eligible individuals to cover coinsurance, copayments, healthcare premiums and deductibles for certain treatments. Also, for those who are eligible for health insurance, but cannot afford the insurance premium, the foundation may be able to help by paying some or all of the medical portion of insurance premiums. The patient is being treated for a specific disease for which funding is available and has insurance that covers the treatment for this disease.

Call for most recent medications as the list is subject to change.
Updated July 20, 2020