Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Program 1 of 2.
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Kineret OnTrack Support Program

This program provides brand name medications at no or low cost

Provided by: Sobi, Inc.


TEL: 866-547-0644


FAX: 866-549-7219 		Languages Spoken:

English, Spanish, Others By Translation Service

Program Website

 

Program Applications and Forms

KineretKare OnTrack Patient Assistance Program Application

Kineret OnTrack Support Program Enrollment and Prescription Form
 

Medications
  • anakinra injection (Kineret) Injection
 

Eligibility Requirements   
Insurance Status Must be uninsured or underinsured
Those with Part D Eligible? Yes, but contact program for details
Income Not disclosed
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 Complete section, sign, attach required documents
Decision Communicated Patient notified
Decision Timeframe Varies
   

Medication
Amount/Supply Varies
Sent To Patient's home, unless otherwise noted
Delivery Time Varies
Refill Process Refill/reorder form included with shipment
Limit Varies
Re-application New application, new documentation yearly
   

Additional Information
Co-payment assistance, reimbursement support, and patient assistance programs are available for eligible patients.

This program may provide a Bridge Program for eligible patients who experience a delay, temporary loss, or change in coverage. Contact program for details.
Updated February 27, 2023


Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Program 2 of 2.
 

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
  • anakinra injection (Kineret) Injection
 

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 June 05, 2023