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

Provided by: AbbVie

AbbVie Customer Service, Department
36M, 1N. Waukegan Road
North Chicago, IL 60064-6163

TEL: 877-628-9738


ALT PHONE: 855-687-7503
FAX: 866-938-6696 		Languages Spoken:

English, Spanish

Program Website

 

Patient Assistance Applications

Mavyret Patient Support Enrollment Form
 

Brand Name Medications Covered
 
  • Mavyret
 

Generic Name Medications Covered
 
  • glecaprevir/pibrentasvir
 

Eligibility Requirements   
Insurance Status Contact program for details.
Those with Part D Eligible? Contact program for details.
Income Not disclosed
Diagnosis/Medical Criteria FDA-approved diagnosis
US Residency Required? Must be a US resident and treated by a US licensed healthcare provider
   

Application
Obtaining Call or download
Receiving Downloaded from website
Returning Varies
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 Varies
Delivery Time Not specified
Refill Process Patient must contact company
Limit Varies
Re-application Not specified
   

Additional Information
This program also provides copay assistance.
Updated January 16, 2019