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

Takeda Help At Hand Patient Assistance Program

This program provides brand name medications at no or low cost

Provided by: Takeda Pharmaceutical

PO Box 5727
Louisville, KY 40255-0727

TEL: 800-830-9159


FAX: 800-497-0928 		Languages Spoken:

English, Others By Translation Service

Program Website

 

Patient Assistance Applications

Takeda Help At Hand Patient Assistance Program Application

Takeda Help At Hand Brochure
 

Brand Name Medications
 
  • Amitiza capsule
  • Mydayis capsule; extended-release
  • Carbatrol capsule; extended-release
  • Nesina tablet
  • Colcrys tablet
  • Oseni tablet
  • Dexilant capsule; delayed release
  • Pentasa capsule; controlled-release
  • Fosrenol powder; oral
  • Prevacid SoluTab tablet; orally disintegrating, delayed release
  • Fosrenol tablet; chewable
  • Rozerem tablet
  • Intuniv tablet; extended release
  • Trintellix tablet
  • Kazano tablet
  • Vyvanse capsule
  • Lialda tablet; delayed release
  • Vyvanse tablet; chewable
  • Motegrity tablet
 

Generic Name Medications
 
  • alogliptin benzoate tablet
  • lisdexamfetamine dimesylate capsule
  • alogliptin benzoate-pioglitazone tablet
  • lisdexamfetamine dimesylate tablet; chewable
  • alogliptin-metformin tablet
  • lubiprostone capsule
  • carbamazepine capsule; extended-release
  • mesalamine capsule; controlled-release
  • colchicine tablet
  • mesalamine tablet; delayed release
  • dexlansoprazole capsule; delayed release
  • mixed salts of a single-entity amphetamine capsule; extended-release
  • guanfacine tablet; extended release
  • prucalopride tablet
  • lansoprazole tablet; orally disintegrating, delayed release
  • ramelteon tablet
  • lanthanum carbonate powder; oral
  • vortioxetine tablet
  • lanthanum carbonate tablet; chewable
 

Eligibility Requirements   
Insurance Status Uninsured or Underinsured with no prescription coverage for needed medication
Those with Part D Eligible? Yes, but contact program for details
Income At or below 500% of FPL
Diagnosis/Medical Criteria Not specified
US Residency Required? Must reside in the US
   

Application
Obtaining Call or download
Receiving Faxed, mailed 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 and Doctor are notified
Decision Timeframe 5-7 business days
   

Medication
Amount/Supply Up to 90 day supply
Sent To Doctor's office or patient's home
Delivery Time Not specified
Refill Process Not specified
Limit Not specified
Re-application New application, new documentation yearly
   

Additional Information
Applicants not approved for enrollment in the program may have the opportunity to seek an exception to the program criteria.
Updated August 29, 2023