Programas de asistencia al paciente para Lotronex

Solicite apoyo para su receta con Lotronex

Si califica, los programas a continuación le pueden ser útiles para conseguir Lotronex. Revise la información para saber si califica. Las solicitudes están disponibles en formato PDF y deben enviarse directamente a quien proporciona el programa de asistencia al paciente.

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Sebela Patient Assistance Program (Lotronex & Ridaura)

(Programa 1 de 1 — Para visualizar todos, deberá desplazarse hacia abajo )

Provienen de: Sebela Pharmaceuticals Inc.
PO Box 219 Gloucester, MA 01931
TEL: 866-562-7902
FAX: 888-246-6527
Idiomas hablados:
English
La Página del Programa
Medicamentos
  • Lotronex (alosetron)
Requisitos de Elegibilidad
  • Insurance Status *See Additional Information section below
  • Those with Part D Elibible? Determined case by case. *See Additional Information Section Below
  • Income At or below 300% of FPL
  • Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
  • U.S. Residency Required? Must be residing in the US or a US territory, and under the care of a US physician
Solicitud
  • Obtaining Call or download
  • Receiving Faxed, emailed, mailed or downloaded
  • Returning The completed application can be faxed, mailed or emailed back.
  • Doctor's Action Complete section and sign
  • Applicant's Action Complete section, sign, attach required documents
  • Decision Communicated Patient notified by email or phone
  • Decision Timeframe 5-7 business days
Medicamento
  • Amount/Supply Contact the program for more details.
  • Sent To Doctor's office or patient's home
  • Delivery Time Once approved; shipped next business day
  • Refill Proces Patient or Doctor's office needs to contact company
  • Limit None
  • Re-application New prescription every 3 months. New application every 6 months.
Información Adicional
* Must not have Health insurance coverage (private or government) that pays for requested products and haven’t for at least three months. **Medicare Part D - Copy of insurance denial letter required. ***The manufacturer supporting this program does not charge for applying to the program nor for any products applicants receive. Applicants using the services of a commercial advocacy service may have to supply additional documentation. 
Actualizado August 12, 2019

Si usted, su paciente o un ser querido no es elegible para este programa o otros, se pueden encontrar precios de aquí.

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