Programas de asistencia al paciente para Tecfidera

Solicite apoyo para su receta con Tecfidera

Si califica, los programas a continuación le pueden ser útiles para conseguir Tecfidera. 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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The Free Drug Program

(Programa 1 de 2 — Para visualizar todos, deberá desplazarse hacia abajo )

Provienen de: Biogen
None
TEL: 800-456-2255
Idiomas hablados:
English, Others By Translation Service
La Página del Programa
Solicitudes y Formularios
Medicamentos
  • Tecfidera (dimethyl fumarate)
Requisitos de Elegibilidad
  • Insurance Status Must be uninsured or underinsured
  • Those with Part D Elibible? Yes
  • Income Not disclosed
  • Diagnosis/Medical Criteria Relapsing form of MS
  • U.S. Residency Required? The patient must also be residing in the US.
Solicitud
  • Obtaining Applicant must call for prescreening
  • Receiving There is no application
  • Returning The completed application's destination is not specified
  • Doctor's Action Fax in prescription
  • Applicant's Action Provide information and proof of income
  • Decision Communicated Decision made during phone screening
  • Decision Timeframe Not specified
Medicamento
  • Amount/Supply Not specified
  • Sent To Not applicable
  • Delivery Time Not specified
  • Refill Proces Company contacts patient to arrange
  • Limit None
  • Re-application Company contacts patient about reapplying
Información Adicional
Patients will be referred to a financial assistance counselor. Decisions made on a case by case basis. Program assistance can range from a temporary need up to a 1 year enrollment period. For Avonex, Tecfidera and Plegridy: up to a 90-day supply is sent to the doctor's office or the patient's home. For Tysabri: a one month supply is sent to the doctor's office or site of care for administration of the infusion. Insurance benefits, claims assistance and/or other reimbursement help is offered.
Actualizado May 3, 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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Patient Access Network Foundation (PAN)

(Programa 2 de 2 — Para visualizar todos, deberá desplazarse hacia abajo )

Provienen de: Patient Access Network Foundation
None
TEL: 866-316-7263
FAX: 866-316-7261
Idiomas hablados:
English, Spanish, Others By Translation Service
La Página del Programa
Medicamentos
  • Tecfidera (dimethyl fumarate)
Requisitos de Elegibilidad
  • Insurance Status *See Additional Information section below
  • Those with Part D Elibible? Determined case by case
  • Income Between 400-500% of FPL
  • Diagnosis/Medical Criteria FDA Approved Diagnosis - See Program Website for Details
  • U.S. Residency Required? Must reside and receive treatment in US
Solicitud
  • Obtaining Call or complete online
  • Receiving Complete online or by phone
  • Returning Complete online or by phone
  • Doctor's Action Will be discussed with patient and Doctor after request is received
  • Applicant's Action Call for information or inform doctor that he/she is in need
  • Decision Communicated Patient and Doctor notified in writing
  • Decision Timeframe Within 48 hours
Medicamento
  • Amount/Supply Not applicable
  • Sent To Patient sent card to be used at pharmacy
  • Delivery Time Once approved; shipped same day
  • Refill Proces Patient presents voucher/card to pharmacy for each refill
  • Limit None
  • Re-application New application every 12 months
Información Adicional
*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.
Actualizado April 30, 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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