Programas de asistencia al paciente para Xyntha

Solicite apoyo para su receta con Xyntha

Si califica, los programas a continuación le pueden ser útiles para conseguir Xyntha. 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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Patient Access Network Foundation (PAN)

(Programa 1 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
  • Xyntha (antihemophilic factor (recombinant))
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 November 22, 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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Pfizer Hemophilia Connect (PHC) Patient Assistance Program

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

Provienen de: Pfizer, Inc.
c/o Pfizer Hemophilia Connect 2730 S. Edmonds Lane, Suite 300, Lewisville, TX 75067
TEL: 844-989-4366
ALT PHONE: 844-989-4366
Idiomas hablados:
English, Spanish
La Página del Programa
Medicamentos
  • Xyntha (antihemophilic factor (recombinant))
Requisitos de Elegibilidad
  • Insurance Status Must have no prescription coverage for needed product
  • Those with Part D Elibible? Not specified
  • Income Not disclosed
  • Diagnosis/Medical Criteria Not specified
  • 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
  • Receiving Faxed or mailed
  • Returning The completed application must be faxed or mailed from the doctor's office.
  • Doctor's Action Complete section, sign, attach required documents
  • Applicant's Action Complete section, sign, attach required documents
  • Decision Communicated Not specified
  • Decision Timeframe Not specified
Medicamento
  • Amount/Supply Amount requested is sent
  • Sent To Doctor's office or patient's home
  • Delivery Time Varies
  • Refill Proces Contact program for details.
  • Limit Not specified
  • Re-application New application yearly
Información Adicional
Co-payment assistance, reimbursement support, and patient assistance programs are available for eligible patients. Free Trial Program: Contact Program for details
Actualizado November 7, 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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