Ajovy Prescription Assistance Programs

Ajovy: Apply for prescription assistance below

If you are eligible, the programs below can help you afford Ajovy. Review the information to see if you qualify. The applications are available in Adobe PDF format and should be mailed directly to the provider of the patient assistance program.

If you have any questions, please call the telephone number for the program (not PharmacyChecker.com) or go to the program website.

Looking for a different medication?

Teva Shared Solutions Program (AJOVY)

(Program 1 of 1 — Scroll down to see them all )

Provided by: Teva Pharmaceutical Industries
None
TEL: 800-887-8100
FAX: 844-257-6127
Languages Spoken:
English
Program Website
Medications
  • Ajovy (fremanezumab-vfrm)
Eligibility Requirements
  • Insurance Status Not specified
  • Those with Part D Elibible? Not specified
  • Income Not disclosed
  • Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
  • U.S. Residency Required? The patient must be a US citizen or legal resident.
Application
  • Obtaining Doctor/Doctor's office must call or download
  • Receiving Faxed or downloaded from website
  • Returning The completed application must be faxed back.
  • 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
Medication
  • Amount/Supply Not specified
  • Sent To Not specified
  • Delivery Time Not specified
  • Refill Proces Not specified
  • Limit Not specified
  • Re-application Not specified
Additional Information
Eligibility determined on a case-by-case basis. This program also provides copay assistance. Sharps disposal program available.
Updated April 10, 2019

If you, your patient or loved one does not qualify for this program or other prescription savings programs, then please search for prices here.

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