Baxdela Prescription Assistance Programs

Baxdela: Apply for prescription assistance below

If you are eligible, the programs below can help you afford Baxdela. 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?

MelintAssist (Baxdela)

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

Provided by: Melinta Therapeutics, Inc.
None
TEL: 844-635-4682
FAX: 844-286-5445
Languages Spoken:
English, Others By Translation Service
Program Website
Medications
  • Baxdela (delafloxacin)
Eligibility Requirements
  • Insurance Status *Contact program for details.
  • Those with Part D Elibible? Yes
  • Income Not disclosed
  • Diagnosis/Medical Criteria FDA-approved diagnosis
  • U.S. Residency Required? Must be residing in the US or Puerto Rico
Application
  • Obtaining Call or download
  • Receiving Faxed or downloaded from website
  • Returning The completed application should be faxed back from the doctor's office.
  • Doctor's Action Complete section, sign, attach required documents
  • Applicant's Action Inform Doctor that he/she is in need
  • Decision Communicated Patient and Doctor are notified
  • Decision Timeframe 2-3 business days
Medication
  • Amount/Supply Contact the program for more details.
  • Sent To Patient's home, unless otherwise noted
  • Delivery Time Contact Program for Details
  • Refill Proces Contact program for details.
  • Limit Contact the program for details
  • Re-application Determined case by case
Additional Information
Resources for HEALTHCARE PROFESSIONALS ONLY. *In the event the patient has no income, a letter on hospital letterhead confrming that the patient has no income must be provided. This program also provides co-pay and reimbursement assistance.
Updated July 12, 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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