Patient Assistance Programs

: Apply for prescription assistance below

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

OnePath Patient Assistance Program (KALBITOR)

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

Provided by: Shire Pharmaceuticals
None
TEL: 866-888-0660
FAX: 855-663-7284
Languages Spoken:
English, Others By Translation Service
Program Website
Medications
  • Kalbitor (ecallantide)
Eligibility Requirements
  • Insurance Status Uninsured or Underinsured with no prescription coverage for needed medication
  • Those with Part D Elibible? No
  • Income Not disclosed
  • Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
  • U.S. Residency Required? The patient must also be residing in the US.
Application
  • Obtaining Call for prescreening
  • Receiving Faxed or downloaded from website
  • Returning The completed application must be faxed back.
  • Doctor's Action Complete section and sign
  • Applicant's Action Complete section and sign
  • Decision Communicated Patient notified
  • Decision Timeframe Within 2-3 days
Medication
  • Amount/Supply Varies
  • Sent To Doctor's office or infusion site
  • Delivery Time Within 48 hours
  • Refill Proces Contact program for details.
  • Limit None
  • Re-application New application every 12 months
Additional Information
This program also provides copay assistance.
Updated September 17, 2018

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