Keveyis Prescription Assistance Programs

Keveyis: Apply for prescription assistance below

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

Strongbridge CareConnection (Keveyis)

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

Provided by: Strongbridge Biopharma plc.
24 Summit Park Dr. Pittsburgh, PA 15275
TEL: 844-538-3947
FAX: 844-538-1030
Languages Spoken:
English
Program Website
Program Applications and Forms
Medications
  • Keveyis tablet (dichlorphenamide tablet)
Eligibility Requirements
  • Insurance Status Determined case by case
  • Those with Part D Elibible? Not specified
  • Income Not disclosed
  • Diagnosis/Medical Criteria FDA-approved diagnosis
  • U.S. Residency Required? US residency requirements are not specified.
Application
  • Obtaining Call
  • Receiving Faxed to Doctor's office
  • 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 Complete section, sign, attach required documents
  • Decision Communicated Not specified
  • Decision Timeframe Not specified
Medication
  • Amount/Supply Varies
  • Sent To Not specified
  • Delivery Time Not specified
  • Refill Proces Not specified
  • Limit Not specified
  • Re-application Not specified
Additional Information
None
Updated August 7, 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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