Onfi Prescription Assistance Programs

Onfi: Apply for prescription assistance below

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

ONFI Patient Assistance Program

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

Provided by: Lundbeck, Inc.
None
TEL: 855-345-6634
FAX: 855-547-8278
Languages Spoken:
English, Others By Translation Service
Program Website
Program Applications and Forms
Medications
  • Onfi tablet (clobazam tablet)
Eligibility Requirements
  • Insurance Status Determined case by case
  • Those with Part D Elibible? Determined case by case
  • Income Not disclosed
  • Diagnosis/Medical Criteria Medically Necessary as determined by a Doctor
  • U.S. Residency Required? The patient must be a US citizen or legal resident.
Application
  • Obtaining Doctor must start by sending referral form to program
  • Receiving Faxed, mailed or downloaded from website
  • Returning The completed application must be faxed or mailed from the doctor's office.
  • Doctor's Action Complete section and sign
  • Applicant's Action Inform Doctor that he/she is in need
  • Decision Communicated Patient and Doctor are notified
  • 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
Resources for HEALTHCARE PROFESSIONAL ONLY. This program also provides copay assistance.
Updated July 8, 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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