Orbactiv Prescription Assistance Programs

Orbactiv: Apply for prescription assistance below

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

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Orbactiv Support Programs

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

Provided by: Melinta Therapeutics, Inc.
2250 Perimeter Park Dr. Morrisville, NC 27560
TEL: 844-672-2284
FAX: 855-886-2482
Languages Spoken:
English, Others By Translation Service
Program Website
Medications
  • Orbactiv (oritavancin diphosphate)
Eligibility Requirements
  • Insurance Status Must be uninsured
  • Those with Part D Elibible? No
  • Income Not disclosed
  • Diagnosis/Medical Criteria FDA-approved diagnosis
  • U.S. Residency Required? Must be a US resident
Application
  • Obtaining Doctor/Doctor's office must call or download
  • Receiving Faxed or downloaded from website
  • Returning The completed application must be faxed or mailed 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 Usually same day
Medication
  • Amount/Supply Contact the program for more details.
  • Sent To Varies
  • Delivery Time Contact Program for Details
  • Refill Proces Contact program for details.
  • Limit Contact the program for details
  • Re-application Contact program for details.
Additional Information
Resources for HEALTHCARE PROFESSIONALS ONLY.
Updated November 11, 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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