Orbactiv Patient 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.

Looking for a different medication?

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
Program Website
Medications
  • Orbactiv (oritavancin diphosphate)
Eligibility Requirements
  • Insurance Status Must have no prescription coverage for needed medication
  • 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 Not specified
  • Decision Timeframe Not specified
Medication
  • Amount/Supply Not specified
  • Sent To Varies
  • Delivery Time Not specified
  • Refill Proces Not specified
  • Limit Not specified
  • Re-application Not specified
Additional Information
Resources for HEALTHCARE PROFESSIONALS ONLY.
Updated November 13, 2018

Back to top