Recordati Reimbursement Hotline
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Peganone tablet (ethotoin tablet)
Those with Part D Elibible?
U.S. Residency Required?
The patient must be a US citizen or legal resident.
Doctor/Doctor's office must call for prescreening
Sent to Doctor's office
The completed application can be faxed or mailed back.
Complete section and sign
Complete section, sign, attach proof of income and any insurance information
Within 24-48 hours
Up to 90 day supply
Within 3-5 business days
Doctor's office must contact the company
New application every 6 months
Insurance benefits, patient assistance, claims assistance and/or other reimbursement help is offered.
Applicant must attach proof of income for all adults in the household.
This program also provides copay assistance for Penhematin. Contact program for details.
Updated December 2, 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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