Valcyte Patient Assistance Programs

Valcyte: Apply for prescription assistance below

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

Genentech Access to Care Foundation (HIV & Transplants)

(Program 1 of 2 — Scroll down to see them all )

Provided by: Genentech, Inc.
PO Box 29064, Phoenix, AZ 85038
TEL: 888-754-7651
FAX: 800-305-1830
Languages Spoken:
English, Spanish, Others By Translation Service
Program Website
Medications
  • Valcyte (valganciclovir)
Eligibility Requirements
  • Insurance Status Uninsured or Underinsured
  • Those with Part D Elibible? Determined case by case
  • Income Household income at or less than $150,000
  • Diagnosis/Medical Criteria Not applicable
  • U.S. Residency Required? Must be treated by US licensed healthcare provider
Application
  • Obtaining Doctor/Doctor's office starts process by filling out enrollment/statement of medical necessity forms
  • Receiving Faxed, mailed or downloaded from website
  • Returning The completed application can be faxed or mailed back.
  • Doctor's Action Complete and sign statement of medical necessity
  • Applicant's Action Complete Patient Authorization and Notice of Information Form available on website, attach proof of income
  • Decision Communicated Patient and/or Doctor are notified
  • Decision Timeframe 2 business days, once application process is complete
Medication
  • Amount/Supply Contact the program for more details.
  • Sent To Doctor's office or patient's home
  • 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
This program also provides copay assistance.
Updated October 15, 2018

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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Good Days Program

(Program 2 of 2 — Scroll down to see them all )

Provided by: Good Days from CDF
Attn: Enrollment 6900 Dallas Parkway Suite #200 Plano, TX 75024
TEL: 877-968-7233
FAX: 214-570-3621
Languages Spoken:
English
Program Website
Medications
  • None (valganciclovir)
Eligibility Requirements
  • Insurance Status Not specified
  • Those with Part D Elibible? Not specified
  • Income Not disclosed
  • Diagnosis/Medical Criteria Not specified
  • U.S. Residency Required? US residency requirements are not specified.
Application
  • Obtaining Call, download or apply online
  • Receiving Faxed, mailed or downloaded from website
  • Returning The completed application can be faxed, mailed or submitted online.
  • Doctor's Action Give prescription to patient
  • Applicant's Action Complete section, sign, attach required documents
  • Decision Communicated Patient and/or Doctor are notified
  • Decision Timeframe Varies
Medication
  • Amount/Supply Not specified
  • Sent To Not specified
  • Delivery Time Not specified
  • Refill Proces Not specified
  • Limit Not specified
  • Re-application Must re-enroll at end of calendar year
Additional Information
Call for most recent medications as the list is subject to change and the medication for which you are seeking assistance must treat the disease directly.
Updated October 5, 2018

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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