Vistogard Patient Assistance Programs

Vistogard: Apply for prescription assistance below

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

Vistogard Support Program

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

Provided by: Biologics, Inc.
None
TEL: 800-850-4306
ALT PHONE: 800-850-4306
FAX: 844-374-0605
Languages Spoken:
English
Program Website
Program Applications and Forms
Medications
  • Vistogard (uridine triacetate)
Eligibility Requirements
  • Insurance Status Must be uninsured
  • Those with Part D Elibible? No
  • Income Not disclosed
  • Diagnosis/Medical Criteria Not specified
  • U.S. Residency Required? The patient must also be a US resident.
Application
  • Obtaining Call
  • Receiving Not specified
  • Returning The completed application should be faxed back from the doctor's office.
  • Doctor's Action Doctor/Doctor's office must call
  • 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 Not specified
  • Delivery Time Not specified
  • Refill Proces Not specified
  • Limit Not specified
  • Re-application Not specified
Additional Information
Resources for HEALTHCARE PROFESSIONALS ONLY. This program also provides copay assistance.
Updated October 3, 2018

Back to top