Xtampza Er Patient Assistance Programs

Xtampza Er: Apply for prescription assistance below

If you are eligible, the programs below can help you afford Xtampza ER. 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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Xtampza ER Financial Assistance Program

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

Provided by: Collegium Pharmaceutical Inc.
None
TEL: 888-884-2655
Languages Spoken:
English
Program Website
Medications
  • Xtampza ER (oxycodone)
Eligibility Requirements
  • Insurance Status Determined case by case
  • Those with Part D Elibible? Determined case by case
  • Income Not disclosed
  • Diagnosis/Medical Criteria FDA-approved diagnosis
  • U.S. Residency Required? US residency requirements are not specified.
Application
  • Obtaining Patient/Doctor must call to register and enroll
  • Receiving Not specified
  • Returning The application must be submitted online by the health care provider
  • Doctor's Action Enroll in the program
  • Applicant's Action Call for information or 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 Contact program for details.
  • Limit Once per calendar quarter per patient
  • Re-application Patient contacts program
Additional Information
Both prescriber and patient must be registered with the REMS Program. Contact program for more detail. This program also provides copay assistance.
Updated September 27, 2018

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