|
Eisai Assistance Program (Akynzeo)
|
2730 S. Edmonds Lane
Suite 300 Lewisville, TX 75067
Phone
:
(855)347-2448
Fax:
(844)494-8063
|
Eligibility
|
> |
Insurance requirements are determined case by case, this includes Medicare part D Patients. Income requirements for this program have not been disclosed. Patient must be a US citizen or legal resident. |
Who Can Apply
|
> |
Call for application to be faxed or download from website. Application is to be faxed back to company. Patient and Doctor will be notified of decision. |
Required
|
> |
Must have medically appropriate condition/diagnosis. Doctor must complete application, sign and attach brand name prescription. Patient must complete application, sign and attach proof of income. |
Supply
|
> |
Amount as prescribed by Doctor. Contact company for refills, which are determined case by case. Refill limit & re-application process not specified. |
Ship To
|
> |
Medication is sent to Doctor's office or specific site in 1-3 business days. |
Note
|
> |
|
|
Includes Support for This Drug NOTE: Linked drugs are available for Prescribers to Apply Online now. Click drug logo or drug name to start online application. |
Akynzeo capsule |
|
|
|