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The Free Drug Program
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5000 Davis Drive
P.O. Box 13919
Morrisville, NC 27709
Phone
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(800)456-2255
Fax:
(877)301-5140
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Eligibility
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Patients must be uninsured or underinsured. Patients enrolled in Medicare Part D may be eligible. Patients must reside in the U.S. and have a relapsing form of MS. Income guidelines are not disclosed. |
| Who Can Apply
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Applicants must call for a prescreening. There is no application for this program. |
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Required
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Doctor's must fax in a copy of a prescription. The patient must provide information and proof of income. The decision will be made during the phone screening. |
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Supply
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For Avonex: up to a 90-day supply of the medication is sent. For Tysabri: a one month supply is sent. |
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Ship To
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Avonex will be shipped to the doctor's office or the patient's home. Tysabri will be sent to the doctor's office or site of care for administration of the infusion. |
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Note
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The company will contact the patient to arrange refills and also regarding the re-application procedure. Insurance benefits, claims assistance and/or other reimbursement help is offered. |
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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.
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| Avonex (interferon beta-1a) |
| Avonex Injection |
| Tysabri IV Infusion (natalizumab) |
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