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Patient Assistance Information

 
 
 
MS LifeLines Patient Assistance Program


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Phone : 877-447-3243
Fax: 866-227-3243
Eligibility
> The patient must have no prescription coverage, have reached his/her cap or cannot afford the co-payments and meet income guidelines that are not disclosed.
Who Can Apply
> The patient must call for a prescreening.
Required
> The doctor/doctor's office must fax a prescription to the company.The patient must fill out a section, sign the application and attach proof of income.
Supply
>
Ship To
> Patient's home
Note
> The patient must call for a prescreening.
 
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.
 
Rebif