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Patient Assistance Information

 
Program Sponsored By Actelion Pharmaceuticals (External Link)
 
 
Tracleer Access Program

PO Box 826
South San Francisco, CA 94083-0826
Phone : 866-228-3546 Ext OPT 1
Fax: 866-279-0669
Eligibility
> The patient cannot have prescription insurance, be ineligible for any federal or state programs and meet income guidelines that are not disclosed. The patient must also be taking the medication for an on-label diagnosis. The patient must be a US citizen or legal resident.
Who Can Apply
> The doctor must apply on the patient's behalf.
Required
> The doctor must complete and sign the application. Insured patients may qualify for reimbursement services. Uninsured patients will be referred to the Patient Assistance Program and will be required to submit additional information.
Supply
> Up to a 30-day supply
Ship To
> Either Doctor's office or Patient's home
Note
> There is no online application available.
 
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.
 
Tracleer Tablets