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Patient Assistance Information

 
2 Programs Sponsored By Cangene Corporation (External Link)
 
 
Episil Patient Assistance Program


,
Phone : (855)437-4745 Ext 5
Fax: (973)656-2626
Eligibility
> Patients must have no prescription insurance for the requested medication, including Medicare Part D. Patients must have an income at or below 300% of the Federal Poverty level and have a medically approved condition.
Who Can Apply
> Requestors can obtain an application by calling the program.
Required
> Patients must complete a section of the application and attachproof of income and any insurance information. The prescriber must also complete and sign the application.
Supply
> The supply/amount provided varies.
Ship To
> The supply will be sent to the healthcare provider or a pharmacy.
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.
 
Episil Concentrated Oral Liquid
 
 
 
WinRho Patient Assistance Program

PO Box 231118
Centreville, VA 20120
Phone : (973)656-2626
Fax:
Eligibility
> Applicants must have no prescription insurance for the requested medication, including Medicare Part D. They must also have an income at or below 200% of the federal poverty level and be a US resident.
Who Can Apply
> To obtain an application, the program must be contacted directly.
Required
> Patients must sign and complete the application. They must also attach proof of income and include any insurance information. The healthcare provider must complete and sign the application.
Supply
> Up to a one week supply of medication will be provided.
Ship To
> The medication will be shipped to the healthcare provider, pharmacy, or hospital.
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.
 
WinRho SDF Injection