Registered Users Log-in:

E-mail Address:
 

Password:
 

  
Forgot Password?
Registration
 
Patient Assistance Information

 
Program Sponsored By Gate Pharmaceuticals (External Link)
 
 
Gate Patient Assistance Program

OpenGATE MedAssist Program
1090 Horsham Rd
North Wales, PA 19454
Phone : (800) 292-4283 Ext 3405
Fax: (215) 653-0839
Eligibility
> Patients must not be eligible for other sources of drug coverage and must be deemed financially eligible based on company guidelines.
Who Can Apply
> Physician's office must call on patient's behalf.
Required
> Signed and completed application, patient proof of income and a prescription for a 90 day supply of medication with up to 3 refills are required.
Supply
> 3 month supply
Ship To
> Physician's office.
Note
> Patient must re-apply after one year.
 
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.
 
Galzin (zinc acetate)
Orap (pimozide)