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Patient Assistance Information

 
1 Program for Urso 250 Tablets
 
 
Axcan ASSIST Program

PO Box 52065
Phoenix, AZ 85072-9152
Phone : 866-292-2679
Fax: Not Applicable
Eligibility
> The patient cannot have prescription insurance, be ineligible for any federal or state programs and have an income at or below 200% of the Federal Poverty Level. The patient must also be a US resident under the age of 65.
Who Can Apply
> Anyone can call to request an enrollment kit to be sent out.
Required
> The doctor needs to provide a prescription to the patient. The patient must fill out a section and sign the application.
Supply
> The patient is sent a pharmacy card to be used once a month.
Ship To
> Patient's home
Note
> There is a $2 co-pay at the pharmacy.
 
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.
 
Urso 250 Tablets