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Patient Assistance Information

 
2 Programs for Targretin Capsules
 
 
Ligand Assistance Program

Ligand Assistance Program
PO Box 222197
Charlotte, NC 28222-2197
Phone : (877) 654-4263
Fax: (877) 654-6760
Eligibility
> The patient must have no prescription coverage or have reached his/her cap and meet income guidelines that are not disclosed. This program is handled on a case-by-case basis. Patients in need should contact them.
Who Can Apply
> With the patient's permission, anyone concerned can call for an application. The application can be either faxed or mailed out. The completed application can be faxed or mailed back. Both the patient and doctor are notified in writing of acceptance or denial. The decision is usually made within 48 hours.
Required
> The doctor must fill out a section, sign the application and attach a prescription. The patient must fill out a section and sign the application.
Supply
> 30 Day supply
Ship To
> Physician's office
Note
> The company contacts the doctor to arrange for refills. Each medication has different guidelines for renewal.
 
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.
 
Targretin Capsules
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form Application Form
(Requires Acrobat Reader
 
 
Valeant Patient Assistance Program

PO Box 836
Somerville, NJ 08876
Phone : (866)268-7325
Fax: (866)217-7164
Eligibility
> Patient must have no prescription coverage, be at or below 200% of the Federal Poverty Level and be a US citizen or legal resident.
Who Can Apply
> Patients or healthcare providers can call to have an application faxed or mailed.
Required
> Doctors must complete a section of the application, sign and attach a prescription. Patients must also complete a section and sign.
Supply
> Up to 90 day supply
Ship To
> Doctor's office
Note
> Wellbutrin XL IS NOT AVAILABLE FOR NEW PATIENTS. Call for information on the most recent medications as the list is subject to change.
 
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.
 
Targretin Capsules