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Patient Assistance Information

 
1 Program for Neulasta® (pegfilgrastim)
 
 
The Safety Net Foundation

PO Box 18769
Louisville, KY 40261
Phone : 888-762-6436
Fax: (866)549-7239
Eligibility
> Eligible patients must be U.S. residents, demonstrate financial need, and have no or limited drug coverage. Qualifying Medicare Part D patients may also be eligible.
Who Can Apply
> The doctor/doctor's office should call for an application.
Required
>
Supply
> The replacement model applies to physician-administered medications that are covered under the patient's medical benefit. Providers administer Amgen product from their stock to qualifying patients and then order replacement from the foundation. Foundation products included are Aranesp®, EPOGEN® for dialysis only, Neulasta®, NEUPOGEN®, Nplate®, Prolia® injection, Vectibix® injection, and XGEVA®. These products must be administered in an outpatient setting.
Ship To
> Doctor's office
Note
> Go to www.safetynetfoundation.com for forms and tip sheets for enrollment.
 
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.
 
Neulasta