Registered Users Log-in:

E-mail Address:
 

Password:
 

  
Forgot Password?
Registration
 
Patient Assistance Information

 
3 Programs for Campath
 
 
Berlex Oncology CamCare Program

Berlex Oncology CamCare Program
PO Box 221289
Charlotte, NC 28222-1289
Phone : (800) 473-5832
Fax: (800) 513-1824
Eligibility
> Patient must be physicially residing in the US or its territories and must be ineligible for third party prescription coverage.
Who Can Apply
> Anyone may call to initiate application process.
Required
> Completed application with original signatures is required.
Supply
> As requested by physician.
Ship To
> Physician's office.
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.
 
Campath
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form Application Form
(Requires Acrobat Reader
 
 
Patient Access Network Foundation (PAN)

PO Box 221858
Charlotte, NC 28222
Phone : (866)316-7263
Fax: (866)316-7263
Eligibility
> This is a copay assistance program for patients that have health insurance. The patient's insurance must cover the qualifying medication that they are seeking assistance for. Patient with Medicare Part D will be considered on a case by case basis. Patients must be at or below 400-500% of the federal poverty level, must have a medically appropriate diagnosis/condition and must reside and receive treatment in the US.
Who Can Apply
> Patients or healthcare providers can complete the application online or by phone.
Required
> Patients must call for information or inform their doctor that they are in need. Doctors action will be discussed with the patient and doctor after the request is received.
Supply
> Not applicable
Ship To
> Patient sent card to be used at pharmacy
Note
> *Patients must have health insurance and their insurance must cover the qualifying medication for which they seek assistance. Call for most recent medications as the list is subject to change and the medication for which you are seeking assistance must treat the disease directly. Note: All new enrollment is now done electronically or over the phone. Contact program for details.
 
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.
 
Campath
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form
(Requires Acrobat Reader
 
 
REACH (Resources for Expert Assistance and Care Helpline)

PO Box 221289
Charlotte, NC 28222-1289
Phone : 877-322-4448
Fax: 866-639-5181
Eligibility
> The patient may be uninsured or be insured but experiencing difficulty accessing the medications. the patient must also also have limited financial resources.
Who Can Apply
> With the patient's permission, anyone concerned can call for an application.
Required
> The doctor must complete the appropriate section and sign the application.The patient must also complete, sign the application and attach proof of income.
Supply
>
Ship To
> Doctor's office
Note
> With the patient's permission, anyone concerned can call for an application.
 
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.
 
Campath
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form Application Form
(Requires Acrobat Reader