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Patient Assistance Information

 
1 Program for Frova Tablet
 
 
Endo Patient Assistance Program

PO Box 66761
St. Louis, MO 63166-6761
Phone : 866-824-4747
Fax: 800-889-0353
Eligibility
> The patient must have no prescription coverage for the requested medication and have an income at or below 200% of the FPL. Medicare partD Patient's are eligible if medication is not covered. The patient must also be a US resident.
Who Can Apply
> Call for application to be faxed. Application must be faxed or mailed back to company from Doctor's office. Patient and Doctor will be notified by mail of decision in 5-7 business days.
Required
> The doctor must fill out a section and sign the application.The patient must fill out a section, sign the application and attach proof of income.
Supply
> Up to a 90-day supply. Doctor/Doctor's office must contact company for refills. Refill limit not specified. New application must be completed every 3 months.
Ship To
> Medication is shipped to Doctor's office within 2 weeks.
Note
> No online application available.
 
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.
 
Frova Tablet