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Patient Assistance Information

 
1 Program for Auryxia tablet
 
 
Keryx Patient Plus Program

PO Box 877
Somerville, NJ 08876
Phone : (855)686-8601
Fax: (866)310-7424
Eligibility
> The Keryx Patient Plus Program provides brand name medications at no or low cost. Patients must have no insurance or prescription coverage. For patients with Part D coverage, a determination will be made on a case by case basis. Patients must be above 150% and at or below 300% of the Federal Poverty Level. This medication must be determined as medically necessary by a doctor. Patients must be a US citizen or legal resident.
Who Can Apply
> Patients or doctors can call or download the application.
Required
> Patients and doctors must complete and sign the application and fax, email or mail with required documents. A new application is needed yearly.
Supply
> Up to a 1 month supply.
Ship To
> Not specified.
Note
> This program also provides co-pay and reimbursement assistance.
 
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.
 
Auryxia tablet
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form
(Requires Acrobat Reader