Registered Users Log-in:

E-mail Address:
 

Password:
 

  
Forgot Password?
Registration
 
Patient Assistance Information

 
1 Program for Picato gel
 
 
Picato Co-Pay Program


,
Phone : 855-242-6936
Fax:
Eligibility
> Picato Co-Pay Program is a co-pay assistance program. Patients with Medicare Part D are not eligible. Income requirements for this program have not been disclosed. Patients must be 18 years of age or older and must be a US citizen.
Who Can Apply
> Patients can call or download from the website.
Required
> Doctor must provide the patient with a prescription. The patient will respond to a questions over the phone to determine eligibility.
Supply
> Patient presents voucher card to the pharmacy for each refill. Voucher can be used 6 times.
Ship To
> Not applicable
Note
> For patients with private health insurance, this card will cover up to $200 of your copay, or up to $250 of the cash price if you are not insured.
 
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.
 
Picato gel