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Patient Assistance Information

 
1 Program for Xenazine tablet
 
 
Xenazine Information Center

PO Box 8725
Gaithersburg, MD 20898
Phone : 888-882-6013
Fax: 866-341-5601
Eligibility
> Xenazine Information Center is a program that provides brand name medications at no or low cost. Insurance requirements are determined on a case by case basis. Income requirements for this program are not disclosed. Diagnosis and residency requirements have not been specified.
Who Can Apply
> Patients and doctors can call or download the application.
Required
> Doctors and patients must complete and sign the application and fax it back.
Supply
> Varies
Ship To
> Patient's home, doctor's office, hospital or pharmacy.
Note
> Depending on insurance coverage, REACH (Resources, Education and Access for patients with Chorea associated with Huntington's disease) offers a variety of services: Information Center, Starter Rx prescription supply, Copay/Co-Insurance Assistance and Patient 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.
 
Xenazine tablet
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form
(Requires Acrobat Reader