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Patient Assistance Information

 
2 Programs for Isentress tablet
 
 
Merck Connect


,
Phone : 800-489-5119
Fax:
Eligibility
> This program is for healthcare professionals only. Patient eligibility will be determined on a case by case basis. Income requirements for this program have not been disclosed. The medication must be medically necessary as determined by a doctor. The patient must be treated by a US licensed healthcare professional.
Who Can Apply
> Patients can enroll online.
Required
> Doctors must enroll in the program. Patients must inform their doctor that they are in need.
Supply
> Up to a 30 day supply.
Ship To
> Not specified
Note
> Resources for HEALTHCARE PROFESSIONALS ONLY. The Physician must register to access tools and materials for patient support, product sample requests, up-to-date professional resources, and other Merck professional sites.
 
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.
 
Isentress tablet
 
 
 
SUPPORT Program for Isentress

SUPPORT Program
PO Box 305
San Bruno, CA 94066
Phone : 800-850-3430
Fax: 866-410-1913
Eligibility
> This program provides brand name medications at no or low cost to patients. Patients with insurance are eligible and Medicare Part D recipients will be considered on an exception basis. Patients must be at or below 500% of the federal poverty level. They must also live in the US and have a prescription from a US licensed doctor.
Who Can Apply
> Anyone interested in the program can call or download an application.
Required
> Doctors and Patients must complete and sign their portions of the application and it can returned by mail.
Supply
> Varies
Ship To
> Doctor's office or patient's home
Note
> nsurance benefits, claims assistance and/or other reimbursement help is offered. Exceptions to guidelines considered. This Program participates in the CPAPA. This single common application allows uninsured HIV-positive individuals with low incomes to use one application to apply for multiple assistance programs. IMPORTANT: Send completed CPAPA to the corresponding addresses listed for each company.
 
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.
 
Isentress tablet
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form
Download printable Form
(Requires Acrobat Reader