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Cosentyx Connect Personal Support Program
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Phone
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(844)267-3689
Fax:
(844)666-1366
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Eligibility
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This program provides brand name medications at no or low cost. Insurance status will be covered on a case by case basis. Medicare Part D recipients will be considered on an exception basis. Income requirements for this program have not been disclosed. Patients must have an FDA-approved diagnosis and be a US resident. |
| Who Can Apply
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Doctors or Patients can obtain an application by calling and having one faxed to them. |
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Required
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Doctors must complete and sign a section of the application. Patients must complete, sign and attach required documents. The application can then be faxed or mailed. |
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Supply
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Varies |
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Ship To
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Not specified |
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Note
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Eligibility determined on a case-by-case basis.
Contact program for more details on copay assistance, the sharps container mail-back program and injection training. |
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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.
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| Cosentyx injection |
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Printable Application Forms
Applications that patients can fill out and bring to their doctor.
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| Download printable Form |
(Requires Acrobat Reader) 
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