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Extavia Go Program
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Customer Interaction CenterNovartis
Pharmaceuticals Corporation
East Hanover, NJ 07936
Phone
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(866)925-2333
Fax:
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Eligibility
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This program provides brand name medications at no or low cost. Patient insurance status will be considered on a case by case basis. Patients with Medicare Part D 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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Patients or doctors can call to have an application faxed or mailed. |
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Required
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Doctors must complete and sign a section of the application. Patients also complete a section of the application, sign, attach proof of income and attach any insurance information. 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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Card obtained from doctor's office |
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Note
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Eligibility determined on a case-by-case basis. |
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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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| Extavia injection |
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