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Patient Assistance Information

 
1 Program for Kalbitor injection
 
 
Pathways 360


,
Phone : (888)452-5248
Fax: (888)806-4829
Eligibility
> This program is intended for patients that are uninsured. Medicare Part D patients are not eligible for this program. Must have FDA-approved diagnosis.
Who Can Apply
> Call to have application faxed or download from the website. Application is to be faxed back to company.
Required
> Must be treated by US licensed healthcare provider and use a US pharmacy. Doctor must complete application, sign, and attach required documents.
Supply
> Amount not specified. Refill process & limit not specified. Re-application process not specified.
Ship To
> Shipping location and delivery time not specified.
Note
> Insurance benefits, claims assistance, and/or other reimbursement help is offered.
 
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.
 
Kalbitor injection
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form Pathways 360
(Requires Acrobat Reader