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Patient Assistance Information

 
1 Program for Akynzeo capsule
 
 
Eisai Assistance Program (Akynzeo)

2730 S. Edmonds Lane
Suite 300
Lewisville, TX 75067
Phone : (855)347-2448
Fax: (844)494-8063
Eligibility
> Insurance requirements are determined case by case, this includes Medicare part D Patients. Income requirements for this program have not been disclosed. Patient must be a US citizen or legal resident.
Who Can Apply
> Call for application to be faxed or download from website. Application is to be faxed back to company. Patient and Doctor will be notified of decision.
Required
> Must have medically appropriate condition/diagnosis. Doctor must complete application, sign and attach brand name prescription. Patient must complete application, sign and attach proof of income.
Supply
> Amount as prescribed by Doctor. Contact company for refills, which are determined case by case. Refill limit & re-application process not specified.
Ship To
> Medication is sent to Doctor's office or specific site in 1-3 business days.
Note
>
 
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.
 
Akynzeo capsule