| |
Supprelin LA Shares Program
|
PO box 2910
Phoenix, AZ 85062
Phone
:
(855)270-0123
Fax:
(888)882-4037
|
|
Eligibility
|
| > |
Insurance requirements are determined case by case. Medicare partD patient's are not eligible for this program. Income requirements are not disclosed. Must be a US resident and treated by a US doctor. Patient over the age of 18 are not eligible. |
| Who Can Apply
|
| > |
Doctor/Doctor's office must call for faxed application, download application from website or apply online. Application is to be returned via fax. Patient and Doctor will are notified of decision. |
|
Required
|
| > |
Must have diagnosis of Central Precocious Puberty (CPP). Patient must inform Doctor that he/she is in need of medication and the Doctor's office must complete application. |
|
Supply
|
| > |
Amount/supply varies. Refill process & limit not specified. Re-application process not specified. |
|
Ship To
|
| > |
Medication will be shipped to Hospital, medical center, or specialty pharmacy. |
|
Note
|
| > |
Resources for HEALTHCARE PROFESSIONALS ONLY.
The SUPPRELIN LA Support Center Representative will help arrange the services needed to begin therapy. |
| |
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.
|
| Supprelin LA implant; subcutaneous |
| |
| |
|
|