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Patient Assistance Information

 
1 Program for Supprelin LA implant; subcutaneous
 
 
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