Registered Users Log-in:

E-mail Address:
 

Password:
 

  
Forgot Password?
Registration
 
Patient Assistance Information

 
1 Program for mechlorethamine injection
 
 
Recordati Reimbursement Hotline

PO Box 4280
Gaithersburg, MD 20885
Phone : (866)209-7604
Fax: (866)209-7599
Eligibility
> Insurance requirements have not been specified and income requirements have not been disclosed for this program. Patients must have an FDA-approved diagnosis and be a US resident.
Who Can Apply
> The doctor or doctor's office must call for a prescreening.
Required
> The doctor must complete a section of the application and sign. The patient must complete a section, sign, attach proof of income and any insurance information. The application must then be faxed or mailed
Supply
> Up to 90 day supply
Ship To
> Doctor's office
Note
> Insurance benefits, patient assistance, claims assistance and/or other reimbursement help is offered. Applicant must attach proof of income for all adults in the household.
 
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.
 
mechlorethamine injection