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Patient Assistance Information

1 Program for Praluent disposal container

1670 Century Center Parkway
Memphis, TN 38134
Phone : 844-772-5836 Ext 1
Fax: 844-872-5447
> Patients must be uninsured or underinsured. Income requirements for this program have not been disclosed. Patients must have a medically appropriate condition/diagnosis and must reside in the US, Puerto Rico or the USVI.
Who Can Apply
> Patients or healthcare providers can call to have an application faxed to the doctor's office or they can download one.
> Patients and doctors must each complete a section and sign the application. The application must then be faxed from the doctor's office.
> As prescribed by Doctor
Ship To
> Patient's home
> Insurance benefits, claims assistance and/or other reimbursement help is offered. This program also provides copay assistance. Additional resources available, including a puncture-resistant sharps disposal container and a PRALUENT Travel Kit.
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.
Praluent disposal container
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
Download printable Form
(Requires Acrobat Reader