| |
MyPraluent
|
MyPRALUENT
1670 Century Center Parkway
Memphis, TN 38134
Phone
:
844-772-5836
Ext 1
Fax:
844-872-5447
|
|
Eligibility
|
| > |
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. |
|
Required
|
| > |
Patients and doctors must each complete a section and sign the application. The application must then be faxed from the doctor's office. |
|
Supply
|
| > |
As prescribed by Doctor |
|
Ship To
|
| > |
Patient's home |
|
Note
|
| > |
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) 
|
| |
|
|