Registered Users Log-in:

E-mail Address:
 

Password:
 

  
Forgot Password?
Registration
 
Patient Assistance Information

 
1 Program for Altera Nebulizer for Cayston nebulizer system
 
 
Cayston Patient Assistance Program

po bOX 13185
La Jolla, CA 92039
Phone : (877)722-9786
Fax: (877)550-1705
Eligibility
> This program is intended for patients that are uninsured. Medicare Part D patients are not eligible for this program. Income based on FPL. Must be a US resident.
Who Can Apply
> Call to have application faxed or mailed. Return application via fax or mail. Patient must complete application, sign and attach proof of income.
Required
> Medically appropriate condition/diagnosis required. Doctor must complete and sign application.
Supply
> Up to 1 month supply. Patient contacts pharmacy. Refill limit not specified. Re-application process not specified. Patient and Doctor notified in writing of decision in 3-5 business days.
Ship To
> Ships to Patient's home, unless otherwise noted within 2 business days.
Note
>
 
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.
 
Altera Nebulizer for Cayston nebulizer system