| |
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 |
| |
| |
|
|