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Patient Assistance Information

 
2 Programs for Aptiom tablet
 
 
Sunovion ProFile (FOR HEALTHCARE PROFESSIONAL ONLY)
84 Waterford Drive
Marlborough, MA 01752
Phone : 888-394-7377
Fax:
Eligibility
> Patients must meet income requirements that have not been disclosed, have a medically appropriate diagnosis/condition and be treated by a US doctor.
Who Can Apply
> Not specified
Required
> Patients must inform their doctor that they are in need. Doctors must determine if the patient is truly in need.
Supply
> Not specified
Ship To
> Not specified
Note
> HEALTHCARE PROFESSIONAL MUST REGISTER.
 
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.
 
Aptiom tablet
 
 
 
Sunovion Support Prescription Assistance Program (Aptiom)
PO Box 220285
Charlotte, NC 28222
Phone : (877)850-0819
Fax: 877-850-0821
Eligibility
> Patients must have no prescription coverage for the needed medication, be at or below 300% of the Federal Poverty Level, must reside in the US, Puerto Rico or USVI and must provide a diagnosis code.
Who Can Apply
> Patients or healthcare providers can call to have an application mailed or it can be downloaded.
Required
> Doctors must complete a section of the application and sign. Patients must also complete a section of the application, sign and attach proof of income.
Supply
> 30 day supply
Ship To
> Pharmacy
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.
 
Aptiom tablet