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Roche Oncoline Patient Assistance Program
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P.O. Box 18647
Louisville, KY 40261
Phone
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(888)249-4918
Fax:
(888)249-4919
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Eligibility
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The patient must have no prescription coverage, have reached his/her cap or cannot afford the co-payments and meet income guidelines that are not disclosed. |
| Who Can Apply
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The doctor, patient, social worker or patient advocate must call for a prescreening. |
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Required
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The doctor must fill out a section, sign the application and attach a prescription for 90 days.The patient must fill out a section, sign the application and attach proof of income. |
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Supply
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Up to a 90-day supply is sent to the doctor's office or the patient's home. |
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Ship To
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Either Doctor's office or Patient's home |
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Note
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The doctor, patient, social worker or patient advocate must call for a prescreening. |
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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.
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| Roferon A Injection |
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