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Astellas Patient Assistance Program for Organ Transplant
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PO Box 220708
Charlotte, NC 28222
Phone
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800-477-6472
Fax:
866-317-6235
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Eligibility
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The patient must meet income and insurance guidelines that are not disclosed. Patients with Medicare and Medicare Part D that are in the donut hole may qualify for assistance. |
| Who Can Apply
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This program will work with the patient and transplant team to complete the application process. The person who starts the process needs to have patient's diagnosis/transplant information, insurance information, health care provider information, and transplant doctor's name and phone number. |
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Required
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The doctor needs to sign the application and provide patient prescription information.The patient needs to sign the application and provide proof of income, expenses and asset information. |
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Supply
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Ship To
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Patient's home |
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Note
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This program will work with the patient and transplant team to complete the application process. The person who starts the process needs to have patient's diagnosis/transplant information, insurance information, health care provider information, and transplant doctor's name and phone number. |
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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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| Prograf (tacrolimus) |
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