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Patient Assistance Information

 
 
 
Astellas Patient Assistance Program for Organ Transplant

PO Box 220708
Charlotte, NC 28222
Phone : 800-477-6472
Fax: 866-317-6235
Eligibility
> 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
> 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.
Required
> 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.
Supply
>
Ship To
> Patient's home
Note
> 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.
 
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.
 
Prograf (tacrolimus)