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Patient Assistance Information

 
 
 
The Free Drug Program

5000 Davis Drive
P.O. Box 13919
Morrisville, NC 27709
Phone : (800)456-2255
Fax: (877)301-5140
Eligibility
> Patients must be uninsured or underinsured. Patients enrolled in Medicare Part D may be eligible. Patients must reside in the U.S. and have a relapsing form of MS. Income guidelines are not disclosed.
Who Can Apply
> Applicants must call for a prescreening. There is no application for this program.
Required
> Doctor's must fax in a copy of a prescription. The patient must provide information and proof of income. The decision will be made during the phone screening.
Supply
> For Avonex: up to a 90-day supply of the medication is sent. For Tysabri: a one month supply is sent.
Ship To
> Avonex will be shipped to the doctor's office or the patient's home. Tysabri will be sent to the doctor's office or site of care for administration of the infusion.
Note
> The company will contact the patient to arrange refills and also regarding the re-application procedure. Insurance benefits, claims assistance and/or other reimbursement help is offered.
 
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.
 
Avonex (interferon beta-1a)
Avonex Injection
Tysabri IV Infusion (natalizumab)