| |
SHARE Patient Assistance Program
|
,
Phone
:
(888)457-4273
Fax:
(877)742-1002
|
|
Eligibility
|
| > |
SHARE Patient Assistance Program is a program that provides brand name medications at no or low cost. Patients with insurance, including Medicare Part D are eligible for this program. Income requirements are based on the federal poverty level. Patients must have an FDA-approved diagnosis and must reside in the US. |
| Who Can Apply
|
| > |
Doctors must fax a referral for this program. |
|
Required
|
| > |
Doctors must fax a referral for this program and provided patient with prescription. Program will contact patient for information. A new application is needed yearly. |
|
Supply
|
| > |
Up to 30 day supply. Pharmacy will contact patient for refill. |
|
Ship To
|
| > |
Patients home |
|
Note
|
| > |
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.
|
| Sabril oral solution |
| Sabril tablet |
| |
| |
|
|