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Patient Assistance Information

Korlym Patient Assistance Program

149 Commonwealth Drive
Menlo Park, CA 94025
Phone : (855)456-7596
Fax: (877)858-7746
> This program is intended for patients that are uninsured. Medicare Part D patients are not eligible for this program. Household income must be at or less than $150,000 or Individual at or less than $75,000 & patient must reside in the US.
Who Can Apply
> Call for or download application which will be sent to the patient. Application must be returned by mail.
> Patient must complete section, sign, & attach copy of proof of income. Patient will be notified of decision.
> Up to 30 day supply. Refill process & limit not specified. Re-application process not specified.
Ship To
> Medication will be sent to patient's home.
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.
Korlym tablet
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
Download printable Form Korlym Patient Assistance Program
(Requires Acrobat Reader