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Patient Assistance Information

 
 
 
Campath Distribution Program


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Phone : 877-422-6728
Fax:
Eligibility
> Insurance requirements for this program are not specified, this includes Medicare PartD.
Who Can Apply
> Doctor/Doctor's office must call to have application faxed to Doctor's office. Application must be faxed or mailed back to company from Doctor's office.
Required
> Doctor must complete section and sign. Patient must inform Doctor that he/she is in need. Doctor will be notified of decision.
Supply
> Amount/supply not specified. Refill process and limit not specified. Re-application process not applicable.
Ship To
> Not specified.
Note
> The Doctor must contact the program to place an order.
 
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.
 
Campath injection