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Patient Assistance Information

 
 
 
GSK Reimbursement Resource Center

PO Box 221425
Charlotte, NC 28222
Phone : (800)745-2967
Fax: (866)216-5292
Eligibility
> May have insurance. Medicare PartD determined case by case. Income requirements for this program have not been disclosed. Must be a US resident.
Who Can Apply
> Call to have application faxed or download from website. Return application via fax.
Required
> Medically appropriate condition/diagnosis required. Patient must complete and sign application.
Supply
> Amount/supply not specified. Refill process and limit not specified. Re-application process not specified.
Ship To
> Shipping location not specified.
Note
> This program helps patients and healthcare professionals in the U.S. with coverage, reimbursement and coding issues for certain GSK products. Services include verification of benefits, and assistance with prior authorization processes, denied or underpaid claims, coding issues, and alternate funding research.
 
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.
 
Advair Diskus powder; inhalation
Advair HFA aerosol; inhalation
Anoro Ellipta powder; inhalation
Avandia tablet
Avodart capsule; softgel
Bactroban
Bactroban cream; topical
Beconase AQ spray; nasal
Breo Ellipta powder; inhalation
Coreg CR capsule; extended release
Duac gel; topical
Fabior aerosol; foam
Flovent Diskus powder; inhalation
Imitrex spray; nasal
Incruse Ellipta powder; inhalation
Jalyn capsule
Lamictal CD tablet; chewable dispersible
Lamictal ODT patient titration kit
Lamictal starter kit
Lamictal tablet
Lamictal tablet; orally disintegrating
Lamictal XR tablet; extended release
Lovaza capsule
Malarone tablet
Mepron oral suspension
Potiga tablet
Relenza powder; inhalation
Requip XL tablet; extended release
Rythmol SR capsule; extended release
Serevent Diskus powder; inhalation
Soriatane capsule
Tanzeum injection
Ventolin HFA
Veramyst spray; nasal