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Patient Assistance Information

 
 
 
Sunovion Support Prescription Assistance Program (Aptiom)

PO Box 220285
Charlotte, NC 28222
Phone : (877)850-0819
Fax: 877-850-0821
Eligibility
> Patients must have no prescription coverage for the needed medication, be at or below 300% of the Federal Poverty Level, must reside in the US, Puerto Rico or USVI and must provide a diagnosis code.
Who Can Apply
> Patients or healthcare providers can call to have an application mailed or it can be downloaded.
Required
> Doctors must complete a section of the application and sign. Patients must also complete a section of the application, sign and attach proof of income.
Supply
> 30 day supply
Ship To
> Pharmacy
Note
>
 
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.
 
Aptiom tablet