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Cephalon Patient Assistance Program
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Gabitril Patient Assistance Program c/o InTeleCenter
P.O. Box 4280
Gaithersburg, MD 20885-4280
Phone
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(866) 209-7589
Fax:
(866) 209-7596
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Eligibility
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Eligibiltiy is based on income, insurance coverage and diagnosis. |
| Who Can Apply
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Physician's office only |
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Required
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Proof of income is required |
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Supply
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Coupon for 90 day supply |
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Ship To
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Coupon mailed to patient's home and confirmation letter sent to physician |
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Note
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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.
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| Gabitril (tiagabine hydrochloride) |
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