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Wyeth Oncology Reimbursement Program
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Wyeth Oncology Reimbursement Program
Lash Group
San Bruno, CA 94066
Phone
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(888) 638-6342
Fax:
(866) 836-0819
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Eligibility
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The patient must not have prescription coverage for the medication and have an income at or below 325% od the US Povertly Level. The patient must be under treatment from a US doctor. |
| Who Can Apply
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The doctor/doctor's office should call for an application. The application will be faxed out. The completed application must be mailed back. |
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Required
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The doctor must fill out a section, sign the application, and attach a prescription and a copy of the DEA or State License number. The patient must fill out a section, sign the application and attach proof of income.
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Supply
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Up to a 90-day supply is sent to the doctor's office. The doctor/doctor's office must contact the company to arrange refills. Once a year a new application with documentation is needed. |
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Ship To
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The medication is shipped to the doctor within 10 business days. Both the patient and doctor are notified in writing of acceptance or denial.
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Note
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The company also provides drug replacement if the insurance is denied and it is for an FDA-approved diagnosis. |
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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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| Mylotarg |
| Neumega |
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Printable Application Forms
Applications that patients can fill out and bring to their doctor.
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| Download printable Form Application Form |
(Requires Acrobat Reader) 
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