|
MS LifeLines Patient Assistance Program
|
,
Phone
:
877-447-3243
Fax:
866-227-3243
|
Eligibility
|
> |
The patient must have no prescription coverage, have reached his/her cap or cannot afford the co-payments and meet income guidelines that are not disclosed. |
Who Can Apply
|
> |
The patient must call for a prescreening. |
Required
|
> |
The doctor/doctor's office must fax a prescription to the company.The patient must fill out a section, sign the application and attach proof of income. |
Supply
|
> |
|
Ship To
|
> |
Patient's home |
Note
|
> |
The patient must call for a prescreening. |
|
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. |
Rebif |
|
|
|