| Pharmaceutical Company | Aventis Oncology Pact Program |
| Program Address | Aventis Pact Program 1101 King St. Suite 600 Alexandria VA 22314 |
| Toll Free Phone Number | 800-996-6626 |
| Alternate Phone Number | n/a |
| Fax Number | 800-996-6627 (for reorders) |
| Guidelines and Notes | Call 9-5 Central Standard Time, Monday through Friday. Patient's income must be less than 250% of federal poverty guidelines: Below $20,125 for household of one; $27,125 for household of two. The program is for labelled indication of the drug, if not being used for that they must request an exception through the drug manufacturer; this will take about a week longer. |
| Initiating Enrollment | Doctor or office calls to register patient by phone, then form sent. Patient specific application is generated is patient and doctor specific. |
| Health Provider's Role | Doctor completes, signs -- prescribing information is on the application. Application must be mailed. |
| Patient's Role | Patient signature not required. |
| How Dispensed | Sends medicine to doctor's office. |
| Amount Dispensed | Approval within 48 hours. 60 day supply -- Either 2 oral doses or an IV and an oral dose per chemo visit as specified under FDA approved use. |
| Refills | Doctor calls, completes and faxes refill request for each additional 60 day supply. If prescription has changed, reorder must be mailed in.. |
| Limit | Indefinitely |