| Pharmaceutical Company | Pharmacia & Upjohn |
| Program Address | Pharmacia Patients in Need Program P.O. Box 52059 Phoenix, AZ 85072 |
| Toll Free Phone Number | 800-242-7014 (1) |
| Fax Number | 480-314-7163 |
| Guidelines and Notes | Call 800 number to discuss patient eligibility, 9AM-8PM EST, M-F. Program will provide immediate assistance. Patients must live in the US, not a territory. This is a high profile program; the company wants to be known as reaching out to those who are falling through the cracks. They also have assistance available to help with reimbursement issues (e.g., denials, coverage, billing) for Oncology products (1-800-808-9111, 8:30-5:30 EST, M-F); Rescriptor (1-800-711-0807, 9-6pm EST M-F) and Genotropin (1-800-645-1280, 24 hr. line). Genotropin is available through Bridge Program during period where insurance claim is being resolved. Patients in Need is program is for those with short-term financial hardship and no other funding sources. |
| Initiating Enrollment | Patient or advocate calls and requests application. The application must be completed by patient and prescriber. Then either the physician, patient or advocate calls the 800 number and reviews the information. |
| Health Provider's Role | They will ask for the certificate number on the application; if the applicant is approved, a 30 day supply will be immediately authorized for the certificate. |
| Patient's Role | Complete patient section of application which asks for income, out-of-pocket medical expense and insurance information. Patient takes certificate to pharmacy with prescription. and sends in completed application. $5 co-pay |
| How Dispensed | Using coupon or card at pharmacy; some drugs on program are still shipped to the prescriber. |
| Amo unt Dispensed | n/a |
| Refills | Not specified |
| Limit | Not specified. |