Prescription Assistance


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Stock Replacement Program - Mycamine-Astellas Pharma US Inc.

PO Box 22708
Charlotte, NC - 28222
1-(800) 477-647

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Program Elegibility

The patient must meet insurance guidelines that are not disclosed and meet income guidelines that are not disclosed. This is a product replacement program, so the drug was already used by the facility for a specific patient. The doctor, social worker, or physician office staff must call to pre-screen the patient for enrollment. A pre-filled application is sent to the provider's office, which must be reviewed for accuracy and the physician's signature. The patient's financial documents must be attached to the completed application too. The application can be faxed or mailed back. Once the completed application is received and processed, drug is shipped to the provider within 10 business days.

Details

Mycamine is used in the inpatient hospital, outpatient hospital, physician office, infusion clinic, and home health setting of care. The medication is sent to the doctor's office. A new application is needed for each request.