rxhelp360.org
| Drug Information | ||||||||||
| Drug | Activase 50mg Vial | |||||||||
| Generic Equivalent | alteplase | |||||||||
| Class | Anticoagulant | |||||||||
| Topic | Cardio | |||||||||
| Program Contact Info / Application Submission | ||||||||||
| Program | Genentech Access to Care Foundation TNKase, Cathflo, Pulmozyme | |||||||||
| Company | GenentechAcc | |||||||||
| Form | Download PDF | |||||||||
| Address | 1 DNA Way, Mail Stop 210 South San Francisco, CA 94080 | |||||||||
| Phone | 800-690-3023 | |||||||||
| Fax | 650-225-1366 | |||||||||
| Program Details | ||||||||||
| Details | The medication is sent to the doctor's office, hospital or pharmacy. | |||||||||
| Program Requirements | ||||||||||
| Information | The hospital contact or doctor must fill out the application and verify the patient's financial situation. The patient must inform the doctor that s/he is in need. | |||||||||
| Details | Proof of Income required | |||||||||
| Delivery of Medication | ||||||||||
| Delivery Options | Can be delivered directly to the doctor | |||||||||
| Application Process | ||||||||||
| App Process | Someone from the hospital must call for an application. The application will be faxed out. The completed application must be faxed back. | |||||||||
| Eligibility | ||||||||||
| Eligibility | This program is based on guidelines that are not disclosed. This is a drug replacement program. If the patient is eligible for Part D but does not enroll then s/he still may be eligible for this program. | |||||||||
| Other Medications | ||||||||||
| Other Medications available in this program |
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