rxhelp360.org
| Drug Information | ||||||||||
| Drug | Fabrazyme | |||||||||
| Generic Equivalent | agalsidase beta | |||||||||
| Topic | Fabry | |||||||||
| Program Contact Info / Application Submission | ||||||||||
| Program | The Charitable Access Program | |||||||||
| Company | GenzymePap | |||||||||
| Address | 500 Kendall St. Cambridge, MA 02142 | |||||||||
| Phone | 800-745-4447, opt 0, ext 16634 | |||||||||
| Fax | 617-768-9626 | |||||||||
| Program Details | ||||||||||
| Details | The medication is sent to either the doctor's office, or a specific site (clinic, hospital, infusion site etc.) in the amount requested. Refills are determined on a case-by-case basis; the patient or doctor must contact the company. | |||||||||
| Program Requirements | ||||||||||
| Information | The doctor must write a letter of intent to treat and a statement of medical necessity. The patient must fill out a section, sign the application and attach proof of income. | |||||||||
| Details | Proof of Income NOT required Letter from Doctor stating zero incomeNOT required as proof of income | |||||||||
| Delivery of Medication | ||||||||||
| Delivery Options | Can NOT be delivered directly to the doctor | |||||||||
| Application Process | ||||||||||
| App Process | The doctor, patient, social worker or patient advocate must call for a prescreening. The application is sent to the patient. The completed application must be mailed back. Both the patient and doctor are notified in writing of acceptance or denial. The decision is usually made within a month. | |||||||||
| New Applications | Patients can NOT apply directly to the program Doctors can NOT apply directly to the program Advocates can NOT apply directly to the program | |||||||||
| Eligibility | ||||||||||
| Eligibility | The patient must have no insurance and meet income guidelines that are not disclosed. The medication must be used for a FDA-approved diagnosis. The application is only sent out when it is determined that the referral is appropriate for the program. | |||||||||
| Other Medications | ||||||||||
| Other Medications available in this program |
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