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| Drug Information |
| Drug | Revlimid capsule | | Generic Equivalent | lenalidomide | | |
| Program Contact Info / Application Submission |
| Program | Celgene Therapy Assistance Program | | Company | Celgene | | Form | Download PDF | | Address | 6900 College Blvd. Suite 1000 Overland Park, KS 66211 | | Phone | 888-423-5436, #3 | | Fax | 800-822-2496 | | |
| Program Details |
| Details | The medication is sent to the doctor's office. The doctor/doctor's office must contact the company to arrange refills. The company will contact the patient regarding reapplication | | |
| Program Requirements |
| Information | The doctor must fill out a section and sign the application. The patient must fill out a section and sign the application.
| | Other Requirements | Must include copies of insurance cards is applicab | | |
| Delivery of Medication |
| Ship Time | 24-48hrs | | |
| Application Process |
| App Process | Anyone requesting assistance can call to request a faxed application or download it from the website. The application will be faxed out. The completed application can be faxed or mailed back. Both the patient and doctor are notified of acceptance into the program. The decision is usually made within 48 hours.
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| Eligibility |
| Eligibility | The patient must have no prescription coverage for the requested medication and meet income guidelines that are not disclosed. For refills of Revlimid, new prescriptions must be faxed to 866-294-1557. For refills of Thalomid, new prescriptions must be faxed to 888-432-9325.
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| Other Medications |
Other
Medications
available in
this program | |
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