Program Contact Info / Application Submission
Program	ACT (Accessing Coverage Today) for EMEND
Company	Merck & Company, Inc.
Form	Download PDF
Address	PO Box 18979 Louisville, KY 40261-0979
Phone	1-866-363-6379 (open M-F 8-8 EST)
Fax	1-866-363-6389
Website	www.emend.com/aprepitant/emend/hcp/managed_care_info/index.jsp
Program Details
Details	Patients in need who appear not to qualify should still call. Must send in new application every 12 months.
Program Requirements
Information	Doctor and patient must fill out respective portions of the application. NO separate prescription is required.
Delivery of Medication
Ship Time	48-72 hours
Delivery Options	Can be delivered directly to the patient Can be delivered directly to the doctor
Application Process
App Process	Both the patient and doctor will be notified of acceptance into the program.
New Applications	New applications accepted Patients can apply directly to the program Doctors can apply directly to the program Advocates can apply directly to the program Can apply for a new application via phone Can apply for a new application via fax Can apply for a new application via mail
Refills	Refills accepted Patients can apply for refills Doctors can apply for refills Advocates can apply for refills
Eligibility
Eligibility	The patient must not have insurance or other coverage options for EMEND. The Patient must not be able to afford to pay for EMEND, based on established criteria and the applicant's financial situation. Eligibility criteria will be based on the patient's net household income, geographic location, the number of people in the household, and the household out-of-pocket medical expenses (that are deducted from net income). The patient must live in the United States (but does not have to be a US citizen) and have a prescription for EMEND from a healthcare professional licensed in the United States.
Other Medications
Other  Medications  available in  this program	EMEND - Nausea (Generic: aprepitant)