Drug:

 
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)