AIDS Treatment Data Network
611
Broadway, Suite 613, New York, NY, 10012 • www.atdn.org • Tel: (212) 260-8868 • (NYS) 800-734-7104
| The Access Project collects and distributes information about medications available for HIV/AIDS and hepatitis co-infection through Medicaid, Medicare Part D, AIDS Drug Assistance Programs (ADAPs), and pharmaceutical industry sponsored patient assistance and expanded access programs (EAP). The Access Project is a program of the The Network (network@atdn.org) |
Hoffman-LaRoche
Patient Assistance Program
Products covered:
Bactrim (TMP/SMX)
Copegas (ribavirin)
Cytovene (ganciclovir)
Fortovase, Invirase (saquinavir)
HIVID (zalcitabine, ddC)
Klonopin (clonazepam)
Kytril (granisetron)
Pegasys (pegylated interferon alfa 2a)
Rocephin (ceftriaxone)
Roferon A (alpha interferon)
Valcyte (valganciclovir)
| Contact | 1-800-443-6676
www.rocheusa.com/programs/patientassist.asp
|
|
| Program Eligibility |
The patient must meet the following criteria to qualify:
- Must be a U.S. citizen.
- Has no health insurance or no prescription coverage.
- Not eligible for Medicaid, ADAP, or other drug assistance programs.
- Income is less than 300 % of the Federal Pverty Level.
|
| Enrollment Process |
To receive an application the doctor or patient must call. If the enrollee is not insured they can expect a faxed application within 24-hours. If the enrollee is insured this process will be delayed by confirmation of the insurance status. Proof of income such as a tax return or a w-2 must be provided.
|
|
| Re-Application |
At the end of a 90-day cycle a new application will need to be filled out. Assuming nothing has changed re-application should be easier than initial application.
|
|