Copaxone Patient Assistance Program
Teva Neuroscience, I
Contact Information
Shared Solutions
901 East 104th Street
Suite 900
Kansas City, MO 64131
1-(800) 887-8100 (phone)
Shared Solutions
901 East 104th Street
Suite 900
Kansas City, MO 64131
1-(800) 887-8100 (phone)
How to Apply:
Select one of the links below to download the application or go to the program site for more information on how to apply. Once you fill out your application, send it to the address on the application. Do NOT send it to RxResource.
Select one of the links below to download the application or go to the program site for more information on how to apply. Once you fill out your application, send it to the address on the application. Do NOT send it to RxResource.
- Click here to visit the program's web site.
- Copaxone®
Eligibility:
Each case is reviewed individually, but is based on patient's income and lack of perscription coverage. The patient is given assitance up from 25%-100% for one year.
Each case is reviewed individually, but is based on patient's income and lack of perscription coverage. The patient is given assitance up from 25%-100% for one year.
Other Information:
The patient must fill out a section about financial and insurance information. The patient may be required to provide proof of income. The patient also needs to sign the application.
The patient must fill out a section about financial and insurance information. The patient may be required to provide proof of income. The patient also needs to sign the application.
Product(s) covered by program:
