Patient Assistance Program for Organ Transplant
Astellas Pharma US I
Contact Information
Astellas Patient Assistance Program for Organ Transplant
Astellas Reimbursement Services
P.O. Box 220708
Charlotte, NC 28222-0708
1-(800) 477-6472 (phone)
1-(866) 317-6235 (fax)
Astellas Patient Assistance Program for Organ Transplant
Astellas Reimbursement Services
P.O. Box 220708
Charlotte, NC 28222-0708
1-(800) 477-6472 (phone)
1-(866) 317-6235 (fax)
Physician requests should be directed to:
1-(800) 477-6472 (phone)
1-(800) 477-6472 (phone)
Eligibility:
In order to be enrolled in the PAP for Organ Transplant, the patient must meet certain eligibility requirements in the following areas: 1. US residency 2. Indication for which patient was prescribed Prograf 3. Household income and financial resources Astellas Reimbursement Services will work with the patient and their transplant team to complete the application process. Please have the following information: 1. Patient's diagnosis/transplant information 2. Insurance information 3. Healthcare provider information 4. Transplant doctor's name and phone number A pre-filled application will be sent to the doctor's office. The patient or provider must return the completed application along with proof of income, expenses, and asset information to Astellas Reimbursement Services. Once the required documents are received a decision is made if the patient qualifies for assistance.
In order to be enrolled in the PAP for Organ Transplant, the patient must meet certain eligibility requirements in the following areas: 1. US residency 2. Indication for which patient was prescribed Prograf 3. Household income and financial resources Astellas Reimbursement Services will work with the patient and their transplant team to complete the application process. Please have the following information: 1. Patient's diagnosis/transplant information 2. Insurance information 3. Healthcare provider information 4. Transplant doctor's name and phone number A pre-filled application will be sent to the doctor's office. The patient or provider must return the completed application along with proof of income, expenses, and asset information to Astellas Reimbursement Services. Once the required documents are received a decision is made if the patient qualifies for assistance.
Other Information:
If the patient is eligible for assistance, a letter will be sent to the patient and provider confirming the enrollment. Drug will be sent directly to the patient at no cost in approximately 1 week.
If the patient is eligible for assistance, a letter will be sent to the patient and provider confirming the enrollment. Drug will be sent directly to the patient at no cost in approximately 1 week.
Product(s) covered by program:
- Prograf
