Bristol-Myers Squibb Destination Access - ERBITUX Patient Assistance Program

Bristol-Myers Squibb

Contact Information
Bristol-Myers Squibb Destination Access - ERBITUX Patient Assistance Program
6900 College Boulevard, Suite 1000
Overland Park, KS 66211
1-(800) 861-0048 (phone)
1-(888) 776-2370 (fax)
Physician requests should be directed to:
Bristol-Myers Squibb Destination Access - ERBITUX Patient Assistance Program
6900 College Boulevard, Suite 1000
Overland Park, KS 66211
1-(800) 861-0048 (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.
Eligibility:
The Destination Access - ERBITUX Patient Assistance Program provides free ERBITUX to qualified uninsured patients, including individuals with insurance who are denied coverage and who meet the program's eligibility criteria. The patient must live in the U.S., Puerto Rico or the U.S. Virgin Islands in order to be considered eligible for enrollment. Patient applications are evaluated on a case-by-case basis.
Other Information:
Healthcare providers should contact the Destination Access - ERBITUX Patient Assistance Program at: (800) 861-0048 to initiate the application process.
Product(s) covered by program:
  • ERBITUX®