Matulane Patient Assistance Program

Sigma-Tau Pharmaceut

Contact Information
PO Box 1968
Danbury, CT 06813-1968
1-(800) 999-6673 (phone)
1-(203) 798-2291 (fax)
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.
  • Click here to visit the program's web site.
  • Eligibility:
    All applicants must be medically eligible for Matulane by having a diagnosis of Stage III or IV Hodgkin's disease documented by the treating physician, or any other lymphomas where a physician feels a response is possible. All applicants must be a U.S. citizen or a permanent U.S. resident. All applicants must sign waivers and release of liability forms. The patient is responsible for shipping and handling costs incurred. Applicants must prove financial need above and beyond the availability of federal and state funds, private insurance or family resources.
    Other Information:
    One application will cover the duration of the therapy regimen that is prescribed by the treating physician. This therapy is used in conjunction with other anticancer drugs for the treatment of Stage III and IV Hodgkin's disease.
    Product(s) covered by program:
    • Matulane