Stock Replacement Program - Vaprisol

Astellas Pharma US I

Contact Information
Stock Replacement Program - Vaprisol
Astellas Reimbursement Services
P.O. Box 22708
Charlotte, NC 28222-0708
1-(800) 477-6472 (phone)
1-(866) 317-6235 (fax)
Eligibility:
The patient must meet insurance guidelines that are not disclosed and meet income guidelines that are not disclosed. This is a product replacement program, so the drug was already used by the facility for a specific patient. The doctor, social worker, or physician office staff must call to pre-screen the patient for enrollment. A pre-filled application is sent to the provider's office, which must be reviewed for accuracy and the physician's signature. The patient's financial documents must be attached to the completed application too. The application can be faxed or mailed back. Once the completed application is received and processed, drug is shipped to the provider within 10 business days.
Other Information:
Vaprisol is used in the inpatient hospital setting of care. The medication is sent to the doctor's office. A new application is needed for each request.