Access Programs for Chlorambucil
Drug Company Assistance
The provides pharmaceutical products at little to no cost for qualified patients. Chlorambucil can be obtained through this program if the patient resides in the US, is not eligible for Medicaid, is enrolled in Medicare Part D, and meets certain income requirements. The patient must also have spent at least $600 on prescription drugs within the last calendar year. For more information on eligibility, please visit the Commitment to Access , or call 1-866-265-6491.
Enrollment in the program requires two steps. First, someone involved in delivering the patient’s healthcare, such as a healthcare provider or social worker, must register as a . The must be completed along with original documents mailed or faxed. There is a checklist included with the enrollment form.
Finally, advocates should ensure that all supporting documentation, such as copies of Medicare Part D Prescription Plan ID Cards, proofs of yearly prescription spending, and proofs of household income, are attached to the application. The forms can be submitted via fax at 1-866-936-3422.
Foundation Assistance
provides grants for patients with insurance who still have trouble affording chlorambucil. Patients or providers can or call 1-800-675-8416 to speak with a representative.
also offers copay assistance for patients needing chlorambucil. Please read the , and then follow the prompts on the .
