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Clinicians

Access Programs for Eltrombopag

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 eltrombopag. Patients or providers can  or call 1-800-675-8416 to speak with a representative.

 provides assistance for patients without prescription drug coverage. To begin the enrollment process, enter the name of the drug in the , and then continue with the personalized parts of the application.

 offers financial support for insured patients who cannot afford their medications. You can view the eligibility requirements for their  and . For further assistance, please call 1-866-512-3861, option 1 to speak with a representative.

 also offers co-pay assistance for patients needing eltrombopag. Please read the , and then follow the prompts on the .

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