[logo]" is an information clearinghouse. We collect and distribute information about medications available for HIV and AIDS through Medicaid, AIDS Drug Assistance Programs (ADAPs), and pharmaceutical industry sponsored patient assistance and expanded access programs.
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Hoffman-LaRoche
Patient Assistance Program

Products covered:

Bactrim (TMP/SMX)
Copegas (ribavirin)
Cytovene (ganciclovir)
Fortovase, Invirase (saquinavir)
HIVID (zalcitabine, ddC)
Klonopin (clonazepam)
Kytril (granisetron)
Pegasys (pegylated interferon alfa 2a)
Rocephin (ceftriaxone)
Roferon A (alpha interferon)
Valcyte (valganciclovir) 1-800-443-6676
www.rocheusa.com/programs/patientassist.asp





Contact
Program Eligibility
The patient must meet the following criteria to qualify:
  • Must be a U.S. citizen.
  • Has no health insurance or no prescription coverage.
  • Not eligible for Medicaid, ADAP, or other drug assistance programs.
  • Income is less than 300 % of the Federal Pverty Level.
Enrollment Process
To receive an application the doctor or patient must call. If the enrollee is not insured they can expect a faxed application within 24-hours. If the enrollee is insured this process will be delayed by confirmation of the insurance status. Proof of income such as a tax return or a w-2 must be provided.
Re-Application
At the end of a 90-day cycle a new application will need to be filled out. Assuming nothing has changed re-application should be easier than initial application.
Comments
After the completed application has been received, it takes about 48-hours to process. After that the drugs are sent overnight to the doctor's office.

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