AIDS Treatment Data Network
611
Broadway, Suite 613, New York, NY, 10012 • www.atdn.org • Tel: (212) 260-8868 • (NYS) 800-734-7104
| The Access Project collects and distributes information about medications available for HIV/AIDS and hepatitis co-infection through Medicaid, Medicare Part D, AIDS Drug Assistance Programs (ADAPs), and pharmaceutical industry sponsored patient assistance and expanded access programs (EAP). The Access Project is a program of the The Network (network@atdn.org) |
Ortho McNeil Pharmaceuticals
Patient Assistance Program
Products covered:
Bicitra (sodium citrate and citric acid)
Dermatop (prednicarbate)
Ditronpan (oxybutynin)
Elmiron (pentosan)
Floxin (ofloxacin)
Grifulvin V (griseofulvin)
Haldol (haloperidol)
Levaquin (levofloxacin)
Monistat (miconazole)
Mycelex (clotrimazole)
Neutra-phos (oral sodium and potassium)
Pancrease (pancrelipase)
Parfon Forte (chlorzoxazone)
Polycitra (tricitrates)
Regranex (becaplermin)
Renova/Rtein-A (tretinoin)
Spectazole (econazole)
Terzol (terconazole)
Testoderm (Testosterone Transdermal System)
Tolectin (tolmetin)
Topamax (topiramate)
Ultracet/Ultram (tramadol)
Urispas (flavoxate)
Vascor (bepridil)
| Contact | 1-800-577-3788
www.ortho-mcneil.com/frames/resources.htm
|
|
| Program Eligibility |
The patient must meet the following criteria to qualify:
- Has no health insurance or no prescription coverage (with proof).
- Not eligible for Medicaid, ADAP, or other drug assistance programs.
- Proof of income, Medicaid Denial Letter, and original presciption must be submitted.
|
| Enrollment Process |
Doctors and patients can call to enroll. An application is sent to the doctor's office for completion by both. Application form can also be downloaded from the program website (see above link).
|
|
| Re-Application |
Patient is eligible for the program for 1 (one) year, but must reapply every three months. Income documentation is required only annually.
|
|
| Comments |
Prescriptions are filled for 90 (ninety) days, with the exception of ULTRAM®and ULTRACET®. These are filled for 30 (thirty) days. Medications are shipped directly to the practitioner. The processing of applications can take as long as 3 weeks. Once this is completed the drugs will be available in four to five days
|
|
|