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)

Immunex
Patient Assistance Program

Products covered:

Leukine, Prokine, GM-CSF (sargramostim)
Novantrone (mitoxantorone) 1-800-321-4669




Contact
Program Eligibility
The patient must meet the following criteria to qualify:
  • Has no health insurance or no prescription coverage.
  • Not eligible for Medicaid, ADAP, or other drug assistance programs.
  • Income eligibility on a case-by-case basis.
Enrollment Process
A case management number is given to the patient over the phone. An application form is faxed to the doctor's office to be filled out.
Re-Application
Each application is good for 12-months. The doctor must call to re-certify every 3 months.
Comments
After the manufacturer receives the completed form, processing will be complete in 2-3 days and the drug will be sent out via overnight mail service.

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Last modified: 11/16/2007
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