Amgen By Your Side Patient Assistance Program: Actimmune

Funded

About

The Amgen By Your Side Patient Assistance Program: Actimmune offers vital support by providing access to Actimmune for eligible patients. The program is designed for patients in the United States who have limited or no prescription insurance coverage and meet certain income guidelines. Through the Amgen By Your Side Patient Assistance Program: Actimmune, patients can receive their medication free of charge, ensuring they get the necessary treatment they require with the help of their healthcare provider.

Insurance requirements: Underinsured, Uninsured

Enrollment Forms

Enrollment Form

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: Yes

•Activation Required: No

Program Details

•Eligible patients may be able to receive medication free of charge

•HCP should fax completed enrollment form to: 8773057706 or emailed to ACTIMMUNEABYS@amgen.com

•For assistance or additional information, call 8773057704

Enrollment Forms

Enrollment Form