Alunbrig SMART Free Trial Program

Funded

About

The Alunbrig SMART Free Trial Program offers a unique opportunity for patients diagnosed with anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer (NSCLC) to access Alunbrig free of charge. Specifically designed for new patients, this program provides a one-month supply of Alunbrig tablets at various dosages, ensuring that healthcare providers can select the most suitable option. By participating in the Alunbrig SMART Free Trial Program, eligible patients in the United States, excluding Puerto Rico and other US territories, can initiate their treatment journey without financial barriers.

Insurance requirements: Commercially insured, Medicare / Medicaid, 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: No

•Activation Required: No

Program Details

•Eligible patients may receive a 1month trial of ALUNBRIG tablets at no cost, regardless of their insurance coverage

•Free trial is available in 30, 90, and 180mg tablets so that HCP can select the 1month trial at the dosage that best suits their needs

•Prescription is valid for one time only with no refills

•Patient must obtain a new prescription

•HCP must complete enrollment form and fax to 8574657247

•For any questions call 18336182786

Enrollment Forms

Enrollment Form