Carbaglu Copay Support Program

Funded

About

The Carbaglu Copay Support Program is designed to assist patients in managing the cost of their Carbaglu prescription. By participating in the Carbaglu Copay Support Program, eligible patients with commercial insurance have the opportunity to pay as little as $0 per prescription for Carbaglu. The Carbaglu Copay Support Program provides significant financial relief to those prescribed Carbaglu for FDA-approved indications, ensuring greater access and adherence to their prescribed treatment regimen.

Insurance requirements: Commercially insured

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 commercially insured patients may pay $0 per prescription

•HCP and patient should fax the completed Prescription & Enrollment Form to 8884548488

•Contact the Recordati Rare Diseases CARBAGLU Support Program for assistance: 8884548860

Enrollment Forms

Enrollment Form