Leadiant Assistance Program: Cystaran

Funded

About

The Leadiant Assistance Program: Cystaran offers a streamlined process for patients in the United States and Puerto Rico to access the drug product, Cystaran. Administered by AllianceRx Walgreens Prime Specialty Pharmacy, the program emphasizes easy enrollment and copay finalization, ensuring patients receive necessary medication efficiently. The Leadiant Assistance Program: Cystaran caters to individuals aged 18 and older, promoting direct support without manufacturer involvement.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Must be 18 years of age or older

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: No

Program Details

•Program is administered by AllianceRx Walgreens Prime Specialty Pharmacy

•HCP should fax completed Prescription and Enrollment Form to 8668891510

•Must provide a valid prescription

•Offer is limited to one voucher redemption per patient.

•Alliance Rx Walgreens Prime Pittsburgh will carry out a benefits investigation and work with the program to finalize copay details

•Do NOT refer the patient to the manufacturer, Leadiant Biosciences

•For more information about patient assistance or ordering, contact AllianceRx Walgreens Prime Specialty Pharmacy at 18775349627

Enrollment Forms

Enrollment Form