Leadiant Patient Assistance Program: Cystaran

Funded

About

The Leadiant Patient Assistance Program: Cystaran aims to provide assistance to patients in need of Cystaran, a vital drug product, by minimizing financial burdens. This program, administered by AllianceRx Walgreens Prime Specialty Pharmacy, ensures that eligible patients receive Cystaran based on specific criteria, including residency, prescription coverage, and income guidelines. The Leadiant Patient Assistance Program: Cystaran stands out by providing critical support for patients prescribed this medication for FDA-approved indications.

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

•Program is administered by AllianceRx Walgreens Prime Specialty Pharmacy

•HCP should fax completed Prescription and Enrollment Form to 8668891510

•Alliance Rx Walgreens Prime Specialty Pharmacy will carry out a benefits investigation and work with the program to finalize 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