SareptAssist Patient Assistance Program

Funded

About

The SareptAssist Patient Assistance Program offers vital support for patients prescribed Exondys 51, Vyondys 53, Amondys 45, and Elevidys. This program is specifically designed to help uninsured or underinsured patients by providing them access to necessary medications. By ensuring that patients with an FDA-approved diagnosis have access to treatment, the SareptAssist Patient Assistance Program plays a crucial role in improving patient health outcomes.

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

•ENROLLMENT FORMS ARE LOCATED AT VERY BOTTOM OF WEBPAGE. SELECT THE CORRECT ENROLLMENT FORM FOR THE MEDICATION

•The PAP Program can help patients, who are uninsured or rendered uninsured and meet certain eligibility requirements

•Patient may be responsible for additional costs associated with administration of the drug

•HCP should complete and submit the SareptAssist START Form or the Sarepta Gene Therapy Enrollment Form (depending on the medication)

•Fax completed form to 18006215203 or email to SareptAssist@Sarepta.com

•Case Manager will call patient to discuss eligibility and go over next steps

•For any questions, please call Call 1888SAREPTA (18887273782), Monday through Friday, 8:30am – 6:30pm ET

Enrollment Forms

Enrollment Form