MS LifeLines Patient Assistance Program: Mavenclad

Funded

About

The MS LifeLines Patient Assistance Program: Mavenclad offers assistance to eligible patients by providing the drug product Mavenclad at no cost. This program supports patients in need by ensuring access to critical medication through specific eligibility criteria. The MS LifeLines Patient Assistance Program: Mavenclad is designed to help patients who are U.S. citizens or legal residents, have limited or no prescription insurance, and meet certain income requirements, making it a vital resource for those needing Mavenclad.

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

•Eligible patients may be able to receive Mavenclad for free

•HCP should fax completed Prescription and Service Request Form to 8662273243

•For assistance or additional information, call 8774473243. Monday through Friday 8 am to 8 pm ET, Saturday 9 am to 5 pm ET

Enrollment Forms

Enrollment Form