Myobloc Patient Assistance Program

Funded

About

The Myobloc Patient Assistance Program offers eligible patients the opportunity to access Myobloc at no charge. This program is designed for patients prescribed Myobloc for cervical dystonia or chronic sialorrhea who lack insurance benefits or cannot afford the therapy. Administered by Solstice Neurosciences, LLC, the Myobloc Patient Assistance Program alleviates financial burdens and ensures continued access to necessary treatment.

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

•MYOBLOC is available at no charge to eligible patients who are approved for the Patient Assistance Program

•HCP can enroll patient online at the Circle of Care Provider Portal or call 8884612255 for assistance

•Criteria for the program is set by Solstice Neurosciences, LLC; acceptance into the program is not a guarantee that patients are entitled to receive assistance indefinitely

•Eligible patients will be notified and details will be faxed to Acredo within 12 business days

•Call 8884612255, Monday Friday, 8am8pm ET for assistance or more information

Enrollment Forms

Enrollment Form