Odomzo Patient Assistance Program

Funded

About

The Odomzo Patient Assistance Program offers a valuable opportunity for patients to receive financial assistance for Odomzo prescriptions. This program is designed to support patients who qualify based on specific eligibility criteria, allowing them to manage their healthcare needs effectively. By participating in the Odomzo Patient Assistance Program, patients can access vital support to help cover the costs of their medication.

Insurance requirements: Underinsured, Uninsured

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: Yes

•Activation Required: No

Program Details

•The SUN PHARMA Patient Assistance Program (PAP) Application enables eligible patients to obtain financial assistance for ODOMZO prescriptions

•Patients can call helpline (18445636696) for information about options to help pay for ODOMZO

•HCP must first attempt to obtain all available authorizations. The authorization or denial must be submitted with the application along with the patient’s proof of income

•The application will need to be signed by the prescriber and the patient and submitted by fax with all supporting documentation

•Completed forms should be faxed to: 18778726575

•For more information about the ODOMZO PAP Program, call 18445ODOMZO (18445636696) Monday Friday, 8 AM 8 PM EST

Enrollment Forms

Enrollment Form