Orgovyx Bridge Program

Not Funded

About

The Orgovyx Bridge Program provides essential support to patients prescribed Orgovyx for advanced prostate cancer. This program is specifically tailored for those experiencing a lapse or delay in their commercial insurance coverage, allowing them to receive necessary medication even while awaiting insurance approval. By facilitating timely access to Orgovyx, the Orgovyx Bridge Program ensures that patients can continue their treatment uninterrupted.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: No

Program Details

•Eligible commercially insured eligible patients who are experiencing a lapse or delay in coverage, or waiting for approval from their insurance provider may be able to receive their drug supply each month for up to 4 months or until they receive insurance coverage approval, whichever occurs earlier

•Patients and prescribers must complete the ORGOVYX Support Program enrollment form, and prescribers must provide an ORGOVYX Bridge prescription

•Fax completed form to 18448268875

•For questions, call 1833ORGOVYX (18336746899), Monday–Friday, 8 AM–8 PM ET

Enrollment Forms

Enrollment Form