PROGRAM MAY NO LONGER BE AVAILABLE: Tabrecta 14-Day Free Trial Program

Not Funded
About
The 'PROGRAM MAY NO LONGER BE AVAILABLE: Tabrecta 14-Day Free Trial Program' offers patients an incredible opportunity to experience the benefits of Tabrecta at no cost for 14 days. This program, specifically designed for those prescribed Tabrecta for an FDA-approved indication, allows for direct home delivery of the medication, making it a convenient choice for eligible U.S. and Puerto Rico residents.
Insurance requirements: Commercially insured, Medicare / Medicaid, 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: No
•Activation Required: No
Program Details
•Eligible patients may be able to receive a 14day free trial of Tabrecta
•Medication can be shipped directly to patients home
•Enrollment form must be completed online or downloaded from the enrollment site and faxed to 18888914924 (HCP)
•Patient and HCP must each submit a separate form; both are available at https://autosrf.force.com/autosrf/ASRF_HCPForm
•For more information, please call 18002827630 from 8:00 am to 8:00 pm ET, Monday through Friday