Ipsen Cares Bridge Supply Program: Tazverik

Funded

About

The Ipsen Cares Bridge Supply Program: Tazverik provides critical support to patients by ensuring an emergency supply of Tazverik for those facing interruptions in drug coverage. Designed for patients with a valid prescription and actively pursuing coverage, this program offers peace of mind by delivering up to a 30-day supply of Tazverik when insurance delays occur. The Ipsen Cares Bridge Supply Program: Tazverik is a lifeline for eligible U.S. residents in urgent need of their medication.

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

•Provides an emergency supply of free product to eligible patients currently on therapy, in accordance with onlabel prescription, who experience an unexpected disruption in product coverage or supply exceeding 5 calendar days

•If eligible, a 15day supply (up to 30 days) of Tazverik will be provided until the prior authorization or coverage request for Tazverik is approved

•Patient and HCP may enroll online, or submit completed enrollment form via fax to 8885252416

•For assistance or additional information, call 8664355677, 8:00 am to 8:00 pm ET, Monday Friday

Enrollment Forms

Enrollment Form