Ipsen Cares Quick Start Program: Tazverik

Funded

About

The Ipsen Cares Quick Start Program: Tazverik offers a valuable opportunity for new patients needing Tazverik, especially when there is a delay in drug coverage. This program ensures that eligible patients without adequate insurance or experiencing coverage delays can receive a supply of Tazverik promptly, enhancing their access to necessary treatment.

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

•New patients may be eligible to receive a limited supply of free medication if they experience a delay in the authorization of prescription drug coverage greater than five business days, and if their doctor has determined there is an immediate medical need to start treatment with Tazverik

•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