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Program Details
BAYER HEALTHCARE PHARMACEUTICALS
Nexavar REACH Program
Nexavar
(sorafenib
)
|
| CONTACT
INFO |
|
| Address: |
PO Box 220765
Charlotte, NC 28222-0765 |
| Phone: |
1-866-639-2827 |
Provider Phone: |
|
| Fax: |
1-866-639-5181 |
Website: |
Nexavar REACH Program |
|
| ELIGIBILITY
|
|
| Eligibility
Info: |
A REACH Program Counselor will explore all options for obtaining assistance for Nexavar. If no alternatives are available, eligibility will be reviewed for patient assistance. |
| Income at or below: |
Not
Published |
| Medical expenses
can be deducted from reported income: |
Not
Published |
| Social security
# requested on form: |
Yes |
| US citizenship/residency specified:
|
Not
Published |
|
|
APPLICATION |
|
| Attachments
Required: |
Financial
|
Physician
License #
Required: |
DEA
NPI
|
Prescriber
Signature
Allowed: |
Physician
|
Application
may be
faxed: |
Yes |
Eligibility
determination
letter sent: |
Both Provider and Patient
|
|
| MEDICATION |
|
| Receives: |
Medication
|
| Shipped To: |
Patient
|
| Quantity in
Shipment: |
30 days
|
| Delivery Time: |
0-1 week
|
| Re-application
Policy: |
Not Published |
| Refill Policy: |
Patient will be notified when refills are due to arrange delivery.
|
| Other Information: |
|
|
|
Last Updated: 09/08/2010
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Form (English)