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Program Details

CATALYST PHARMACEUTICALS, INC.
Catalyst Pathways
Firdapse (amifampridine tablet)
 
CONTACT INFO
Address:
,
Phone: 1-833-422-8259 Provider Phone:
Fax: 1-833-422-8260 Website: Program Website
ELIGIBILITY
Eligibility Info:
  • Catalyst Pathways has different types of financial assistance programs, such as co-pay assistance and financial assistance, to help you with out-of-pocket costs.
  • Patient who do not have insurance or are denied coverage may be eligible for the patient assistance program.
    		•
    Income at or below: Not Published
    Medical expenses can be deducted from reported income: Not Published
    Social security requested on form: No
    US citizenship/residency specified: Yes
    APPLICATION
    Attachments Required: Not Published
    Physician License #
    Required:    		 Both DEA and State
    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: Up to 1-month supply
    Delivery Time: Not Published
    Re-application Policy: Must re-enroll at end of calendar year.
    Refill Policy: Pharmacy will contact patient
    Other Information:

    Last Updated: 01/09/2024

    		  

     

     


    Application Forms
    & Instructions
    The following documents are provided in interactive PDF format, allowing you to type information directly into the form.


    DocumentForm (English)

     

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