| Pharmaceutical Company |
Axcan Scandipharm -- Urso Patient Assistance Program |
| Program Address |
Axcan Scandipharm
Patient Assistance Program
PO Box 52150
Phoenix, AZ 85072-2150 |
| Toll Free Phone Number |
888-877-6471 |
| Alternate Phone Number |
none |
| Fax Number |
n/a |
| Guidelines and Notes |
Urso is very similar to Actigall but the dosing is a little different. Call 9-5 EST Monday through Friday. Program guidelines are based on federal poverty levels and they don't figure in prescription costs; they will not give out exact guidelines. Case managers screen for other possible reimbursement sources first. American Liver Foundation is underwriting a portion of the program. Patients with ANY forn of prescription benefits are ineligible. |
| Initiating Enrollment |
Anyone can register the patient by phone. Case managers take information and do initial screening. If patient qualifies, forms are then sent. |
| Health Provider's Role |
Initially, physician involvement not required. If patient is enrolled in program, the physician will have to sign the enrollment form and attack an original prescription refillable for up to a year. (a 90 day prescription with 3 refills) |
| Patient's Role |
Detailed financial and insurance information needed. |
| How Dispensed |
Sent through mail order pharmacy to patient. |
| Amount Dispensed |
90 day supply |
| Refills |
Completely new application again after 1 yr.. |
| Limit |
Indefinitely -- one year at a time. |