Contact info
- Phone
- 1-844-437-6611
- Fax
- 1-844-504-8652
Eligibility
- Contact program for details.
- Program offers co-payment assistance, reimbursement support, and patient assistance programs for eligible patients.
- Income limit, single
- Not published
- Income limit, couple
- Not published
- Medical expenses can be deducted
- Not published
- Social Security number asked for
- Not published
- US citizenship or residency required
- Yes
Not sure where your income falls? See this year's federal poverty guidelines (opens in a new tab).
Application process
- Documents to attach
- Not published
- Prescriber license number
- Not published
- Who can sign
- Physician
- Application can be faxed
- Yes
- Decision letter sent to
- Provider
Getting the medication
- Patient receives
- Not published
- Shipped to
- Provider
- Supply per shipment
- Not published
- Time to first delivery
- Not published
- Refills
- Not published
- Staying enrolled
- New application every 12 months
Medications covered
- Aponvie (aprepitant injectable emulsion; iv)
- Cinvanti (aprepitant injectable emulsion; iv)
- Sustol (granisetron injection; extended release)
- Zynrelef (bupivacaine/meloxicam solution)