Patient must be a U.S. citizen ineligible for prescription assistance through Medicaid or private insurance. Patient must meet established financial criteria. Application form, prescription, and patient's income documentation are required. Maximum of three months supply may be provided per request. Complete financial re-application is required annually.
Renewal requests within the same year require only the application form and a prescription.
Program is subject to change without notice. Current program specifics can be obtained by calling the toll-free number above. The Sankyo Pharma Open Care Program is available to qualified patients with demonstrated medical and financial need. The program assists patients who are prescribed Sankyo products and are uncertain of their insurance coverage, in locating alternative payment sources. Free product is provided to uninsured patients who qualify and for whom no alternative source of reimbursement can be identified.