Celgene Corporation
Celgene Therapy Assistance Program
Sponsor Organization
Celgene Corporation
Prescription Medication Assistance Organization Contact
Celgene Therapy Assistance Program
6900 College Boulevard
Ste. 1000
Overland Park, KS 66211
1-888.423.5436 Option 3
Fax: (800) 822-2496
Medications sent to: Patient’s Doctor
Prescription Medications/Products Covered:
Thalomid
Program Information And Resources:
Celgene Therapy Assistance Program Application
Program Eligibility Requirements:
Patient must have no insurance that covers the drug or has maxed out their insurance benefit; patient must be on a limited income with little or no LIQUID assets. Supply: 28 cycle as mandated by Federal Law
Additional Information and/or Requirements (known):
Who Can Apply: Physician's office should initiate Application Form by calling 888-423-5436, Option 3. Application Form will be faxed to the physician for completion by physician and patient.
Completed Application Form should be faxed back to 800-822-2496. Eligibility outcome will be determined within 2 business days. Required: Physician's signature; patient signature (faxed signature is accepted) Shipped To: Physician's office to be dispensed to the patient.
