Dalbavancin Savings Tips
Many manufacturers offer programs that will reduce your out-of-pocket costs for this prescription. These programs are free but may have some rules or restrictions, so you’ll want to review carefully. When you’re ready to use this coupon, simply present the coupon to your pharmacist with a valid prescription for your medication.
|Program Name:||Dalvance Connects Co-Pay Assistance Program|
|How do I get the discount?||Call 1-855-387-2824 for more information and to enroll|
|How much can I save?||Your co-pay can be reduced by as much as $800 for one year.|
|Do I need insurance?||Yes. The program is for commercially insured patients only.|
|Number of uses:||Up to 1 use|
|Other notes:||Offer only valid if receiving an infusion in a practice-based or freestanding infusion center, hospital outpatient department, or home infusion service.|
Patient Assistance Program
Many programs are available from federal and state governments, non-profits, manufacturers, and other organizations to help you get the drugs you need at a reduced cost. Eligibility is often based on income, insurance or Medicare status, and other factors. You’ll need to apply through each program, either online, over the phone, or with your doctor's help. The following program is offered by the manufacturer of this drug.
|Program Name:||Allergan U.S. Patient Assistance Program|
|How do I apply?||Ask your doctor to help you submit an application. You can find the form on the program website, or request one by calling 1-800-851-0758.|
|What are the benefits?||You can enroll for 12 months at a time, and your medication will be shipped to your doctor or pharmacy every 90 days at no charge if you are approved.|
|What are the restrictions?||You will need a valid prescription, proof of gross monthly househould income, and a copy of your LIS denial letter (Medicare Part D only). Please contact the program for more information about income eligibility requirements.|
|Keep in mind||N/A|