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ASSIST ProgramSM
The ASSIST ProgramSM, from Axcan Pharma™, helps meet the needs of low income patients who lack insurance coverage. This program allows for a recurring 30-day supply of URSO Forte® Scored, CANASA®, CARAFATE® (1 g tablet or 10 mL suspension) or ULTRASE® MT over a period of 12 months.
What is the ASSIST ProgramSM Pharmacy Card?
The ASSIST ProgramSM Pharmacy Card is a “patients in need” prescription card. It provides eligible patients, at minimal cost(s), with medication for selected Axcan Pharma™ products.
Who is eligible for the Program?
Participants eligible for the ASSIST ProgramSM Pharmacy Card:
- Have total annual incomes below Federal Poverty level
- Have NO prescription drug coverages
- Are residents of the United States
How will patients know which pharmacies honor their ASSIST ProgramSM Pharmacy Card?
There are more than 55,000 pharmacies who transmit claims electronically and are prepared to redeem prescriptions for the ASSIST ProgramSM. The prescriber DEA# is required and even if a local pharmacy does not transmit electronic claims, your patients can have their prescription(s) for URSO Forte® Scored, CANASA®, CARAFATE® (tablet or suspension) or ULTRASE® MT filled, and the pharmacy will be reimbursed by submitting a Universal Claim Form to McKesson Specialty Arizona Inc., the program administrator.
How do patients use the ASSIST ProgramSM Pharmacy Card?
Patients take their prescription(s), along with their ASSIST ProgramSM Pharmacy Card, to a retail pharmacy to obtain medication.
Is there a cost to use the ASSIST ProgramSM Pharmacy Card?
There is no cost to apply for the ASSIST ProgramSM Pharmacy Card; however, patients must pay a standard $3 pharmacy dispensing fee and may be subject to minor additional costs.
What if I have additional questions?
Patients and physicians may speak directly to a Customer Service Representative by contacting the ASSIST ProgramSM Line at (866) AXCAN-RX (866-292-2679), Monday through Friday, 9 am - 5 pm, Eastern Time, excluding holidays.
Click here to download the PDF on how to get started with the Axcan ASSIST ProgramSM. (PDF 1.626 MB)
This document is available in PDF format only.
