Patient Assistance Program
The Valeant Patient Assistance program is designed to offer free medicine to patients who are financially disadvantaged. This program is available to patients who are legal residents of the 50 United States and whose income is at or belowless that 200% of the Federal Poverty Level with the exception of Mysoline which is at 300%. It is limited to patients who do not have medical insurance covering prescription costs and who do not have resources from government or private programs to pay for medicine.
Applications must be completed and signed by the patient and the physician. Applications are available for downloading on www.rxhope.com/valeant or by calling (800) 511-2120. Physicians have the convenience to apply for their patient online at www.rxhope.com/valeant.
| 8-Mop®(methoxsalen, USP) | Migranal® (dihydroergotamine mesylate, USP) Nasal Spray |
| Ancobon Capsules® (flucytosine) | Mysoline 50mg and 250mg –Open item for discussion |
| Diastat® AcuDial™ 10 mg (diazepam rectal gel) | Oxsoralen-Ultra® Capsules (Methoxsalen, USP, 10mg) |
| Diastat® AcuDial™ 20 mg (diazepam rectal gel) | Prostigmin® Tablets, 15 mg (Neostigmine Bromide) |
| Diastat® Gel 2.5 mg (diazepam rectal gel) | Tasmar® (Tolcapone) Tablets |
| Mestinon® 60 mg Syrup (pyridostigmine bromide, USP) | Zelapar® (Selegiline HCl) Orally Disintegrating Tablets |
| Mestinon Timespan Tablets® 180 mg (pyridostigmine bromide, USP) |