Patient Assistance Foundation
Bristol-Myers Squibb Patient Assistance Foundation
1-800-736-0003
Monday through Friday
9:00 AM - 6:00 PM EST
The Bristol-Myers Squibb Patient Assistance Foundation program information for:
- BiCNU® (carmustine for injection)
- CeeNU® (lomustine)
- ETOPOPHOS® (etoposide phosphate)
- LYSODREN® (mitotane tablets)
- VUMON® (teniposide injection)
1. How do you apply for patient assistance through the Bristol-Myers Squibb Patient Assistance Foundation?
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Please contact Destination Access at 1-800-861-0048, Monday–Friday, 7:00 AM - 7:00 PM CST. Destination Access will provide an enrollment form, requiring patient signature allowing Destination Access to conduct a full alternative coverage search to identify if a patient might be eligible for state programs or other alternative benefits. If it is determined that the patient is a candidate for patient assistance, the patient’s healthcare provider will be contacted within the next business day by a Bristol-Myers Squibb Patient Assistance Foundation program specialist to initiate the application process.
For more information about the Bristol-Myers Squibb Patient Assistance Foundation, please call 1-800-736-0003, Monday through Friday, 9:00 AM - 6:00 PM EST, or visit the website at http://www.bmspaf.org.
2. What are the eligibility criteria for the patient assistance program?
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The Bristol-Myers Squibb Patient Assistance Foundation program provides assistance to qualifying patients who:
- Are U.S. Citizens or U.S. Legal Resident Aliens
- Generally lack public or private prescription drug coverage
- Have an established financial hardship
If you have additional questions regarding patient assistance, please contact the Bristol-Myers Squibb Patient Assistance Foundation at 1-800-736-0003, Monday through Friday, 9:00 AM - 6:00 PM EST and a program specialist will assist you.
693US09WA02301 03/09