| Pharmaceutical Company | Pharnacia and Upjohn Patients In Need Program - Direct Ship Drugs |
| Program Address | Pharmacia and Upjohn Patients in Need PO Box 52059 Phoenix AZ 85072 |
| Toll Free Phone Number | 800-242-7014 |
| Alternate Phone Number | n/a |
| Fax Number | 480-314-7163 |
| Guidelines and Notes | This program is listed separately because the protocol is different for the Pharmacia and Upjohn medications that are administered by the physician. |
| Initiating Enrollment | Phyisican, patient or advocate can call for applications. Once application is complete, call is made to program and they review the application. If patient is approved, the physician will be asked fo fax a prescription for a 30 day supply and the certificate to them. |
| Health Provider's Role | After calling and determining patient eligibility, completed form and documents are mailed to the program. |
| Patient's Role | Form requires financial details and insurance information as well as patient signature. Patient needs to schedule appointments with the doctor for the administration of treatment. |
| How Dispensed | Sent and delivered within 3-5 business days |
| Amount Dispensed | Initially 30 days or one-cycle |
| Refills | . |
| Limit | Patient must completely reapply every 6 months. |