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m. and 8 p.m. Eastern Time Monday through Friday. is a trademark of Otsuka Pharmaceutical Co. Ltd. and are trademarks of Bristol-Myers Squibb Company NOUS14UB00812 June 2014 SECTION I Patient Information to be completed by patient Patient Name Social Security Number Date of Birth Gender Providing Social Security Number is optional. Female Male Patient Address City State Zip Home Phone Cell Phone Best Time to Call Alternate Contact Name Relationship Phone Allergies Current Medications Do you have ...

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Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (205 Votes)
2020	4.3 Satisfied (30 Votes)
2014	4.2 Satisfied (75 Votes)
2014	4 Satisfied (57 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Are and Orencia the same?

Orencia and belong to different drug classes. Orencia is a recombinant DNA generated fusion protein and is an injectable protein (antibody). Side effects of Orencia and that are similar include headache, stomach pain, and cold symptoms such as stuffy head/nose, sneezing, sore throat, or cough.

How much does cost?

Table 1Cost-Comparison Table for Biologic Disease-Modifying Drugs for Rheumatoid Arthritis ComparatorsStrengthPrice ($) SC (Orencia)125 mg/mL358.9000Abatacept IV (Orencia)250 mg/15 mL480.4100Adalimumab SC ()40 mg/0.8 mL740.3600Anakinra ()100 mg47.581410 more rows

Is patient assistance program legitimate?

Patient assistance programs (PAPs) are usually sponsored by pharmaceutical manufacturers and are promoted as a safety net for Americans who have no health insurance or are underinsured.

What is the generic drug for ?

What is Orencia and how is it used? Orencia is a prescription medicine used to treat the symptoms of Moderate-to-Severe Rheumatoid Arthritis and Psoriatic Arthritis. Orencia may be used alone or with other medications. Orencia belongs to a class of drugs called DMARDs, Immunomodulators; Immunosuppressants.

What is the cost of ORENCIA infusion?

The lowest GoodRx price for the most common version of Orencia is around $4,934.49, 13% off the average retail price of $5,689.43. Compare CTLA-4 agonists.

orencia copay assistance enrollment form

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What can I do if I cant afford ?

Call Tap to call 1-855- (354-7847) from Monday Friday, 8 AM 8 PM (ET). Live specialists are here to: Help you find out if is covered by your insurance plan. Determine if you are eligible for assistance paying for .

What is simple fill?

Simplefill is a full-service prescription assistance company that is dedicated to making. prescribed medications affordable for our members. ARE YOU... one of the millions. of Americans who.

Does Bristol Myers have a patient assistance program?

The Bristol Myers Squibb Patient Assistance Foundation (BMSPAF) is an independent, charitable organization that helps eligible patients who need temporary help obtaining the medicines listed on this website.

Does Orencia reduce inflammation?

(Orencia) is often prescribed after failure of a disease-modifying anti-rheumatic agent (DMARD), like methotrexate but it can be used as first-line therapy. is used to reduce inflammatory symptoms such as swelling, pain, and stiffness.

How do you qualify for free ?

You may be eligible for the Free 30-Day Trial Offer for () if: You have not previously filled a prescription for ; You have a valid 30-day prescription for ; You are being treated with for an FDA-approved indication that an HCP has planned for more than 35 days of treatment;

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