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Dexilant patient assistance program

Download printable Form Takeda Application for ... - RxHope 2025

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The Takeda Patient Assistance Program provides support for eligible patients in the U.S. who lack prescription coverage and meet specific income criteria. The application process requires patients to complete several sections, including income attestation and healthcare provider information. Patients must provide financial documentation and may receive medications at reduced costs or for free based on their household income. The program aims to assist those in need with access to medications like COLCRYS and ULORIC.

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