

patient information USA / Pegasys
Thank you for your interest in Pegasys. pharma& recognizes that this is a very important medication to patients and is seeking permission to distribute and market this product under our umbrella to keep it available for patients in need. Once pharma& receives all approvals we do intend to have a patient assistance program for those underserved patients who do not have access through their insurance and have a financial challenge.
The timeframe for receiving approval and having a program available is April 11, 2022. We are excited to serve the patients at that time and you may contact the pharma& Patient Foundation after that time.
How to apply to the pharma& Patient Foundation?
Step 1
Please download and comlete page 1 of the "pharma& Patient Foundation Enrollment Form" and sign and date and provide it to your physician to complete the next step.
Step 2
Please ask your physician to complete page 2 along with the prescription information signing with original signatures (no stamps).
Step 3
Please fax the completed Enrollment Form to: 833-313-8348
Download Link
pharma& Patient Foundation Enrollment Form
Contact by phone: 855-443-7028