Sculptra Patient Access Program - Patient Assistance Programs

Summary

Dermik Laboratories, Inc was founded in 1964 as a United States subsidiary of Sanofi-Aventis. Dermik Laboratories, Inc is a company whose focus is specifically geared towards creating treatments and therapies at a prescription strength level for acne, dermatitis, eczema, psoriasis, rosacea, and rough skin. Dermik Laboratories, Inc is the producer of Benzamycin, which when initially developed, was one of the first dermatological companies in the United States to develop and market a topical treatment for acne. In the over 40 years of experience has worked with industry leading companies such as AP Pharma and has even developed the Dermik Aesthetics Division to specifically handle that partnership and future partnerships as well.

Sculptra is a synthetic, biocompatible, bioabsorbable material launched by Dermik Laboratories, Inc in 2004. Sculptra has been approved by the FDA for restoration and correction of the signs of lipoatrophy in people with human immunodeficiency virus. Sculptra is administered through injection.

Eligibility

Sculptra Patient Access Program, a patient assistance program provided by Dermik Laboratories, Inc, offers Sculptra at a discounted cost for one prescription to those who are eligible for the program. Eligibility is based off of the following requirements:

- You must be a citizen of the United States or its Territories.

- You must not be covered by any private, public, or Medicare Part D prescription coverage programs.

- You must be taking Sculptra for an FDA approved diagnosis.

- You must meet an undisclosed income guideline.

The medication must be sent to the physicians office.

SOURCE: 2008 Poverty Chart

Family Size

300%

250%

200%

150%

133%

100%

$32,490

$27,075

$21,660

$16,245

$14,404

$10,830

$43,710

$36,425

$29,140

$21,855

$19,378

$14,570

$54,930

$45,775

$36,620

$27,465

$24,352

$18,310

$66,150

$55,125

$44,100

$33,075

$29,327

$22,050

$77,370

$64,475

$51,580

$38,685

$34,301

$25,790

$88,590

$73,825

$59,060

$44,295

$39,275

$29,530

$99,810

$83,175

$66,540

$49,905

$44,249

$33,270

$111,030

$92,525

$74,020

$55,515

$49,223

$37,010

Each Additional Family Member

$11,220

$9,350

$7,480

$5,610

$4,974

$3,740

What´s Next?

Fill out the program enrollment form located to your right. If you don't see an enrollment form available please call Dermik Laboratories, Inc program directly. After filling out the enrollment form please bring the form to your doctor for proper signatures and procedures. Do not forget a self stamped envelope for them to mail in your application to the program.

Other Tips

If you have any questions please call the Dermik Laboratories, Inc program directly.
Fill out as much of the information on the enrollment form as possible. The more information you have pre-filled the easier the progrm is to enroll in.
Write down the refill dates for your program and set a reminder here on PatientAssistance.com so that you don't run out of medication.
Do not write messy on your forms as this will delay any response.
Call and write thank you notes to AAI Pharma Inc. program. Without their help millions of people will be without medication.