Wellspring Patient Assistance Program - Patient Assistance Programs

Summary

Wellspring was founded in 1999 by Dr. Robert Vukovich. Vukovich founded his own pharmaceutical company in 1983 called Roberts Pharmaceuticals Corporation , which was acquired by Shire Pharmaceuticals out of England. Prior to this, Robert spent seventeen years as an employee of many worldwide pharmaceutical companies, one of which includes Bristol Myers Squibb. In 1999, Wellspring licensed two important drugs from Smith Kline Beecham Pharmaceuticals â€“ Dyrenium and Dibenzyline, which treat swelling and high blood pressure, respectively. Since then, the company has been well on itsâ€™ way to developing the highest quality products on the market in their field.

Dibenzyline is a high blood pressure treatment launched by Wellspring in 2008. Dibenzyline has been approved by the FDA to treat high blood pressure caused by pheochromocytoma. Dibenzyline is administered orally via a tablet.

Dyrenium is a treatment for swelling launched by Wellspring in 1964. Dyrenium has been approved by the FDA to treat swelling induced by heart, kidney, and liver problems. Dyrenium is administered orally via a tablet.

Eligibility

Wellspring Patient Assistance Program, a patient assistance program provided by Wellspring, offers a three month supply Dyrenium and Dibenzyline at no cost to those who are eligible for the program. Eligibility is based off of the following requirements:

- You must not be covered by any private, public, or Medicare Part D prescription coverage programs OR you must have reached your coverage cap OR the insurance company pays under 25% of the cost for the prescription.

- You must meet an undisclosed income guideline.

- You must send in proof of Medicaid should you be enrolled.

The medication must be sent to the physicians office.

Those eligible for Medicare Part D but not enrolled may still be eligible.

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 Wellspring 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 Wellspring 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.