Fetroja Patient Assistance Program
The Fetroja® Patient Assistance Program provides Fetroja to eligible, uninsured patients at no cost, through healthcare institutions, clinics and home infusion sites throughout the country. In order to be considered for the Patient Assistance Program, patients must meet all the following criteria:
- No commercial, government (state or federal health insurance, including but not limited to: Medicare, Medicare Advantage, Medicaid, Veterans Affairs health benefit programs, TRICARE, or the Indian Health Service program), or other insurance coverage
- An annual household income at or below 300% of the Federal Poverty Level
- U.S. or applicable U.S. territory resident
- Either (1) a valid prescription for an FDA-approved indication for Fetroja from a healthcare provider licensed in the U.S., or (2) (a) a valid prescription for Fetroja from a healthcare provider licensed in the U.S. and (b) a susceptibility test that confirms Fetroja is the only option for treatment.
Please email a completed enrollment form to accesssupport@shionogi.com. Please note, the form must be completed in its entirety by the patient or caregiver and their treating physician.
To request medical information, report an adverse event (medication side effect) or report a product complaint for a Shionogi Inc. product, please visit Shionogi Medical or call 1-800-849-9707.