At Fortovia, we proudly offer the Fortovia Direct Rx Program, which has been designed to facilitate access for all people who need our products, regardless of their insurance coverage, when fulfilled by a Fortovia Direct Rx specialty pharmacy.
Fortovia Direct Rx Program offers
|•||Support across our portfolio of products, including Gelclair® Bioadherent Oral Gel, Zuplenz® (ondansetron) oral soluble film, Oravig® (miconazole) buccal tablets, and Soltamox® (tamoxifen citrate) oral solution|
|•||As little as $25 out-of-pocket costs for people who meet eligibility criteria*|
|•||A streamlined Patient Assistance Program is available for uninsured, underinsured, Medicare, Medicaid, and indigent patients|
|•||Free, 24-48 hour home delivery when ordered from a specialty pharmacy within the Fortovia Direct Rx network|
Get started today
It is simple to help people who are living with cancer access support. In just a few steps, providers can prescribe via faxed form or e-prescribe via Electronic Health Record (EHR) directly to a partner specialty pharmacy.
|•||First, download the prescription form|
|•||Next, patients should be reminded that the specialty pharmacy must contact them via phone prior to shipping their prescription to verify insurance, address, and collect co-pay|
|*||Terms and Conditions: Certain patients in Federal programs may not qualify. Qualified patients will pay $25 per GELCLAIR/ZUPLENZ/ORAVIG/SOLTAMOX prescription. After a maximum reimbursement allowance, any remaining costs will be the responsibility of the patient. Co-pay assistance is not valid for prescriptions reimbursed, in whole or in part, under Medicaid, Medicare, including Medicare Advantage and Part D prescription drug plans, or any other federal or state program (including state pharmaceutical assistance programs) or where prohibited, taxed, or otherwise restricted. Fortovia Therapeutics reserves the right to rescind, revoke, or amend this offer without notice. Patients understand and agree to comply with the terms and conditions of this offer as set forth here.|