TRACLEER^® and VENTAVIS^®

Tracleer^® and Ventavis^® Patient Assistance Programs (TPAP and VPAP)

Actelion Pharmaceuticals 

 
Who is Eligible?

You are eligible if you meet all of the following criteria:

• Uninsured or rendered underinsured by payor denial, including a denial from your state Medicaid program
• Meet undisclosed income guidelines
• Take the medication for a FDA-approved diagnosis
• Reside in the United States

How Do I Apply?

• Fill out and submit an enrollment form through PAH Pathways.
  You and your doctor will need to fill out and sign the patient enrollment form, but must do so through the PAH Pathways program.
   
  
• Submit the form along with proof of income and a denial letter from Medicaid to the TPAP for Tracleer and VPAP for Ventavis.
  A counselor will screen your application for eligibility using income, residency and diagnosis guidelines.
   
  
• Complete the secondary application.
  If you are considered eligible to enroll in the program, you will receive a secondary application asking you for more information and proof of income. Both you and your healthcare professional are notified of acceptance into the program, usually within 24-48 hours.
   
  
• Each year, you will need to fill out a new application.

How Does The Program Work?

After you have been approved for the program, up to a 30-day supply will be sent to either your doctor's office or your home within 7-10 business days.

You or your doctor must contact the company for refills.

Contact Information

PAH Pathways
P.O. Box 826
South San Francisco, CA 94083-0826

1-866-ACTELION (1-866-228-3546)

• Option 1 for Tracleer^®
• Option 2 for Ventavis^®

1-866-279-0669 (fax)

Find out more information about Tracleer^® (bosentan)

Find out more information about Ventavis^® (iloprost)