Protopic Astellas Access ProgramSM Explanation
The Astellas Access ProgramSM (AAP) provides Protopic at no cost to patients who meet the eligibility criteria, which can be found in the AAP Eligibility criteria.
To enroll your patient with the Astellas Access ProgramSM, you must complete and submit a request via Astellas eService.
Please retain one of the following as proof of income for your records:
- Copy of the patient's most recent tax return
- Copy of the patient's 1099 Social Security form
- Copy of the patient's most recent Social Security Benefit letter
- Copy of the patient's latest pay stub for a consecutive 30 days
- A letter stating the patient's annual income as confirmed by your institution, on office or corporation letterhead
Once the Astellas Access ProgramSM approves your patient for assistance, we will notify both the provider and patient that they have been enrolled. An initial 90-day supply of Protopic is then shipped directly to the patient's home. Subsequent 90-day refills are then sent automatically to the patient's home throughout the approval period. Patients may be approved for assistance with Protopic for up to one year.
The Astellas Access ProgramSM will notify patients and their healthcare providers 45 days before the approval period is scheduled to end. Healthcare providers can then reapply on behalf of their patients via the simple re-enrollment process.
*The application must be submitted by the prescribing physician or an authorized employee at the treating facility.
