Patient Instructions for AAP Application Submission
The Astellas Access ProgramSM (AAP) provides Protopic at no cost to qualified patients who are uninsured. This program is managed by Astellas Reimbursement ServicesSM (ARS).
Step 1: Application Process for Enrollment
Work with your prescriber to collect the necessary information to submit an AAP request. Your prescriber is required to obtain proof of your income and retain it in your file. Acceptable forms of documentation include:
- Latest federal or state tax return
- Latest W-2 statement
- SSDI/SSI award letter
- Latest bank statement (one month)
- Latest pay stub(s) (one month)
- State program acceptance letter or card
- 1099 Social Security form
Step 2: Enrollment Process
If accepted into the Astellas Access ProgramSM both the patient and the provider will receive an acceptance letter confirming the start and end dates for the enrollment period. Upon approval, the provider will receive the first shipment of Protopic within 3 to 5 business days of the patient's acceptance into the program. For subsequent shipments of Protopic, providers will be contacted by CVS Caremark to verify the correct shipping address. If the patient's shipping address or prescription for Protopic changes at any time during the enrollment period, please call ARS at 1-800-477-6472.
Should you have any questions regarding the Astellas Access ProgramSM, please do not hesitate to call ARS at 1-800-477-6472. We remain committed to supporting and improving access to Protopic.
