CALL US AT
CALL US AT
Helping uninsured, income-eligible patients overcome financial barriers, the Compassionate Care Program is designed to provide eligible patients savings on Gonal-f® (follitropin alfa for injection), Ovidrel® PreFilled Syringe (choriogonadotropin alfa injection), or Cetrotide® (cetrorelix acetate for injection).
Depending on income, eligible patients† may save 25%, 50%, or 75% off the self-pay price of medicine or receive a 10% discount per unit, via a mail-in rebate, off their out-of-pocket costs for the following EMD Serono fertility products:
The discount levels are detailed in the chart below. Please note that discounts are taken off the retail price and cannot be combined with any other discount programs.
Prices effective 2/1/2018 All Prices subject to change due to manufacturer price increase *Retail price before 10% rebate. Discount percentages are based off of Retail Price.**Patients who do not qualify for 25%, 50% or 75% discounts will automatically be enrolled in either Compassionate Care Rebate Program or Go Direct Rebate Program for discounts on entire Serono product line. Patients will pay Retail Price at checkout and receive rebate check in mail.
Patients can APPLY ONLINE HERE. THIS IS THE EASIEST METHOD.
DOWNLOAD AN APPLICATION HERE (English Version)
Spanish Version – forma en espanol
Then submit via one of the following options
Send completed enrollment forms to:
Mail: The Compassionate Care Program
2250 Perimeter Park Drive Suite 300, Morrisville, NC 27560
Fax: (919) 415-2870
APPLICATIONS ARE NO LONGER ACCEPTED VIA EMAIL. IF YOU WISH TO SUBMIT ELECTRONICALLY, PLEASE DO SO HERE.
*Although Mandell’s Clinical Pharmacy is a participating provider for Compassionate Care and offers this program through our pharmacy, it is a third party program. Mandell’s does not determine or influence patient eligibility or acceptance.