Help your patients save on EULEXIN®
If you or your patient is uninsured, below are two ways to access our patient access program:
Patients with Commercial Insurance
Commercially insured patients may pay as little as $15 for their prescription. Access your digital copay card using this form:
Medicare / Government Insurance OR No Insurance
Medicare / government insured patients and patients without insurance may qualify to get EULEXIN® at no cost.
- Fax: Fill out this PAP form (PDF) and fax it to Waylis Patient Access and Affordability at (844) 470-1931
- Call: Call Waylis Patient Access and Affordability at (888) 218-8897 to get started.
EULEXIN™ Savings Program Information:
BIN #: 610600
PCN#: AS
RxGroup: 377
ID#: 37701557109
Your Copay Card Information is below, please save for your records.
