Patient Assistance

You are responsible for any co-pays or deductibles at the time you pick up or ship your medication. Many specialty drug manufacturers and private foundations offer co-pay assistance programs. We will help determine your eligibility for these programs and assist with any necessary applications. If you are out-of-network for the Duke Specialty Pharmacy, we will either refer you to a pharmacy in your network or provide a written notice to you of the cost of your medications prior to filling your prescription.

Bring your insurance card as well as any information provided by a drug manufacturer that your provider may have given you or that you may have received in the mail. 

If you are uninsured or underinsured, our patient assistance technicians can help.  In addition, please bring any forms your provider or drug manufacturer has given to you.

Patient Acknowledgment and Authorization Form (PDF, 100 KB)
This form is required to participate in the Duke Patient Assistance program.  By signing this form, the patient accepts financial responsibility for medications even if the Duke Patient Assistance program is unable to obtain additional co-pay assistance.

Patient Assistance HIPAA form (PDF, 275 KB)
This required form grants Duke Patient Assistance permission to release personal information to manufacturer programs or foundations.