Helping Ensure Access to Your Medications
Get a one-time 30-day supply of your medication at no cost.
Waiting for an Application to process? Recently experienced financial hardship? The Sanofi Temporary Access Program could provide you with immediate access to a 30-day supply of certain Sanofi products while you wait.
Follow these steps to apply
Once you have submitted your completed application, call Sanofi Patient Connection®
Inform the representative that you have submitted your application and you are interested in the Sanofi Temporary Access Program.
Answer a few short questions to see if you qualify for the program (see below for eligibility criteria).
If you're eligible, you will be provided with a voucher ID, along with additional pharmacy numbers.
Bring your Voucher ID and Pharmacy numbers to your pharmacy, along with a valid prescription, to receive your 30-day supply.
Start the process. Apply to our Sanofi Patient Assistance Program.
To be eligible for the Temporary Access Program you must:
- Be 18 years of age or older
- Be prescribed Adlyxin®, Admelog®, Apidra®, Lantus®, Multaq®, Soliqua 100/33® or
- Be a resident of the United States, the District of Columbia, Puerto Rico, Guam or U.S. Virgin Islands
- Be uninsured or functionally uninsured and have suffered a recent financial hardship
- Have submitted a completed application for the Sanofi Patient Assistance Program
- Not have commercial insurance or Medicare that covers Sanofi medication costs
Multaq® (dronedarone) 400 mg Tablets
Soliqua® 100/33 (insulin glargine and lixisenatide injection) 100 Units/mL and 33 mcg/mL
Temporary Access Program Pharmacist Instructions
The Temporary Access Program provides eligible patients with a one-time 30-day supply of medication. The voucher information is valid only for the patient whose name appears on the prescription or prescriptions, and is limited to one redemption per person per lifetime. The voucher covers up to two injectable brands (max 150 mL) and/or up to one 60 tablet package of Multaq (dronedarone) 400 mg tablets (when prescriptions are filled at the same time) for the duration of the program.
Redeem one time for product(s) only when accompanied by valid, signed prescription(s). Please submit claim to RxC Acquisition Company d/b/a RxCrossroads by McKesson using BIN #610524. The BIN#, PCN#, GROUP# and VOUCHER ID# should be used when submitting for reimbursement. For questions regarding RxC Acquisition Company d/b/a RxCrossroads by McKesson processing, please call the Pharmacy Help Desk at: 1-800-657-76131-800-657-7613.
By accepting the voucher, the pharmacist certifies that (1) they have not submitted a claim for reimbursement to the patient or any third party payer (public or private); and (2) they have read, understood, and are in compliance with the terms and conditions pertaining to this program and applicable laws. Use of this voucher does not create any obligation or involve any past or future (i) purchase requirement or (ii) notice at any time. Prescriber ID # required on prescription. Sanofi US reserves the right to rescind, revoke, or amend this offer without notice. Limit 1 offer per patient.