NUWIQ Free Trial Program for Patients with Hemophilia A
NUWIQ Free Trial Program
Please call 1-800-554-4440 to start your patient on the NUWIQ Free Trial Program.
If you are currently using another FVIII product, or if you’re not currently using factor treatment, you may want to consider NUWIQ.
With the Free Trial Program, eligible Hemophilia A patients can receive treatment with NUWIQ (not to exceed 6 doses or not exceed approximately 20,000 IUs) at no cost, shipped directly to you and administered under the supervision and care of your physician.
There’s never been a better time to try NUWIQ and see if it’s right for you.
3 Steps to Enroll
Your physician initiates the Enrollment and Patient Consent Forms and writes a prescription for NUWIQ
Your physician provides the Enrollment and Patient Consent Forms and prescription to you, the patient
Patient completes both forms, signs and faxes all documents to the Program Administrator, Covance at 1-800-554-6744
What Happens Next?
- Program Administrator reviews documents to ensure patient meets program criteria
- Program Administrator processes completed Enrollment and Patient Consent Forms then transmits prescription to pharmacy for dispensing of NUWIQ
- Program Administrator confirms NUWIQ is shipped to patient
- Patient is administered NUWIQ under the supervision and care of their physician