Astellas Stock Replacement Program
The Astellas Stock Replacement Program provides stock replacement of injectable/infused Astellas products, including AmBisome® (amphotericin B) liposome for injection, at no cost, for medications administered to eligible, uninsured patients who meet program requirements.
In order for the healthcare provider or facility to receive no-cost stock replacement of Astellas medications through the Astellas Stock Replacement Program, the treated patient must satisfy the following criteria:
- Be unisured
- Have a verifiable shipping address in the United States
- Have been prescribed AmBisome® (amphotericin B) liposome for injection, for an FDA-approved indication
- Meet the program financial eligibility requirementsa
- Have had AmBisome administered in a healthcare facilityb
To initiate the Astellas Stock Replacement Program application process, log into Astellas eServicec to submit an application for the Astellas Stock Replacement Program. The application must be submitted within one hundred eighty (180) days of the date of service for the last injection or infusion.
Upon completion and submission of the Astellas Stock Replacement Program Application, we will evaluate whether the patient meets the program criteria.
If the application is approved, the replacement product will be shipped to the facility.
a Astellas Stock Replacement Program requires the healthcare provider or facility to retain proof of patient income on file in their office.
b Under the Astellas Stock Replacement Program, a healthcare facility may include a physician's office, clinic, hospital inpatient or outpatient department, long-term care facility, or infusion center. It is required under this program that the healthcare provider or an authorized employee at the treating facility certify that the facility is a) under no legal obligation under any federal, state, or local law or regulation to provide a patient with product, and b) will not be receiving a payment for a service that would otherwise fund the provision of the product to the patient (e.g., a capitated or bundled payment for an inpatient hospital admission) and also certifies that the facility will waive charges for the administration of product from patients without any health insurance that satisfy all other eligibility criteria.
c If you do not have an eService account, it is easy to set one up. If you need technical assistance or help with your account, please call us at 1-800-477-6472. We are available Monday–Friday, 9:00 am–8:00 pm ET.
AmBisome® is a registered trademark of Gilead Sciences, Inc.