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Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia

Get Help with Your Treatment

Apply Online or call 1-866-316-7263

 

Program Status

Program Fully Allocated

Currently Closed – We are no longer accepting or processing applications for new or renewal patients.

 

 

Assistance Amount

$7,300 per year. Patients may apply for a second grant during their eligibility period subject to availability of funding.

Eligibility Criteria

  1. The patient must be getting treatment for the disease named in the assistance program to which he or she is applying.
  2. The patient must have Medicare health insurance that covers his or her qualifying medication or product. 
  3. The patient’s medication or product must be listed on PAN’s list of covered medications.
  4. The patient’s income must fall at or below 500% of the Federal Poverty Level.
  5. The patient must reside and receive treatment in the United States or U.S. territories. (U.S. citizenship is not a requirement.)
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See the list of medications covered in this program
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  • Active Injection Kit D (dexamethasone sodium phosphate/pf)
  • Adriamycin (doxorubicin hcl)
  • Arranon (nelarabine)
  • Blincyto (blinatumomab)
  • Calcium Folinate (leucovorin calcium)
  • Cerubidine (daunorubicin hcl)
  • Clolar (clofarabine)
  • Cyclophosphamide (cyclophosphamide)
  • Cytarabine (cytarabine/pf)
  • Daunorubicin Hcl (daunorubicin hcl)
  • Deltasone (prednisone)
  • Dexamethasone Sodium Phosphate (dexamethasone sod phosphate)
  • Dexpak (dexamethasone)
  • Doubledex (dexamethasone sodium phosphate/pf)
  • Doxorubicin Hcl (doxorubicin hcl)
  • Erwinaze (asparaginase (erwinia chrysanthemi))
  • Gleevec (imatinib mesylate)
  • Iclusig (ponatinib hcl)
  • Ifex (ifosfamide)
  • Ifosfamide (ifosfamide)
  • Ifosfamide-Mesna (ifosfamide/mesna)
  • Imatinib Mesylate (imatinib mesylate)
  • Leucovorin Calcium (leucovorin calcium)
  • Marqibo (vincristine sulfate liposomal)
  • Mesna (mesna)
  • Mesnex (mesna)
  • Methotrexate Sodium (methotrexate sodium/pf)
  • Oncaspar (pegaspargase)
  • Prednisone (prednisone)
  • Rayos (prednisone)
  • Sprycel (dasatinib)
  • Tasigna (nilotinib hcl)
  • Vincasar Pfs (vincristine sulfate)
  • Vincristine Sulfate (vincristine sulfate)

Diagnosis Codes:

ICD-10: C91.00-C91.02