The Daiichi Sankyo Open Care Program offers assistance to qualified individuals who demonstrate medical and financial need. The program provides free products to those who are prescribed Daiichi Sankyo products and are under- and uninsured, as well as unable to identify alternative payment sources.

How to Apply

Please either download the application below (if available) or go to the program website for more information on how to apply. Once you fill out your application, send it to the address on the application. Remember not to send program applications to PPA.

Product(s) Covered by Program

  • A

    • Azor®
  • T

    • Tribenzor®
  • W

    • Welchol® Oral Suspension
    • Welchol® Tablets