The Fycompa® Patient Assistance Program is for patients who need assistance paying for Fycompa®. This program provides Fycompa® at no or low cost to financially needy patients who meet program eligibility criteria.

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

  • F

    • Fycompa®