SUPPORT™

A Program of Reimbursement Support and Patient Assistance Services

Merck & Co., Inc., knows that healthcare reimbursement can be difficult to understand. To make the process of identifying and securing coverage for CRIXIVAN^® (indinavir sulfate) less confusing, we have created the SUPPORT™ program to assist people who have been prescribed CRIXIVAN.

Through a single toll-free number, 1-800-850-3430, physicians and their patients can receive assistance when reviewing insurance coverage options, applying for alternate insurance, addressing reimbursement issues, and applying for product assistance.

The SUPPORT program assists insured people in obtaining maximum reimbursement for CRIXIVAN and assists uninsured people in locating and applying for alternate coverage sources. For uninsured people with no alternate insurance sources, the program may provide CRIXIVAN at no cost when medically indicated. These services are described in more detail below.

Reimbursement Support Services

The program assists insured people and their physicians with questions related to insurance coverage and reimbursement for CRIXIVAN, filing claims for CRIXIVAN, and claims management. For uninsured patients and those who are uncertain of their insurance coverage and what public assistance options may be available to them, the program’s Reimbursement Support Services will assist in locating payment sources for CRIXIVAN.

Program Benefits

A reimbursement counselor will be assigned to your case. The counselor will:

• Answer questions regarding your insurer’s policies, whether you have private insurance, HMO, or insurance through public programs, such as Medicaid or AIDS Drug Assistance Programs (ADAPs)
• Assist patients in identifying and applying for alternate insurance coverage for CRIXIVAN
• Assist physicians, their patients, and patients’ families with the application process for patient assistance
• Arrange for eligible patients to have CRIXIVAN shipped to the prescribing physician’s office
• Assist physicians with billing, claim form completion, and coding for CRIXIVAN
• Work with physicians or patients to resolve specific issues related to payment, reimbursement, or claims denials for CRIXIVAN

Although the program provides direct assistance on individual claims problems, it cannot guarantee coverage or a specific reimbursement rate for CRIXIVAN.

Patient Assistance Services

The program’s Patient Assistance Services works with patients and physicians to identify payment sources for CRIXIVAN. For patients who qualify, the SUPPORT program will provide access to CRIXIVAN until other, more complete coverage becomes available.

Receiving Assistance

Call 1-800-850-3430 to speak with a reimbursement counselor.

The reimbursement counselor will attempt to answer all questions during the call.

If the question requires contacting an insurer or conducting other research, the reimbursement counselor will research the issue and contact the caller with a response.

Applying for Assistance

The physician, patient, or patient’s guardian may begin the application process by calling the SUPPORT program at 1-800-850-3430.

The application that will be sent has two parts. The patient must complete and sign the patient application and return it to the SUPPORT program. The physician must then complete and sign the physician application and return it to the SUPPORT program with a prescription for CRIXIVAN.

Completed applications should be mailed or faxed to:

SUPPORT™
PO Box 222137
Charlotte, NC 28222-2137
Fax:1-704-357-0036

Completion of an application does not ensure qualification for free drug.

Physicians and their patients can reach the SUPPORT program by calling 1-800-850-3430 Monday through Friday, 9 AM to 8 PM, Eastern time.

After hours, or if a reimbursement counselor is not available, the caller may leave a message. The message should include the caller’s name and a telephone number where the caller would like to receive a return call. Calls will generally be returned the next business day.

Multiple language capabilities are available, and every effort will be made to address special language needs that a caller may have.