Free Product for Takeda Help At Hand is available for those applicants meeting all program eligibility requirements and whose health care provider has prescribed a Takeda product. Follow the eligibility requirements.
Application Checklist
Follow the checklist to complete the application along with your doctor. Be sure to include all supporting documents and submit.
Application
If you are eligible, click on the application to obtain the PDF or call 1-800-830-9159 to have a physical copy of the application mailed/faxed to your physician’s office or to your home.
The application can be faxed from your health care provider to 1-800-497-0928 or mailed to
Takeda Patient Assistance Program
P.O. Box 5727, Louisville, KY 40255-0727
Phone: 1-800-830-9159
Fax: 1-800-497-0928
Next Steps
Once your application has been submitted, we will start the review process which may take up to 3-5 business days. We encourage you to submit a complete application as incomplete applications result in processing delays. You will receive a letter indicating the eligibility decision.
Approved
- A letter will be mailed to you to inform you how you will receive your medication from the program. Your prescriber will also receive a similar letter via fax.
- Our pharmacy will ship the prescribed medication directly to the address indicated on the application.
- VYVANSE or MYDAYIS patients must take their CII voucher in their approval letter to their local retail pharmacy along with their prescription. The CII voucher will cover the full cost of the medication.
- VYVANSE and MYDAYIS will no longer be available through Help at Hand after December 31, 2023 (please work with your health care provider to determine the appropriate next steps to best address your individual needs). The completed application with all required supporting documentation must be approved by October 16, 2023 in order to continue to receive product from the Help at Hand Patient Assistance Program for the remainder of 2023.
Missing Information
- If any information is missing or illegible, you and your health care provider will receive a notification letter (fax or mail).
- If the missing information is obtained successfully, all new documentation and information will be reviewed.
- After three unsuccessful attempts to reach you and your HCP, a denial decision is made.
Denied
You will receive a denial letter if it was determined that your application did not meet the eligibility criteria. You may appeal this decision within 90 days of the processing date or reapply after the 90-day period.
Re-Enrollment in the Program
Once approved, you’ll receive your prescribed and approved medicines for up to one year, but you will need to re-apply in advance of your program eligibility end date if you continue to need help. Before your enrollment ends, we’ll send you a reminder to renew your application.
Please note, VYVANSE and MYDAYIS will no longer be available through Help at Hand after December 31, 2023 (please work with your health care provider to determine the appropriate next steps to best address your individual needs). The last day to be approved, or re-approved, for these products is October 16, 2023.