Mepron

Indicated For

toxoplasmosis, HIV

About This Medication

# GSK Patient Assistance Program Patient Guide: How to Get Mepron (Atovaquone) at Low or No Cost ## About This Program The **GSK Patient Assistance Program** helps eligible patients obtain GSK medications, including Mepron (atovaquone), at no cost. This program is managed by the GSK Patient Access Programs Foundation, an independent 501(c)(3) charitable foundation separate from GSK. The program does not constitute health insurance, and availability varies based on individual eligibility and product availability. ## What is Mepron (Atovaquone)? Mepron is a prescription medication manufactured by GSK used to treat certain parasitic infections. If you have been prescribed Mepron by your healthcare provider, this assistance program may help you access it affordably or at no cost if you meet eligibility requirements. ## Who Qualifies for This Program? To be eligible for the GSK Patient Assistance Program for Mepron, you must meet the following requirements: **Residency and Insurance Status:** - Live in the United States or Puerto Rico - Be either uninsured with no prescription drug benefits, OR have Medicare prescription drug coverage and meet additional program requirements - Not currently receive prescription drug coverage through Medicaid, VA, DOD, or TriCare benefits - Not be eligible for Puerto Rico's Government Health Plan Mi Salud (or have applied and been denied) **Financial Requirements:** You must meet income eligibility criteria based on your household size. Income thresholds vary and are based on federal poverty level guidelines. Contact the program directly at **(866) 728-4368** to confirm your specific income limits, as these are subject to change. **Medical Requirements:** - Have a valid, signed prescription from your healthcare provider for Mepron - The prescription must be written as medically appropriate by your physician ## Income Eligibility Breakdown While specific 2026 income thresholds for Mepron are not detailed in available program materials, the GSK Patient Assistance Program uses federal poverty level guidelines to determine eligibility. Income limits typically range from approximately 200-300% of the federal poverty level depending on your household size. | Household Size | Approximate Range* | |---|---| | 1 person | $47,880 - $59,850 | | 2 people | $64,920 - $81,150 | | 3 people | $81,960 - $102,450 | | 4 people | $99,000 - $123,750 | | Each additional person | Add $17,040 - $21,300 | *These are reference ranges based on program guidelines. Contact GSK directly for current, exact thresholds for your situation. ## Insurance Requirements Explained **If You Are Uninsured:** You may qualify if you have no prescription drug benefits through any insurer, payer, or program (excluding Medicare). You must also not be receiving coverage through government programs like Medicaid, VA, DOD, or TriCare. **If You Have Medicare:** If you have a Medicare prescription drug plan (Medicare Part D), you may still qualify for this program if you meet other eligibility requirements. Medicare Part D applicants must provide additional documentation, including their Medicare Beneficiary Identifier (MBI) and Part D ID card. **If You Have Other Insurance:** If you have private insurance or other coverage, you may be directed to copay assistance programs instead of the full patient assistance program. Contact GSK to explore all available options for your situation. ## Step-by-Step Application Process ### Step 1: Gather Required Documents Before starting your application, collect the following: - **Completed GSK Patient Assistance Program application form** (available by phone or online) - **Signed prescription** for Mepron from your healthcare provider (original or faxed directly from physician's office with cover sheet) - **Proof of income** (recent tax return, pay stubs, or benefit statements) - **Proof of residency** (utility bill or lease agreement) - **Medicare Part D ID card and MBI** (if applicable) ### Step 2: Complete the Application Fill out all required sections of the GSK Patient Assistance Program application completely. An incomplete application will delay processing. Required information includes: - Your full name, date of birth, and contact information - Mailing address - Insurance status and details - Income information - Medication details and prescription information ### Step 3: Sign and Date Your original signature is required on the application. Do not send original documents as they will not be returned—keep copies for your records. ### Step 4: Submit Your Application You have three enrollment options: **By Mail:** Send your completed application and supporting documents to: GSK Patient Assistance Program PO Box 220590 Charlotte, NC 28222-0590 **By Fax:** Fax your application to: **(855) 474-3063** Note: Prescriptions must be faxed directly from your physician's office with a fax cover sheet to be valid. **By Phone (Urgent Cases Only):** Call **(866) 728-4368** if you need medication immediately. Phone enrollment is available Monday–Friday, 8 AM–8 PM ET. ## Timeline and Medication Delivery **Processing Time:** The program does not specify exact processing timelines in available materials. However, submitting a complete application with all required documents will help expedite approval. Incomplete applications will experience delays. **Delivery Method:** Once approved, Mepron will be shipped either directly to you or to your physician's office, depending on program procedures and your preference. **Refills and Reauthorization:** This program requires reauthorization for continued access to medication. You will need to reapply or provide updated information periodically to maintain eligibility. The program will contact you with reauthorization requirements. ## What If Your Application Is Denied? If your application is denied, you have several options: 1. **Review denial reasons** – Contact GSK at (866) 728-4368 to understand why you were not approved 2. **Explore alternatives** – Ask about copay assistance programs if you have insurance, or other GSK support programs 3. **Contact patient advocacy organizations** – Social workers and patient advocacy groups may help identify additional funding sources 4. **Reapply** – If your circumstances change (income, insurance status), you may reapply 5. **Discuss with your healthcare provider** – Your doctor may have information about other assistance programs or alternative medications ## Important Information and Disclaimer - This program does not constitute health insurance - Eligibility and program terms are subject to change - Income thresholds and requirements vary and should be confirmed directly with GSK - The GSK Patient Assistance Program is managed by an independent charitable foundation - All information provided in your application will be used only to determine eligibility and administer the program - GSK may contact your healthcare provider, pharmacist, or insurance company to verify information and ensure program guidelines are met - You must live in the United States or Puerto Rico to qualify ## Contact Information **Phone:** (866) 728-4368 **Fax:** (855) 474-3063 **Hours:** Monday–Friday, 8 AM–8 PM ET **Mailing Address:** PO Box 220590, Charlotte, NC 28222-0590 **Online:** Visit www.gskpatientassistanceprogramportal.com for more information and to register ## Next Steps 1. Call **(866) 728-4368** to confirm your eligibility and request an application 2. Gather all required documents 3. Complete and sign the application thoroughly 4. Submit via mail, fax, or phone 5. Keep copies of all submitted documents for your records 6. Wait for approval notification and medication delivery If you have questions at any point in the process, do not hesitate to contact the GSK Patient Assistance Program team. They are available to help you access the medication you need.

Program information last verified: March 30, 2026