Orbactiv

Indicated For

ABSSSI, gram-positive infections

About This Medication

# ORBACTIV Patient Assistance Program: How to Get Oritavancin at No Cost ## About ORBACTIV (Oritavancin) ORBACTIV is a prescription antibiotic used to treat acute bacterial skin and skin structure infections (ABSSSI) in adults. It is administered as a single-dose injection and is effective against various gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA). Unlike some other antibiotics that require multiple doses, ORBACTIV's single-dose formulation offers convenience and efficiency for eligible patients. ## Who Qualifies for the ORBACTIV Patient Assistance Program The ORBACTIV Patient Assistance Program is designed to help uninsured patients access this medication at no cost. To qualify, you must meet the following criteria: **Insurance Status:** You must be uninsured and not receive prescription drug coverage from any government-funded healthcare program, including Medicare, Medicaid, managed Medicaid, or TRICARE. **Income Requirements:** You must meet household income requirements set by Melinta Therapeutics. While specific income thresholds are not publicly listed, the program evaluates your household income as part of the eligibility determination process. **Patient Type:** Both inpatients and outpatients are eligible for assistance, making this program accessible regardless of your treatment setting. **Age and Residency:** You must be a United States resident and at least 18 years of age. ## Income Eligibility The program requires that patients meet household income requirements, though specific income thresholds are not publicly disclosed. Income eligibility is evaluated on a case-by-case basis during the application process. When you apply, you will need to provide information about your household income to determine if you qualify. | Eligibility Factor | Requirement | |---|---| | Insurance Status | Uninsured; no government healthcare coverage | | Income | Must meet program requirements (evaluated individually) | | Patient Type | Inpatient or outpatient | | Age | 18 years or older | | Residency | United States resident | ## Insurance Requirements and Restrictions This program is exclusively for uninsured patients. You are **not eligible** if you have: - Medicare coverage - Medicaid or managed Medicaid coverage - TRICARE or other military healthcare coverage - Any private commercial insurance - Any government-funded healthcare program If you have private insurance, you may be eligible for the ORBACTIV Copay Savings Program instead, which can cover up to $600 of your copayment or coinsurance obligation. ## How to Apply: Step-by-Step **Step 1: Contact the ORBACTIV Support Program** Call the ORBACTIV Patient Support Program at **1-844-ORBACTIV (1-844-672-2284)** Monday through Friday, 8:00 AM to 8:00 PM ET. You can also email OrbactivSupport@Asembia.com for assistance. **Step 2: Request an Enrollment Form** Ask for the ORBACTIV Patient Assistance Program enrollment form. This form will be provided by phone or email. **Step 3: Complete the Enrollment Form** You and your healthcare provider (HCP) must complete the enrollment form together. The form requires: - Your personal information (name, date of birth) - Attestation that you do not receive prescription drug coverage from any government-funded healthcare program - Your household income information - Your healthcare provider's signature and information **Step 4: Submit the Form** Your healthcare provider will fax the completed and signed enrollment form to **1-855-886-2482**. Both you and your HCP must sign the form for it to be processed. **Step 5: Await Eligibility Determination** Melinta Therapeutics will review your application and determine your eligibility. The company may request additional documentation to confirm your eligibility status. ## Timeline and Medication Delivery The program does not publicly specify an exact processing timeline. However, once you are approved, the medication is delivered as a **replacement program for the unit used on the eligible patient**—meaning ORBACTIV will be provided at no cost for your treatment. For specific information about processing times and delivery timelines, contact the ORBACTIV Support Program directly at 1-844-672-2284. ## What Happens If Your Application Is Denied If your application for the ORBACTIV Patient Assistance Program is denied, you have several options: 1. **Review Denial Reasons:** Contact the ORBACTIV Support Program to understand why your application was denied. Common reasons include having insurance coverage or not meeting income requirements. 2. **Explore Alternative Programs:** If you have private commercial insurance, ask your healthcare provider about the ORBACTIV Copay Savings Program, which can reduce your out-of-pocket costs by up to $600. 3. **Reapply:** If your circumstances change (such as losing insurance coverage), you may reapply for the patient assistance program. 4. **Discuss with Your Healthcare Provider:** Your doctor may have information about other resources or treatment alternatives. ## Important Program Information **Program Modifications:** Melinta Therapeutics reserves the right to modify, discontinue, or change the eligibility criteria for this program at any time without notice. **Consent to Contact:** By enrolling, you consent to being contacted by the ORBACTIV Support Program via mail, telephone, fax, and email regarding your enrollment and follow-up. You can revoke this consent at any time. **Patients Already Enrolled:** If you are already enrolled in the ORBACTIV Patient Assistance Program, you are not eligible for the Copay Savings Program. ## Disclaimer This guide provides general information about the ORBACTIV Patient Assistance Program. Program eligibility, benefits, and terms are subject to change at any time. Melinta Therapeutics does not guarantee coverage or payment for any particular claim. For the most current and complete information, contact the ORBACTIV Support Program at 1-844-672-2284 or visit www.orbactiv.com. Always consult with your healthcare provider and the program directly regarding your specific situation and eligibility.

Program information last verified: March 30, 2026