Syprine

Bausch Health Patient Assistance Program Patient Guide: How to Get Syprine (trientine) at Low or No Cost

Syprine (trientine) is a prescription medication used to treat Wilson's disease, a rare genetic disorder where the body accumulates too much copper, potentially damaging the liver, brain, and other organs. This guide explains how to apply for the Bausch Health Patient Assistance Program (PAP), which provides Syprine at no cost to eligible patients who meet specific financial and insurance criteria. The program helps uninsured or underinsured U.S. residents access this vital treatment without financial burden.[1][2]

Who Qualifies for the Program?

Eligibility is determined on a case-by-case basis. To qualify, you must:

• Be a legal U.S. resident (including Puerto Rico) and treated as an outpatient (not residing in a hospital, nursing home, correctional facility, or similar).[1][2]
• Have a valid prescription from a licensed U.S. healthcare professional for Syprine (trientine), a product covered by the Bausch Health PAP.[1][2]
• Lack insurance coverage for Syprine, or have been denied coverage by commercial insurance after exhausting appeals, or have no coverage through government programs like Medicare Part D, Medicaid, VA, TRICARE, etc. Medicare Part D patients may appeal for review.[1][2]
• Meet household income limits: Annual income must not exceed 300% of the Federal Poverty Level (FPL) based on household size. Guidelines are available at https://aspe.hhs.gov/poverty-guidelines.[2]
• Have a prescriber not excluded from federal healthcare programs.[2]

Important: Medicaid patients should use a separate application. All applications are free, and Bausch Health makes the final decision.[1][2]

About Syprine (trientine)

Syprine is the brand name for trientine hydrochloride, an oral chelating agent that binds to excess copper in the body and promotes its excretion through urine. It's typically prescribed for patients with Wilson's disease who cannot tolerate penicillamine (another chelator). Common side effects include nausea, fatigue, and skin rashes; your doctor will monitor copper levels via blood and urine tests. Always follow your healthcare provider's dosing instructions, usually starting at 750-1250 mg daily in divided doses. This program ensures access for those who need it most.[1]

Income Eligibility Breakdown

Income eligibility is based on total annual household income not exceeding 300% of the FPL. Exact dollar amounts vary yearly and by household size—check current guidelines for precision. Here's an approximate table based on standard FPL calculations (adjust for latest figures):

Add ~$5,380 per additional person at 100% FPL. Reviewed case-by-case; provide proof like tax returns.[2]

Insurance Requirements

You must have no insurance coverage for Syprine. This includes:

• Uninsured patients.
• Denied by commercial insurance (after appeals).
• No coverage via Medicare Part D, Medicaid, Medigap, VA, DoD, TRICARE, or state programs.[2] Discount cards don't count as coverage. Attach copies of insurance cards (front/back) and pharmacy statements. Medicare patients: Appeal possible, but all terminated Dec 31 annually and must reapply.[1][2]

Step-by-Step Application Process

1. Download the form: Get the application at https://www.bauschhealthpap.com/siteassets/pdf/docs/bhc-bhpap-application-all-other-patients.pdf.[1]
2. Patient section: Complete Patient Information, Insurance Information (page 2), and sign Patient Authorization/Certification (page 3).[1]
3. Prescriber section: Have your doctor complete pages 4-6, including diagnosis, prescription, and Prescriber Certification. Electronic or handwritten signatures required (no stamps for controlled substances).[1]
4. Gather documents: Valid prescription, insurance cards (front/back), proof of income if requested.[1]
5. Submit: Fax to 844-705-0160 or mail to Bausch Health Patient Assistance Program, P.O. Box 991624, Louisville, KY 40269. Call (888) 607-7267 or 833-862-8727 (8 AM-5 PM ET) for help.[1][3]

Applications with missing info (marked with *) are held until complete.[1]

Timeline and Delivery

Processing time varies as reviews are case-by-case; expect several weeks. Once approved, medication is shipped directly to you at no cost for up to 12 months.[1][2][3] Reconfirm eligibility annually; changes in income/insurance may affect status. Medicare patients reapply post-Dec 31.[2]

Alternatives if Denied

• Appeal the decision or reapply with updated info.[2]
• Explore other programs like HealthWell Foundation for Homocystinuria/Organic Acidemias (may cover Wilson's).[3]
• Patient Access Network (PAN) Foundation or state assistance.
• Generic trientine if available; discuss biosimilars (none listed here).[3]
• Contact your doctor for samples or low-cost pharmacies.

Disclaimer

This guide is for informational purposes only and based on publicly available program details as of 2026. Eligibility, terms, and availability can change—verify with Bausch Health at (888) 607-7267 or BauschHealthPAP.com. Not medical advice; consult your healthcare provider. Bausch Health reserves discretion in approvals.[1][2]