Log me out of my Sancuso session and bring me to the patient Rx solutions landing page

Welcome

Welcome to Patient Rx Solutions

Healthcare providers can easily submit prescription information to help streamline your patient’s access to SANCUSO (Granisetron Transdermal System). This unique program also provides real-time status reporting, the benefits of a dedicated team for prior authorization support and the convenience of home delivery.

it's easy to get your benefit verification started!
Simply complete a one page form by logging into your secure account or send the form via fax.

Fax
Complete and fax the SANCUSO
Benefit Verification Form
Fax the form to Patient Rx Solutions at 844-214-3444

*Kyowa Kirin will pay up to $530 dollars per month (after the patient pays the initial $20) for up to 4 patches per month and a yearly maximum benefit of $3,180. This offer is not valid for prescriptions under Medicare (including Medicare Advantage, Part A, B and D Plans), Medicaid, VA, DOD, TRICARE, CHAMPUS, or other federal or state healthcare programs. This offer is not valid for prescriptions in Massachusetts or in any other state that does not permit copay reimbursement consistent with this program. Patients without commercial insurance are not eligible for this program. Unless otherwise indicated on submission form, Sancuso will be dispensed through select ASPN network pharmacy partners; available at participating pharmacies. Kyowa Kirin, Inc., reserves the right to cancel or modify the program at any time. Offer expires January 31, 2018.