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Amyloidosis

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Program Status

Currently Closed – We are no longer accepting or processing applications for new or renewal patients.

The PAN Foundation’s Amyloidosis fund is currently closed. As of November 20, 2019, the Leukemia and Lymphoma Society’s Myeloma Associated Amyloidosis fund is accepting applications.

For current information, log in to FundFinder.

 

Assistance Amount

$7,800 per year. Patients may apply for a second grant during their eligibility period subject to availability of funding.

Eligibility Criteria

  1. The patient must be getting treatment for amyloidosis.
  2. The patient must have Medicare health insurance that covers his or her qualifying medication or product.
  3. The patient’s medication or product must be listed on PAN’s list of covered medications.
  4. The patient’s income must fall at or below 500% of the Federal Poverty Level. 
  5. The patient must reside and receive treatment in the United States or U.S. territories. (U.S. citizenship is not a requirement.)
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See the list of medications covered in this program
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  • Aciphex (rabeprazole sodium)
  • Aciphex Sprinkle (rabeprazole sodium)
  • Actemra (tocilizumab)
  • Actemra Actpen (tocilizumab)
  • Active Injection Kit D (dexamethasone sodium phosphate/pf)
  • Akynzeo (fosnetupitant chloride hcl/palonosetron hcl)
  • Akynzeo (netupitant/palonosetron hcl)
  • Alferon N (interferon alfa-n3)
  • Alkeran (melphalan)
  • Alkeran (melphalan hcl)
  • Amitiza (lubiprostone)
  • Anzemet (dolasetron mesylate)
  • Aprepitant (aprepitant)
  • Astagraf Xl (tacrolimus)
  • Ativan (lorazepam)
  • Bortezomib (bortezomib)
  • Cinvanti (aprepitant)
  • Clenpiq (sodium picosulfate/magnesium oxide/citric acid)
  • Colchicine (colchicine)
  • Colcrys (colchicine)
  • Compazine (prochlorperazine)
  • Compazine (prochlorperazine maleate)
  • Constulose (lactulose)
  • Cyclophosphamide (cyclophosphamide)
  • Dexamethasone Acetate La (dexamethasone acetate in sodium chloride, iso-osmotic)
  • Dexamethasone Acetate-sod Phos (dexamethasone acetate and sodium phosphate in sterile water)
  • Dexamethasone Sodium Phosphate (dexamethasone sodium phosphate)
  • Dexamethasone-0.9% Nacl (dexamethasone sodium phosphate in 0.9 % sodium chloride)
  • Dexonto (dexamethasone sodium phosphate)
  • Dexycu (dexamethasone/pf)
  • Dimenhydrinate (dimenhydrinate)
  • Diphenhydramine Hcl (diphenhydramine hcl)
  • Diphenhydramine-0.9% Nacl (diphenhydramine hcl in 0.9 % sodium chloride)
  • Diphenoxylate-atropine (diphenoxylate hcl/atropine sulfate)
  • Dmt Suik (dexamethasone/pf/norflurane/pentafluoropropane (hfc 245fa))
  • Doubledex (dexamethasone sodium phosphate/pf)
  • Emend (fosaprepitant dimeglumine)
  • Enbrel (etanercept)
  • Enbrel Mini (etanercept)
  • Enbrel Sureclick (etanercept)
  • Enulose (lactulose)
  • Envarsus Xr (tacrolimus)
  • Erythromycin (erythromycin base)
  • Esomeprazole Magnesium (esomeprazole magnesium)
  • Esomeprazole Sodium (esomeprazole sodium)
  • Esomeprazole Strontium (esomeprazole strontium)
  • Evomela (melphalan hcl/betadex sulfobutyl ether sodium)
  • Fosaprepitant Dimeglumine (fosaprepitant dimeglumine)
  • Generlac (lactulose)
  • Granisetron Hcl (granisetron hcl)
  • Haldol (haloperidol lactate)
  • Haloperidol (haloperidol)
  • Haloperidol Lactate (haloperidol lactate)
  • Humira (adalimumab)
  • Humira Pediatric Crohn's (adalimumab)
  • Humira Pen (adalimumab)
  • Humira Pen Crohn's-uc-hs (adalimumab)
  • Humira(cf) (adalimumab)
  • Humira(cf) Pediatric Crohn's (adalimumab)
  • Humira(cf) Pen (adalimumab)
  • Humira(cf) Pen Psor-uv-adol Hs (adalimumab)
  • Ilaris (canakinumab/pf)
  • Inflectra (infliximab-dyyb)
  • Intron A (interferon alfa-2b,recomb.)
  • Kineret (anakinra)
  • Kristalose (lactulose)
  • Lactulose (lactulose)
  • Lansoprazole (lansoprazole)
  • Lidocidex-i (dexamethasone sodium phosphate/lidocaine hcl)
  • Linzess (linaclotide)
  • Lomotil (diphenoxylate hcl/atropine sulfate)
  • Loperamide (loperamide hcl)
  • Lorazepam Intensol (lorazepam)
  • Lorazepam-0.9% Nacl (lorazepam in 0.9 % sodium chloride)
  • Lorazepam-d5w (lorazepam in 5 % dextrose and water)
  • Mas Care-pak (dexamethasone sodium phosphate/pf)
  • Meclizine Hcl (meclizine hcl)
  • Metoclopramide Hcl (metoclopramide hcl)
  • Mitigare (colchicine)
  • Motegrity (prucalopride succinate)
  • Nexium (esomeprazole magnesium)
  • Nexium I.v. (esomeprazole sodium)
  • Octreotide Acetate (octreotide acetate)
  • Olanzapine (olanzapine)
  • Omeprazole (omeprazole)
  • Ondansetron Hcl (ondansetron hcl)
  • Ondansetron Hcl (ondansetron hcl/pf)
  • Ondansetron Hcl-0.9% Nacl (ondansetron hcl in 0.9 % sodium chloride)
  • Ondansetron Hcl-d5w (ondansetron hcl in dextrose 5% in water)
  • Ondansetron Odt (ondansetron)
  • Onpattro (patisiran sodium, lipid complex)
  • Opium Tincture (opium tincture)
  • Pantoprazole Sodium (pantoprazole sodium)
  • Polyethylene Glycol 3350 (polyethylene glycol 3350)
  • Pomalyst (pomalidomide)
  • Prepopik (sodium picosulfate/magnesium oxide/citric acid)
  • Prevacid (lansoprazole)
  • Prilosec (omeprazole magnesium)
  • Prochlorperazine (prochlorperazine)
  • Prochlorperazine Edisylate (prochlorperazine edisylate)
  • Prochlorperazine Maleate (prochlorperazine maleate)
  • Prograf (tacrolimus)
  • Protonix (pantoprazole sodium)
  • Protopic (tacrolimus)
  • Rabeprazole Sodium (rabeprazole sodium)
  • Readysharp Dexamethasone (dexamethasone sodium phosphate)
  • Reglan (metoclopramide hcl)
  • Remicade (infliximab)
  • Renflexis (infliximab-abda)
  • Revlimid (lenalidomide)
  • Sancuso (granisetron)
  • Sandostatin (octreotide acetate)
  • Sandostatin Lar Depot (octreotide acetate, microspheres)
  • Scopolamine (scopolamine)
  • Sustol (granisetron)
  • Tacrolimus (tacrolimus)
  • Tegsedi (inotersen sodium)
  • Thalomid (thalidomide)
  • Tpn Electrolytes Ii (sodium/potassium/magnesium/calcium/chloride/acetate)
  • Transderm-scop (scopolamine)
  • Varubi (rolapitant hcl)
  • Velcade (bortezomib)
  • Vyndamax (tafamidis)
  • Vyndaqel (tafamidis meglumine)
  • Zofran (ondansetron hcl)
  • Zofran Odt (ondansetron)
  • Zuplenz (ondansetron)
  • Zyprexa (olanzapine)
  • Zyprexa Relprevv (olanzapine pamoate)

Diagnosis Codes:

ICD-10: E85.0, E85.1, E85.2, E85.3 , E85.4, E85.81, E85.82,E85.89, E85.9

 

About the Disease:

Amyloidosis is characterized by a build-up in amyloid protein in specific organs or throughout the body. It is a rare disease that affects multiple systems. Subtypes include amyloid A (AA) amyloidosis, immunoglobin light change amyloidosis (AL amyloidosis) and hereditary amyloidosis.

 

Source: National Institutes of Health