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Chemotherapy-Induced Nausea and Vomiting

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Program Status

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

 

 

Assistance Amount

$1,000 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 the disease named in the assistance program to which he or she is applying.
  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 400% 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
View List  
  • Active Injection Kit D (dexamethasone sodium phosphate/pf)
  • Akynzeo (netupitant/palonosetron hcl)
  • Aler-Caps (diphenhydramine hcl)
  • Aler-Tab (diphenhydramine hcl)
  • Alka-Seltzer Plus Allergy (diphenhydramine hcl)
  • Aller-G-Time (diphenhydramine hcl)
  • Allergy Relief (diphenhydramine hcl)
  • Aloxi (palonosetron hcl)
  • Alprazolam (alprazolam)
  • Antihistamine (diphenhydramine hcl)
  • Anzemet (dolasetron mesylate)
  • Aprepitant (aprepitant)
  • Ativan (lorazepam)
  • Banophen (diphenhydramine hcl)
  • Benadryl Allergy (diphenhydramine hcl)
  • Benztropine Mesylate (benztropine mesylate)
  • Cesamet (nabilone)
  • Cogentin (benztropine mesylate)
  • Compazine (prochlorperazine maleate)
  • Compro (prochlorperazine)
  • Dexamethasone Sodium Phosphate (dexamethasone sod phosphate)
  • Dexpak (dexamethasone)
  • Diphen (diphenhydramine hcl)
  • Diphenhist (diphenhydramine hcl)
  • Diphenhydramine Hcl (diphenhydramine hcl)
  • Doubledex (dexamethasone sodium phosphate/pf)
  • Dronabinol (dronabinol)
  • Emend (aprepitant)
  • Emend (fosaprepitant dimeglumine)
  • Geri-Dryl (diphenhydramine hcl)
  • Granisetron Hcl (granisetron hcl)
  • Granisol (granisetron hcl)
  • Haldol (haloperidol lactate)
  • Haloperidol (haloperidol)
  • Lorazepam (lorazepam)
  • Marinol (dronabinol)
  • Metoclopramide Hcl (metoclopramide hcl)
  • Metozolv Odt (metoclopramide hcl)
  • Naramin (diphenhydramine hcl)
  • Niravam (alprazolam)
  • Olanzapine (olanzapine)
  • Ondansetron Hcl (ondansetron hcl/pf)
  • Ormir (diphenhydramine hcl)
  • Pharbedryl (diphenhydramine hcl)
  • Phenadoz (promethazine hcl)
  • Phenergan (promethazine hcl)
  • Prochlorperazine Maleate (prochlorperazine maleate)
  • Promethazine Hcl (promethazine hcl)
  • Promethegan (promethazine hcl)
  • Q-Dryl (diphenhydramine hcl)
  • Quenalin (diphenhydramine hcl)
  • Reglan (metoclopramide hcl)
  • Sancuso (granisetron)
  • Siladryl (diphenhydramine hcl)
  • Silphen (diphenhydramine hcl)
  • Sustol (granisetron)
  • Valu-Dryl (diphenhydramine hcl)
  • Varubi (rolapitant hcl)
  • Vicks Qlearquil Nighttime (diphenhydramine hcl)
  • Xanax (alprazolam)
  • Zofran Odt (ondansetron)
  • Zuplenz (ondansetron)
  • Zyprexa Zydis (olanzapine)

Diagnosis Codes:

ICD-10: R11.0, R11.10, R11.11, R11.12, R11.2, T45.1X1A, T45.1X1D, T45.1X1S, T45.95XA, T45.95XD, T45.95XS, T50.905A, T50.905D, T50.905S

Related Organizations: