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Chemotherapy-Induced Nausea and Vomiting

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Program Status

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Fully Allocated - We are no longer accepting or processing applications for new or renewal patients.

Maximum Award Level

$4,000 per year.

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 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  
  • Akynzeo (netupitant/palonosetron)
  • Aloxi (palonosetron)
  • Alprazolam Intensol (alprazolam)
  • Anzemet (dolasetron)
  • Ativan (lorazepam)
  • Baycadron (dexamethasone)
  • Cesamet (nabilone)
  • Cogentin (benztropine)
  • Compazine (prochlorperazine)
  • Compro (prochlorperazine)
  • Decadron (dexamethasone)
  • Dex (dexamethasone)
  • Dexpak (dexamethasone)
  • Doubledex (dexamethasone)
  • Dytuss (diphenhydramine)
  • Emend (aprepitant)
  • Emend (fosaprepitant)
  • Granisol (granisetron)
  • Haldol (haloperidol)
  • Kytril (granisetron)
  • Marinol (dronabinol)
  • Metoclopramide ODT (metoclopramide)
  • Metozolv (metoclopramide)
  • Metozolv Odt (metoclopramide)
  • Niravam (alprazolam)
  • Pharbedryl (diphenhydramine)
  • Phenadoz (promethazine)
  • Phenergan (promethazine)
  • Promethegan (promethazine)
  • Reglan (metoclopramide)
  • Sancuso (granisetron)
  • Sustol (granisetron)
  • Syndros (dronabinol)
  • Varubi (rolapitant)
  • Xanax (alprazolam)
  • Zema-Pak (dexamethasone)
  • Zofran (ondansetron)
  • Zuplenz (ondansetron)
  • Zyprexa (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

 

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