EMFLAZA Bridge Program and Prescription Start Form

PTC is committed to getting patients onto EMFLAZA as quickly as possible, without interruption of therapy. For patients that are currently accessing EMFLAZA through Master Pharmacy importation from outside of the US, they may have immediate access to a “Bridge Program” that will provide EMFLAZA free of charge while their insurance status is being investigated. It is our goal that all eligible patients have access to EMFLAZA regardless of their insurance status or ability to pay.

To get started and obtain product, an EMFLAZA Prescription Start Form is required to be completed and submitted to the EMFLAZA Cares program via the fax number at the top of the form.

For more information, please review the following documents.






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