Corporate Responsibility
Corporate Responsibility

Welcome to the Help At Hand Patient Assistance Evaluation Tool

To find out which Help At Hand program you may be eligible for, simply answer the brief questionnaire below. Based on your answers, you’ll see if you may be eligible for assistance through Takeda’s Patient Assistance Program (PAP), Together Rx Access® or the Partnership for Prescription Assistance (PPA).

Along with your results, you’ll find links to more information about the programs you may qualify for and next steps for applying.

patient assistance evaluation tool
Select
ACTOS®
ACTOplus met®
ACTOplus met® XR
AMITIZA®
DEXILANTTM
duetact®
PREVACID®
Rozerem®
ULORIC®
Select the Takeda medicine you have been prescribed
  
Are you a resident You must live in the United States and for some assistance programs must provide proof of residency with either a Social Security Number, Green Card Number or Visa Number. of the United States?
Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
What state do you live in?
1
2
3
4
5
6
7
8
9
10+
How many people are
in your household Includes all persons who live in the same individual residence at a given time such as spouses and children but not pets.
What is your annual household income Your yearly household income includes all money that comes into your household. If you are married and live with your spouse, you must include both of your incomes. You must also include income earned by dependents living with you.?
  
Do you have any prescription drug coverage Prescription coverage includes Medicaid/Medicare prescription drug coverage; state-sponsored prescription drug assistance programs; employee, military, retirement or pension program drug coverage.?
  
Do you have a Medicare Prescription Drug Plan-Part D?

ACTOS, ACTOplus met, ACTOplus met XR and Duetact are trademarks of Takeda Pharmaceutical Company Limited registered with the U.S. Patent and Trademark Office and used under license by Takeda Pharmaceuticals America, Inc.

ROZEREM is a trademark of Takeda Pharmaceutical Company Limited registered with the U.S. Patent and Trademark Office and used under license by Takeda Pharmaceuticals America, Inc.

DEXILANT is a trademark of Takeda Pharmaceuticals North America, Inc. and used under license by Takeda Pharmaceuticals America, Inc.

AMITIZA is a trademark of Sucampo Pharmaceuticals, Inc. registered with the U.S. Patent and Trademark Office and used under license by Takeda Pharmaceuticals America, Inc.

ULORIC is a trademark of Teijin Pharma Limited registered with the U.S. Patent and Trademark Office and used under license by Takeda Pharmaceuticals America, Inc.

This program, as well as all Takeda Pharmaceuticals America, Inc. programs, can be discontinued or changed at any time without notice at the discretion of Takeda Pharmaceuticals America, Inc.

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