VERIFY BENEFITS

Please complete this form and click submit to see the patient’s prescription coverage for Vigadrone™ (vigabatrin) for Oral Solution. If you have any questions, please contact us at 1-866-923-1954, Monday through Friday, 8:00am-9:00pm EST

*Required

PATIENT INFORMATION

Please select the quantity of packets per dose to be taken after titration is complete

 

PHYSICIAN INFORMATION

Please click below to verify your provider's information.

Please enter Provider First Name, Last Name,
and either a State or Zip code before verifying.



POLICY INFORMATION

*Select Insurance Plan:

Please complete all required fields.

Please verify your provider's information.