First Steps Program

DesignRx and Glen Rock Medical Pharmacy are committed to providing fertility patients with a wide number of financial options for achieving their family. We know that life isn’t always easy, and that everyone can use a little help from time to time. First Steps is available to self pay patients needing help paying for their medications. Patients who qualify based on income or hardship cases may receive to up to 75% off their prescription purchase price! Furthermore, everyone who applies will receive some level of discount, with the largest discounts reserved for those who have the largest financial need. A tiered approach (5%, 25%, 50%, and 75%) makes it easy for patients to qualify, and easy for patients and health care providers to understand. Prescriptions eligible for these discounts may be filled at Glen Rock Medical Pharmacy. Qualified patient discounts are good for up to a year*.

 *Re-enrollment necessary after 12 months. 

First Steps Program Details

  • Discounts for patients with documented financial need and a valid prescription for Follistim® (follitropin beta for injection),or Ganirelix® (ganirelix acetate for injection),and Pregnyl
  • Patients can save 5%, 25%, 50% or 75% off the available self-pay price at participating DesignRx pharmacies
  • A valid prescription for an eligible drug at a participating pharmacy
  • Benefit is available at DesignRx network pharmacies only
  • Patients may not combine this card with any rebate, coupon, free trial, or similar offer
  • Patient may use the discounts multiple times within a calendar year
  • Patients must reapply each year
  • DesignRx reserves the right to rescind, revoke, terminate, or amend First Steps at any time without notice

 

Covers the following products:

  • Follistim AQ Pen 300 IU (follitropin beta injection)
  • Follistim AQ Pen 600IU(follitropin beta injection)
  • Follistim AQ® Pen 900 IU (follitropin beta injection)
  • Ganirelix® 250 μg/0.5 mL (ganirelix acetate for injection)
  • Pregnyl (chorionic gonadotropin for injection USP)

 

Patient Enrollment:

  1. Download the First Steps form or call Glen Rock at 855.672.9260 and we’ll assist you with the application process.
  2. Complete the First Steps enrollment form, patient General Authorization to Use and Disclose Health and Other Personal Information form, and include the required income verification documents. Patients can submit all of these documents via fax or email:

Eligible patients will be notified via email by First Steps Program.

Offer not valid for prescriptions that may be covered under private or public insurance or reimbursed under a federal or state healthcare program, including Medicare, Medicaid, or any other similar state healthcare program, including any state medical pharmaceutical assistance program. If you become insured by any private or government insurance you must notify the program by calling 855.672.9260.