Free Trial Program for Hemophilia Medication

The wilate Free Trial Program is a unique opportunity for patients and their providers to experience the safety, efficacy and convenience of wilate at no cost.

With the wilate Free Trial Program, eligible patients can receive treatment with wilate (not to exceed 1-3 doses or not exceed approximately 5,000 IUs) at no cost, shipped directly to the patient and administered under the care and supervision of the healthcare provider.

*IU = International Unit

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Call 1.800.554.4440 if you have questions on how to start the wilate Free Trial Program.

How to Enroll

  1. Patient or physician downloads and completes the Free Trial Enrollment and HIPAA forms
  2. Physician writes / gives patient a prescription for wilate
  3. Patient or physician faxes completed forms and wilate prescription to Program Administrator, Covance, at 1.800.554.6744.

What Happens Next?

  • Program Administrator reviews documents to ensure patient is eligible to participate in the program
  • Program Administrator processes completed wilate Free Trial Enrollment and HIPAA forms and sends prescription to pharmacy for dispensing of wilate
  • Program Administrator confirms wilate is shipped to patient
  • Patient is administered wilate under the care and supervision of a healthcare provider
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Your local Octapharma Coagulation Specialist (CSS) is prepared to answer your questions about wilate.

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