Teva-Support

Prescription and Service Request Form

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Acquiring CINQAIR® Administering CINQAIR® Supporting Patients FAQs Resources

When will Teva Support Solutions® refer a prescription to a specialty pharmacy?

Teva Support Solutions® will refer a prescription to a specialty pharmacy when requested by a treatment provider, or if a health plan requires acquisition of CINQAIR® by one or more specialty pharmacies. To request confirmation of specialty pharmacy requirements, select Specialty Pharmacy as the preferred acquisition method on the Prescription and Service Request Form. In some cases, a specialty pharmacy may contact your office to request additional information, including a request to re-send a CINQAIR® prescription directly to the specialty pharmacy.

For more information, go to Acquiring CINQAIR® or call Teva Support Solutions® at 1-844-838-2211, Monday through Friday, 9am to 7pm ET.