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Compassionate Use (Expanded Access) Request Portal

Registration

To use this portal, a one-time registration is required. Please submit this form to establish a personalised account to request compassionate use of GSK investigational medicines and view the status of your requests. You may return to this page at any time after registration to update your profile or contact information as needed. (*) indicates required fields.

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Enter a password of at least 6 characters including a number, a symbol, and a mix of upper and lower case letters.
   

If you are associated to an Institution, type in the field below and select from the popup.

By clicking the I AGREE button, you acknowledge and agree to the following terms:

  • I confirm that I have reviewed and agree and understand the GSK Privacy Policy and that I consent to the collection and use of my personal data for the purposes of using this site and for the management of requests for compassionate use of GSK investigational medicines. Please note that recipients of personal information may reside in countries that do not have the same level of data privacy protection as your country of residence. In such case, GSK ensures that all necessary guarantees have been implemented to secure your personal data when transferred abroad.
  • I understand that I will NOT submit any patient’s personally identifiable information, which includes a patient’s name, address, date of birth, initials, government issued identification numbers (e.g., social security numbers and national IDs), race or ethnicity, gender and sexual orientation.
  • I confirm that I am a Healthcare Professional with a valid, current medical license.
  • I understand that my request will be considered in line with GSK’s compassionate use policy.
  • I understand that I will NOT submit any safety information on this portal, such as adverse event or side effect information.
  • I acknowledge that GSK reserves the right to correct any administrative or technology-based errors which may occur during the request or review process.

You may request information about your personal data and exercise your rights related to your personal data, including deletion and withdrawal of the consent, by contacting us here.

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