PAP Contact Information

 

3M Pharmaceuticals
3M Center Bldg.275-6W-13
St. Paul, MN 55144
(800) 328-0255
(651) 733-6068 (fax)
http://www.3m.com/us/healthcare/pharma/patient_assistance.jhtml
Online Application: http://www.3m.com/us/healthcare/pharma/PatientAssistance.pdf

Abbott Patient Assistance Program
D-31C, AP52
200 Abbott Park Road
Abbott Park, IL 60064-6214
(800) 222-6885
(866) 898-1473 (fax)
http://www.abbott.com/global/url/content/en_US/40.40.20.3:3/general_content/General_Content_00066.htm
Online Application: http://www.needymeds.com/papforms/abblab0001.pdf

Alcon Cares Patient Assistance Program
Humanitarian Services T7-18
6201 South Freeway
Ft. Worth, TX 76134
(800) 222-8103 option2
(817) 568-6644 (fax)
http://www.alcon.com/corporate-responsibility/patient-clinic-inst-assistance.asp
Online Application: http://www.alconlabs.com/us/aj/humanitarian_srvc/US_patient_assistance_programs.jhtml

Allergan Patient Assistance Program
PO Box 4015
Clinton, NJ 08809
(800) 553-6783
(908) 713-7736 (fax)
http://www.allergan.com/site/
Online Application: http://www.needymeds.com/papforms/allerg0004.pdf

Alpharma Kadian Patient Assistance Program
PO Box 66554
St. Louis, MO 63166
(866) 884-5907
http://www.alpharma.com/pages/default.aspx

American Regent Labs Venofer Patient Assistance Program
c/o InTeleCenter
P.O. Box 4280
Gaithersburg, MD 20885-4133
(800) 282-7712
http://www.americanregent.com/home.html

Amgen Safety Net Foundation
PO Box 13185
La Jolla, CA 92039-3185
(800) 272-9376, opt 3
(888) 508-8090 (fax)
http://www.amgen.com/

Amylin Patient Assistance Program
PO Box 8435
Gaithersburg, MD 20898
(800) 330-7647
http://www.amylin.com/

Astra/Zeneca Patient Assistance Program
AstraZeneca Foundation
P.O. Box 66551
St. Louis, MO 63166-6551
(800) 424-3727
http://www.astrazeneca-us.com/content/patientAssistance/patientAssistanceProgram/default.asp
Online Application: http://www.astrazeneca-us.com/content/drugAssistance/patientAssistanceProgram/pdf/PAPEnglishAppA8.pdf

Bayer Patient Assistance Program
PO Box 29209
Phoenix, AZ 85038-9209
(800) 998-9180, opt. 1
http://www.pharma.bayer.com/en/home.html

Berlex Laboratories, Inc. Patient Assistance Program
PO Box 1000, M2/3-4A
Montville, NJ 07045-1000
(888) 237-5394 Opt6
(973) 305-3545 (fax)
http://www.berlex.com/html/patients/index.html

Boehringer Ingelheim Care Foundation Patient Assistance Program
c/o Express Scripts Specialty Distribution Services
PO Box 66555
St. Louis, MO 63166-6555
(800) 556-8317
(866) 851-2827 (fax)
http://us.boehringer-ingelheim.com/about-us/philanthropy/patient-assist.html
Online Application:  http://www.needymeds.com/papforms/boehri0039.pdf

Bradley Pharmaceuticals Indigent Patient Program
383 Route 46 West
Fairfield, NJ 07004
Attn: Indigent Patient Program
(800) 929-9300
(877) 935-0073 (fax)
http://www.bradpharm.com/
Online Application: http://www.needymeds.com/papforms/bradle0270.pdf

Bristol-Myers Squibb Patient Assistance Foundation, Inc.
(800) 736-0003
(800) 736-1611 (fax)
http://www.bmspaf.org/index.htm
Online Application: http://www.needymeds.com/papforms/brispa0042.pdf

Centocor Patient Assistance Program for Remicade
P.O. Box 221709
Charlotte, NC 28222
(866) 489-5957
(866) 489-5958 (fax)
http://www.centocor.com/
Online Application: http://www.needymeds.com/papforms/remica0192.pdf

ECR Pharmaceuticals Patient Assistance Program
PO Box 71600
Richmond, VA 23255
(800) 527-1955
(804) 527-1959 (fax)
http://www.ecrpharmaceuticals.com/

Lilly Cares Patient Assistance Program
PO Box 230999
Centreville, Virginia, 20120
(800) 545-6962
http://www.lillycares.com/index.jsp
Online Application: http://www.lillycares.com/docs/LillyApp.pdf

Enzon Financial Assistance Program for Abelcet
750 The City Drive, Suite 210
Orange, CA 92868
(800) 345-2252
http://www.enzon.com/

Enzon Patient Assistance Program
1620 Century Center Parkway
Suite 109
Memphis, TN 38134
(888) 276-2217, opt 1
(866) 489-1898 (fax)
http://www.enzon.com
http://www.needymeds.com/papforms/enzonp0370.pdf

ESP Pharma
P.O. Box 4008
Clinton, NJ 08809
(800) 319-4031
(908) 713-7706 (fax)
http://www.esppharma.com/

Ferndale Laboratories Patient Assistance Program
Customer Service
780 West Eight Mile Rd.
Ferndale, MI 48220
(800) 621-6003
(248) 548-0708 (fax)
http://www.ferndalelabs.com/

Forest Pharmaceuticals Patient Assistance Program
13600 Shoreline Drive
St. Louis, MO 63045
(800) 851-0758
http://www.forestpharm.com/pap/
Online Application: http://www.forestpharm.com/pap/regular3.pdf

GlaxoSmithKline Bridges to Access
PO Box 29038
Phoenix, AZ 85038-9038
(866) 728-4368
(800) 750-9832 (fax)
http://bridgestoaccess.gsk.com/

GlaxoSmithKline Commitment to Access
PO Box 29038
Phoenix, AZ 85038-9038
866-265-6491
http://commitmenttoaccess.gsk.com/

IVAX Patient Assistance
4400 Biscayne Blvd.
Miami, FL 33137
(800) 507-8334
(800) 507-8339 (fax)
http://www.clozapineregistry.com/pages/index.jsp
Online Application: www.clozapineregistry.com/files/registration_form_for_one_patient.pdf

Johnson & Johnson Patient Assistance Program
PO Box 221857
Charlotte, NC 28222-1857
(800) 652-6227
(800) 526-5168 (fax)
http://www.jnj.com/our_company/healthcare_issues/index.htm
Online Application: http://www.needymeds.com/papforms/johnso0996.pdf

Kos Pharmaceuticals Patient Assistance Program
2200 N. Commerce Parkway, Ste 300
Weston, FL 33326
(866) 363-1024, ext. 2
(954) 331-3778 (fax)
http://www.kospharm.com/
Online Application: http://www.needymeds.com/papforms/kospha0244.pdf

Ligand Assistance Program
PO Box 222197
Charlotte, NC 28222-2197
(877) 654-4263
(877) 654-6760 (fax)
http://www.ligand.com/
Online Application: http://www.needymeds.com/papforms/ligpap0095.pdf

Medpointe Pharamaceuticals Patient Assistance Program
265 Davison Ave, Suite 300
Somerset, NJ 08873-4120
800-678-4657
http://www.medpointepharma.com/
Online Application: http://www.needymeds.com/papforms/medpoi0047.pdf

Merck Patient Assistance Program
PO Box 690
Horsham, PA 19044-9979
(800) 727-5400 (patients)
(800) 994-2111 (providers)
http://www.merck.com/merckhelps/
Online Application: http://www.merckhelps.com/patientassistance/english_enrollment.pdf

Merck Prescription Discount Card Program
http://www.merck.com/merckhelps/uninsured/home.html
Online Application: http://www.merckhelps.com/uninsured/enrollment_form.pdf

Mission Pharmaceutical Assistance Program
PO Box 786099
San Antonio, TX 78278-6099
(800) 292-7364
(800) 681-4050 (fax)
http://www.missionpharmacal.com/index.jsp

Novartis Patient Assistance Program
PO Box 66556
St. Louis, MO 63166-6566
(800) 277-2254
http://www.pharma.us.novartis.com/novartis/pap/pap.jsp
Online Application: http://www.needymeds.com/papforms/novapa0118.pdf

Novo Nordisk, Inc. Patient Assistance Program
PO Box 1096
Somerville, NJ 08876
(866) 310-7549
(908) 429-8764 (fax)
http://www.novonordisk.com/
Online Application: http://www.needymeds.com/papforms/novopa0119.pdf

Patient Assistance Foundation Co-Pay Relief
700 Thimble Shoals Blvd., Suite 201
Newport News, VA 23606
(866) 512-3861
http://www.copays.org/
pap@patientadvocate.org

Pfizer, Inc. Connection to Care
PO Box 66585
St. Louis, MO 63166-6585
(800) 707-8990
http://www.pfizer.com/pfizer/subsites/philanthropy/access/us.programs.index.jsp
Online Application: http://www.needymeds.com/papforms/pficon0133.pdf

Pharmion Corporation
2525 28th St
Suite 200
Boulder, CO 80301
(866) 742-7646, Option 4
http://www.pharmion.com/CorporateWeb/home.nsf/Content/Home

Proctor & Gamble Patient Assistance Program
c/o Express Scripts
PO Box 66553
St. Louis, MO 63166-66553
(800) 830-9049
(866) 277-9329 (fax)
http://www.pgpharma.com/patient_assistance.shtml
Online Application: http://www.needymeds.com/papforms/procte0136.pdf

Reliant Rx Support Program
PO Box 6842
Somerset, NJ 08875-9878
(866) 792-2737
http://www.reliantrx.com/

Roche Patient Assistance Program
c/o JoAnn Hanly
340 Kingsland St.
Nutley, NJ 07110
(877) 757-6243
http://www.rocheusa.com/programs/patientassist.asp

RxOutreach
http://www.rxoutreach.com
Online Application: http://www.rxoutreach.com/en/dpa_print.aspx?x=94826

Sankyo Pharma Open Care Program
PO Box 8409
Somerville, NJ 08876
(866) 268-7387, ext. 1
http://www.sankyopharma.com/news/patientassistance.html
Online Application: http://www.needymeds.com/papforms/sankyo0209.pdf

Sanofi-Aventis PACT program
http://oncology.sanofi-aventis.us/reimbursementnew.do

Sanofi-Aventis Patient Assistance Program
PO Box 759
Somerville, NJ 08876
(800) 221-4025
http://www.sanofi-aventis.us/
Online Application: http://www.needymeds.com/papforms/sanofi0150.pdf

Schering-Plough Commitment to Care
(800) 521-7157
http://www.sgp.com/schering_plough/pc/commitment_care.jsp

SP Cares Patient Assistance Program
PO Box 52122
Phoenix, AZ 85072
(800) 656-9485
(800) 995-9620 (fax)
http://www.sgp.com/schering_plough/pc/sp_cares.jsp
Online Application: http://www.sgp.com/pdf/patient_assistance.pdf

Shire US Patient Assistance Program
PO Box 698
Somerville, NJ 08876
(866) 325-8224
http://www.shire.com/shire/index.jsp

Americares' Solvay Pharmaceuticals, Inc. Patient Assistance Program
c/o Express Scripts Specialty Distribution Services, Inc.
P.O. Box 66550
St. Louis, MO 63166-6650
(800) 256-8918
http://www.solvaypharmaceuticals-us.com/patients/patientassistanceprogram/0,998,7438-2-0,00.htm
Online Application: http://www.needymeds.com/papforms/solpap0163.pdf

Sun Association Discount Card Program
(866) 662-1351
http://www.esunhealth.net/
Online Application: http://www.esunhealth.net/sun_enrollNprint.aspx

Takeda Pharmaceuticals Patient Assistance Program
PO Box 66552
St. Louis, MO 63166
(800) 830-9159
(800) 497-0928 (fax)
http://www.tpna.com/patasstProgram.asp
Online Application: http://www.needymeds.com/papforms/takeda0165.pdf

TAP Prevacid Patient Assistance Program
PO Box 66586
St. Louis, MO 63166-6586
(800) 830-1015
(800) 394-2794 (fax)
http://www.tap.com/

TogetherRx Access
(800) 444-4106
http://togetherrxaccess.com/
Online Application: http://www.togetherrxaccess.com/en/TRx_Access_Enroll.pdf

UCB Keppra Patient Assistance Program
1950 Lake Park Dr.
Smyrna, GA 30080
(800) 477-7877, opt. 7
http://www.ucb.be/

Watson Iron Reimbursement Assistance Program
PO Box 1265
San Bruno, CA 94066
(800) 964-4766
(888) 891-4924 (fax)
http://www.watsonpharm.com/

Wyeth Pharmaceutical Patient Assistance Program
PO Box 66762
St. Louis, MO 63166-6762
(800) 568-9938
http://www.wyeth.com/hcp/pap
Online Application: http://www.needymeds.com/papforms/wyepha0181.pdf