Program website: http://www.cellceptforliving.com/
The patient must meet insurance guidelines that are not disclosed and have an income at or below 300% of the Federal Poverty Level.
Cyclosporine (Neoral)
Novartis Patient Assistance Program for Specialty Medicines
Program website: http://www.pharma.us.novartis.com/products/name/neoral.jsp
Minocycline (Minocin, Dynacin)
Triax Pharmaceuticals Patient Assistance Program
Application: http://www.needymeds.org/papforms/triaxp1081.pdf
Mefenamic acid (Ponstel)
Sciele Patient Assistance Program
Application: http://www.needymeds.org/papforms/sciele0194.pdf
Indomethacin (Indocin, Indocin SR)
Ovation Pharmaceuticals Patient Assistance Program
Chlorambucil (Leukeran)
Committment to Access http://www.commitmenttoaccess.com/
The patient must not have any private nor public insurance and have an income at or below $52000 for an individual, $70000 for a family of 2, $88,000 for a family of three, $106,000 for a family of four, for each addtl person add $18000 to limits. Medical diagnosis necessary for this program is not specified. The patient must live in the US and utilize the US healthcare system. Medicare Part D enrollees can enroll with proof that they have spent at least $600 on prescription medications through the Medicare Part D prescription Drug Plan in the current calendar year. GlaxoSmithKline requests that an 'Advocate' be the contact person for the patient throughout the entire process.
GSK-Access for medicare only http://www.gsk-access.com/
Application form http://www.gsk-access.com/enrollment/enrollment_forms.html
The patient must have Medicare Part D, and have an income at or below 250% of the Federal Poverty Level. Medical diagnosis necessary for this program is not specified. US residency requirements not specified The patient must also have spent $600 dollars on medications through the Medicare Part D plan
Application Process
The patient is sent a pharmacy card. The pharmacy card is good for one year. Every year a new application is needed.
Oxycodone (OxyContin, Roxicodone, OxyFAST, OxyIR (liquid))
Purdue Frederick Patient Assistance Program
The patient must have no insurance and have an income at or below 200% of the Federal Poverty Level. Medical diagnosis necessary for this program is not specified. The patient must also be a US resident. There is also a co-pay of $25 for each prescription that must be sent in as a money order. Any patient who is denied assistance can appeal the decision by resending the application with a letter of explanation. This includes patients with insurance, patients in a gap, people who are eligible for Medicare Part D but did not enroll and patients who are in the Medicare Part D Donut Hole.
Pfizer Connection to Care
Program website: http://www.pfizerhelpfulanswers.com/pages/misc/default.aspx
Includes:
Diclofenac sodium with misoprostol (Arthrotec)
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