Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
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Pfizer Patient Assistance Program

This program provides medication at no cost.

Provided by: Pfizer, Inc.

PO Box 66585
St. Louis, MO 63166-6585

TEL: 866-706-2400


FAX: 866-470-1748
Languages Spoken:

English

Program Website

 

Program Applications and Forms

Pfizer Group A Application for Primary Care Medicines

Pfizer Group A Application for Primary Care Medicines (Spanish)

Pfizer Group B Application for Oncology and Specialty Medicines

Pfizer Group B Application for Oncology and Specialty Medicines (Spanish)

Pfizer Group C Application for Vaccines

Pfizer Group C Application for Vaccines (Spanish)

Pfizer Group D Application for Lyrica

Pfizer Group D Application for Lyrica (Spanish)

Pfizer Patient Assistance Program Medication List

 

Medications

  • Arthrotec (diclofenac sodium/misoprostol)
 

Eligibility Requirements   

Insurance Status Uninsured or Underinsured
Those with Part D Eligible? Yes
Income Varies
Diagnosis/Medical Criteria Not specified
US Residency Required? Must be residing in the US or US territory
   

Application

Obtaining Call or download
Receiving Mailed or downloaded from website
Returning Fax or mail
Doctor's Action Complete section and sign
Applicant's Action Complete section, sign, attach required documents
Decision Communicated Patient and Doctor are notified
Decision Timeframe Varies
   

Medication

Amount/Supply Varies
Sent To Varies
Delivery Time Varies
Refill Process Varies per medication
Limit None
Re-application New application, new documentation yearly
   

Additional Information

Pfizer also has programs that provide eligible patients with insurance, support assistance, and medicines at a savings. Contact Pfizer RxPathways for details (844-989-7284).


Updated August 18, 2017


Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Program 2 of 3.
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Patient Access Network Foundation (PAN)

This is a copay assistance program

Provided by: Patient Access Network Foundation

PO Box 221858
Charlotte, NC 28222-1858

TEL: 866-316-7263


FAX: 866-316-7261
Languages Spoken:

English, Spanish, Others By Translation Service

Program Website

 

Program Applications and Forms

Patient Access Network Foundation (PAN) Application: Contact program

 

Medications

  • Arthrotec (diclofenac sodium/misoprostol)
 

Eligibility Requirements   

Insurance Status *See Additional Information section below
Those with Part D Eligible? Determined case by case
Income Between 400-500% of FPL
Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
US Residency Required? Must reside and receive treatment in US
   

Application

Obtaining Call or complete online
Receiving Complete online or by phone
Returning Complete online or by phone
Doctor's Action Will be discussed with patient and Doctor after request is received
Applicant's Action Call for information or inform doctor that he/she is in need
Decision Communicated Patient and Doctor notified in writing
Decision Timeframe Within 48 hours
   

Medication

Amount/Supply Not applicable
Sent To Patient sent card to be used at pharmacy
Delivery Time Once approved; shipped same day
Refill Process Patient presents voucher/card to pharmacy for each refill
Limit None
Re-application New application every 12 months
   

Additional Information

*Patients must have health insurance and their insurance must cover the qualifying medication for which they seek assistance.

Call for most recent medications as the list is subject to change and the medication for which you are seeking assistance must treat the disease directly.

Note: All new enrollment is now done electronically or over the phone. Contact program for details.


Updated June 29, 2017


Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Program 3 of 3.
 

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Pfizer Savings Program

Provided by: Pfizer, Inc.

PO Box 66585
St. Louis, MO 63166-6585

TEL: 866-706-2400


FAX: 866-470-1748
Languages Spoken:

English

Program Website

 

Program Applications and Forms

Pfizer Savings Program Medication List

 

Medications

  • Arthrotec (diclofenac sodium/misoprostol)
 

Eligibility Requirements   

Insurance Status Must be uninsured
Those with Part D Eligible? No
Income Varies
Diagnosis/Medical Criteria Not specified
US Residency Required? Must be residing in the US or US territory
   

Application

Obtaining Call for prescreening
Receiving There is no application
Returning Not applicable
Doctor's Action Give prescription to patient
Applicant's Action Call to enroll
Decision Communicated Decision made during phone screening
Decision Timeframe Decision made during phone screening
   

Medication

Amount/Supply Contact the program for more details.
Sent To Pharmacy
Delivery Time Not applicable
Refill Process Varies per medication
Limit None
Re-application New enrollment every 12 months
   

Additional Information

This program provides uninsured patients with savings on their prescriptions at the pharmacy.

Pfizer also has programs that provide eligible patients with insurance support, copay assistance, and medicines for free. Contact Pfizer RxPathways for details (844-989-7284)

Updated August 18, 2017