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

Nuplazid Connect

For Healthcare Professionals Only

Provided by: Acadia Pharmaceuticals Inc.

TEL: 844-737-2223

FAX: 844-737-2224
Languages Spoken:


Program Website


Patient Assistance Applications

Nuplazid Connect Treatment Form

Nuplazid Fact Sheet


Brand Name Medications Covered

  • Nuplazid tablet

Generic Name

  • pimavanserin tablet

Eligibility Requirements   

Insurance Status Must have no insurance or prescription coverage
Those with Part D Eligible? No
Income Not disclosed
Diagnosis/Medical Criteria FDA-approved diagnosis
US Residency Required? Yes


Obtaining Doctor must start by faxing enrollment form to program
Receiving Downloaded from website
Returning Fax from Doctor's office
Doctor's Action Complete section, sign, attach required documents
Applicant's Action Inform Doctor that he/she is in need
Decision Communicated Not specified
Decision Timeframe Not specified


Amount/Supply Not specified
Sent To Not specified
Delivery Time Not specified
Refill Process Not specified
Limit Not specified
Re-application Not specified

Additional Information


Updated February 28, 2018