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Program 1 of 3 Scroll down to see them all.

This program provides brand name medications at no or low cost.
Pharmaceutical Company	ALCON
Program Name	Alcon Cares
Program Address	Alcon Cares, Inc. TB3-4 6201 South Freeway Fort Worth, TX 76134-0450
Phone Number	800-222-8103
Fax Number	800-554-2660
Medications on Program	Alphagan P Opthalmic Solution 0.15% (brimonidine tartrate)
Application Forms	Alcon Cares
On-line Application	No on-line application available at this time
Web Site	Click to go to program's web site
Eligibility Guidelines and Notes	Applicants with insurance are eligible. and have an income at or below 200% of the Federal Poverty Level, adjusted for family size. Medical diagnosis necessary for this program is not specified. The patient must also be under treatment from a US doctor. Applicants with Medicare Part D are considered. Those over the 200% FPL guidelines may have their medical expenses taken into consideration. This program also provides generic products to those eligible. OTC products may be sent to either the patient's home or the doctor's office.
Application Process	Anyone can call to get an application faxed out. The application can be either faxed or mailed out upon request. The completed application can be faxed or mailed back. Doctor or patient needs to call to find out about acceptance/denial. No letter is sent out. The medication will be shipped within 10-14 days.
Application Requirements	The doctor must fill out a section and sign the application. The patient must also complete, sign the application and attach proof of income.
Program Details	The medication is sent to the doctor's office. A copy of the same application with new dates is needed for refills.
Last Updated	July 08, 2010

Program 2 of 3 Scroll down to see them all.

This program provides brand name medications at no or low cost.
Pharmaceutical Company	Allergan, Inc.
Program Name	Allergan Patient Assistance Program
Program Address	P.O. Box 42847 Cincinnati, OH 45242
Phone Number	800-553-6783
Fax Number	513-618-0054
Medications on Program	Alphagan P Solution 0.1% (brimonidine)
Application Forms	Allergan Patient Assistance Program
On-line Application	No on-line application available at this time
Web Site	Click to go to program's web site
Eligibility Guidelines and Notes	The patient must have no prescription coverage for the requested medication and and have an income at or below 200% of the Federal Poverty Level, adjusted for family size. Medical diagnosis necessary for this program is not specified. The patient must live in the US and have a prescription from a doctor licensed in the US. Patients must provide their social security number.
Application Process	The doctor or patient can call to request an application. The application can be either faxed or mailed out upon request. The completed application can be faxed or mailed back.
Application Requirements	The doctor must fill out a section and sign the application. The patient must fill out a section, sign the application and attach proof of income.
Program Details	A 6-month supply is sent to the doctor's office. A copy of the application signed by the doctor is needed for refills. Every year a new application is needed. Proof of income is required every 3 years.
Last Updated	September 07, 2010

Program 3 of 3.

This company does not offer a patient assistance program.
Pharmaceutical Company	Xubex Pharmaceuticals
Program Name	Xubex Copay Assistance Program
Program Address	PO Box 1244 Winter Park, Fl 32790-1244
Phone Number	866-699-8239
Fax Number	407-671-7960
Medications on Program	Alphagan P Solution 0.1% (brimonidine)
Application Forms	Xubex Copay Program
On-line Application	No on-line application available at this time
Web Site	Click to go to program's web site
Eligibility Guidelines and Notes	Applicants may have individual or employer sponsored prescription insurance. Those with Medicare, Medicaid or other state or federal funded are not eligible. This program does not have income limitations. Medical diagnosis is not necessary This program is not valid in Massachusetts, so MA residents are not eligible. This is a copay assistance program that covers all or part of the applicant's copay for the medication. The amount of the copay assistance varies by medication, check the program's website for the exact amount. The application does not require a HCP signature, however the applicant must send the prescription(s) in with the application.
Application Process	Anyone requesting assistance can call the above number to request an application be mailed or faxed out or download it from the website. The application can be either faxed or mailed out upon request. The completed application can be faxed or mailed back.
Application Requirements	Not applicable.
Program Details	The medication is sent to the patient's home.
Last Updated	August 03, 2010