Program

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Program 1 of 2 Scroll down to see them all.

This program provides generic medications at a discount.
Pharmaceutical Company	Xubex Pharmaceuticals
Program Name	Xubex Patient 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	fluriprofen Tablets 50mg, 100mg (Ansaid)
Application Forms	Xubex Pharmaceutical Services
On-line Application	Link to online application
Web Site	Click to go to program's web site
Eligibility Guidelines and Notes	Applicants with insurance are eligible. The patient must have an income at or below 243% of the Federal Poverty Level. Medical diagnosis necessary for this program is not specified. US residency requirements are not specified. This is a program for generic medications only. There are fee for the medications either $20 or $30 for a 90 day supply. ($40 or $60 for a 180 day supply and $80 or $120 for a 360 day supply.)Xubex now offers a 30 day supply of some medications free of charge. Patients may apply online or print the prescription, complete and fax to the Xubex pharmacy for processing. Requests may be expedited by having the physician fax the completed form to the Xubex pharmacy.
Application Process	Anyone requesting assistance can call to request a faxed application or download it from the website. The application will be faxed out. The completed application can be faxed or mailed back. The medication is shipped within 10 business days.
Application Requirements	The doctor needs to provide a prescription to the patient. The patient must fill out a section and sign the application.
Program Details	The medication is sent to either the doctor's office or the patient's home. The company automatically sends out refills. Once a year a new application with financial documentation is needed.
Last Updated	August 14, 2009

Program 2 of 2.

This is a discount card program.
Pharmaceutical Company	Together Rx Access
Program Name	Together Rx Access
Program Address	PO Box 9426 Wilmington, DE 19809-9944
Phone Number	800-444-4106
Fax Number
Medications on Program	Ansaid Tablets 100mg (flurbiprofen)
Application Forms	Together Rx Access
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 any medications and have an income at or below $45000 if single, $60000 for a family of 2, $75000 for a family of 3, $90000 for a family of 4, $105000 for a family of 5 Medical diagnosis necessary for this program is not specified. The patient must also be a US resident. The patient must not be eligible for Medicare. Most cardholders save between 25%-40% on brand name prescription medications. Each card holder's savings depend on such factors as the particular drug purchased, amount purchased, and the pharmacy where purchased.
Application Process	The patient can call to get an application, apply on line, or download the application.
Application Requirements	Not applicable.
Program Details	The patient is sent a Together Rx Access prescription savings card.
Last Updated	July 31, 2009