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Program 1 of 6 Scroll down to see them all.

This program provides brand name medications at no or low cost.
Pharmaceutical Company Pfizer, Inc.
Program Name Pfizer Connection to Care
Program Address PO Box 66585
St. Louis, MO 63166-6585
Phone Number

866-706-2400

Fax Number
Medications on Program Feldene Capsules 10mg, 20mg (piroxicam)
Application Forms Pfizer Connection to Care
Pfizer Connection to Care (Spanish)
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 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 reside in the US.  If a patient has insurance, including Medicare Part D,meets the income guidelines and has a prescription to a medication on this program and cannot afford the co-pay due to extreme medical or financial hardship, s/he may qualify to get assistance and should call the program. For Lyrica only: the prescription for Lyrica, as well as a copy of the patient's driver's license or other picture ID must be sent with the application. Please note, Lopid is on back order and will be added back to the program when it is available.

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 faxed, mailed out or downloaded from website. The completed application must be mailed back.  Both the patient and the health care professional are notified in writing of acceptance or denial.  Allow 4 weeks for processing and delivery of medication.

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

Up to a 90 day supply is sent to the doctor's office, except for Lyrica which is sent to the patient's home. The doctor can refill prescriptions or add new Pfizer medicines by calling 866-706-2400. Once a year a new application with financial documentation is needed.

Last Updated July 19, 2010


                                         

Program 2 of 6 Scroll down to see them all.

This program provides brand name medications at no or low cost.
Pharmaceutical Company Pfizer, Inc.
Program Name Pfizer Maintain Program
Program Address PO Box 66549
St Louis, MO 63166-6549
Phone Number

866-706-2400

Fax Number
Medications on Program Feldene   (piroxicam)
Application Forms Pfizer Maintain Program
Pfizer Maintain Program (Spanish)
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 can have no public or private prescription insurance and be financially unable to afford the medication. Medical diagnosis necessary for this program is not specified. The patient must also reside in the US. This program helps eligible people in financial need continue to get their Pfizer medications if they became unemployed on or after 1/1/09 and do not have prexcription coverage. The program will run through 12/31/10. Applicants must have been taking a Pfizer medication for at least three months prior to unemployment and enrollment. Proof of unemployment is required. Spouse and dependents may also be eligible. Medications may be provided for up to one year. Please note that Lopid is on back order and will be added back to the program when it is available.

Application Process

Anyone requesting assistance can call to request a mailed application or download it from the website. The application is sent to the patient. The completed application must be mailed back.    

Application Requirements

Not applicable.

Program Details

A 90-day supply is sent to the patient's home.  

Last Updated July 19, 2010


                                         

Program 3 of 6 Scroll down to see them all.

This program provides generic medications at a discount.
Pharmaceutical Company Express Scripts Specialty Distribution Services
Program Name Rx Outreach Medications
Program Address PO Box 66536
St Louis, MO 63166-6536
Phone Number

800-769-3880

Fax Number
Medications on Program piroxicam Capsules 10mg, 20mg (Feldene)
Application Forms Rx Outreach
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. have an income at or below 300% of the Federal Poverty Level. Medical diagnosis necessary for this program is not specified. US residency requirements are not specified. This program is for generic medications only. Many medications are available for a fee of $20 for up to a 180 day supply. Prices vary for Tier 2 and Tier 3 medications. Please refer to the Rx Outreach website for more information.

Application Process

Anyone requesting assistance can call to request a faxed application or download it from the website. The application can be either faxed or mailed out upon request. The completed application must be mailed back.  The patient is notified of eligibility for the program.  

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 patient must contact the company to arrange for refills. Every year a new application is needed.

Last Updated July 08, 2010


                                         

Program 4 of 6 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 piroxicam Capsules 10mg, 20mg (Feldene)
Application Forms Xubex 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

Applicants with insurance are eligible. This program does not have income limitations. 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 fees for the medications:$20-$45 for a 90 day supply. ($40 or $60 for a 180 day supply and $80 or $120 for a 360 day supply.) Check the website for the exact price. A shipping and ordering fee of $3.85 is charged for each order. 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 04, 2010


                                         

Program 5 of 6 Scroll down to see them all.

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 Feldene Capsules 10mg, 20mg (piroxicam)
Feldene Capsules 20mg (piroxicam)
Application Forms Not Applicable
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 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 enroll online to get their ID number which can be used immediately.      

Application Requirements

Not applicable.

Program Details

The patient is sent a Together Rx Access prescription savings card.  

Last Updated May 10, 2010


                                         

Program 6 of 6.

This is a discount card program.
Pharmaceutical Company Pfizer, Inc.
Program Name Pfizer Pfriends
Program Address PO Box 66543
St Louis, MO 63133
Phone Number

866-706-2400

Fax Number
Medications on Program Feldene Capsules 10mg, 20mg (piroxicam)
Application Forms Pfizer Pfriends
Pfizer Pfriends (Spanish Application)
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 insurance. Not applicable Medical diagnosis necessary for this program is not specified. The patient must also reside in the US. This is not an income based program. It is a savings card program. Phone enrollments are accepted. For Lyrica only: the prescription for Lyrica, as well as a copy of the patient's driver's license or other picture ID must be sent with the application. Lopid is currently not available, but will be added back to the program when available.

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 must be mailed back.  The patient is notified in writing of acceptance or denial.  

Application Requirements

The doctor needs to provide a prescription to the patient. The patient must fill an application form. Renewal information will be sent to the patient prior to the end of the enrollment year.

Program Details

If accepted, the patient is sent a Pfizer Pfriends savings card that can be used at over 95% of pharmacies in the US. When filling their Pfizer prescription, accepted patients simply present the Pfizer Pfriends card to their pharmacist for immediate saving  Every year a new application is needed.

Last Updated August 12, 2010