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Program 1 of 4 Scroll down to see them all.

This program provides brand name medications at no or low cost.
Pharmaceutical Company Merck & Company , Inc.
Program Name Merck Patient Assistance Program
Program Address PO Box 690
Horsham, PA 19044-9979
Phone Number

800-727-5400

Fax Number
Medications on Program Janumet Tablets 50/500mg, 50/1000mg (sitagliptin/metformin)
Application Forms Merck Patient Assistance Program
Merck Patient Assitance Program (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 coverage for the requested medication and and have an income at or below 400% of the Federal Poverty Level. Medical diagnosis necessary for this program is not specified. The patient must also be a US resident. Anyone in need should apply because they do make exceptions for people truly in need. The program speaks both Spanish and English. Medicare D partipants may be eligible through an appeals process.

Application Process

Anyone requesting assistance can call to get an enrollment form sent out, or download it from the website. The application is sent to either the doctor or the patient. The completed application must be mailed back.  Doctor or patient needs to call to find out about acceptance/denial. No letter is sent out.   

Application Requirements

The doctor must fill out a section and sign the application. The patient must fill out a section and sign the application.

Program Details

Up to a 90-day supply is sent to the doctor's office or the patient's home. The patient or doctor must contact the company for refills. Every year a new application is needed.

Last Updated August 16, 2010


                                         

Program 2 of 4 Scroll down to see them all.

This program provides brand name medications at no or low cost.
Pharmaceutical Company Xubex Pharmaceuticals
Program Name Xubex Free Medication Program
Program Address PO Box 1244
Winter Park, Fl 32790-1244
Phone Number

866-699-8239

Fax Number 407-671-7960
Medications on Program Janumet Tablets 50/500mg, 50/1000mg (sitagliptin/metformin)
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

Applicants with insurance are eligible. Not applicable Medical diagnosis necessary for this program is not specified. US residency requirements are not specified. This program is non-need based. Some medications may be offered for less than a 30 day supply .Check the program's website as the medications change frequently. Certain medications may not be available in MA.

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 should be faxed back from the doctor's office.    The medication will be shipped within 10-14 days.

Application Requirements

The doctor must fill out a section and sign the application. 

Program Details

Up to a 30-day supply is sent to the patient's home.  

Last Updated August 03, 2010


                                         

Program 3 of 4 Scroll down to see them all.

This is a discount card program.
Pharmaceutical Company Merck & Company , Inc.
Program Name Merck Prescription Discount Program
Program Address Merck Prescription Discount Program
PO Box 369
Horsham, PA 19044-9945
Phone Number

800-506-3725

Fax Number
Medications on Program Janumet Tablets 500mg, 1000mg (sitagliptin/metformin)
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 insurance. meet income guidelines that are not disclosed. Medical diagnosis necessary for this program is not specified. The patient must also be a US resident with a prescription from a US doctor. Eligible patient will receive a 15%-20% discount on medications. Enrollment can also be done on line. If patient enrolls on line or the phone and are approved for the program, s/he is given an active membership ID number to be used at the pharmacy until the permanent card arrives. AS OF 8/1/2010 THIS PROGRAM WILL MERGE WITH SCHERING-PLOUGH

Application Process

The patient can call to get an application, apply on line, or download the application.  The completed application must be mailed back.   The decision is usually made within 2 weeks. 

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 patient is sent a card to be used at the pharmacy.  Every year a new application is needed.

Last Updated August 16, 2010


                                         

Program 4 of 4.

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 Janumet Tablets 50/1000mg (sitagliptin/metformin)
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