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This program provides brand name medications at no or low cost.
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| Pharmaceutical Company |
Procter and Gamble Pharmaceuticals, Inc |
| Program Name |
Procter & Gamble Patient Assistance Program |
| Program Address |
PO Box 66553
St. Louis MO 63166-6553 |
| Phone Number |
800-830-9049
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| Fax Number |
866-277-9329 |
| Medications on Program |
Macrodantin Capsules 25mg, 50mg, 100mg (nitrofurantoin)
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| Application Forms |
Procter & Gamble Patient Assistance Program
Procter & Gamble Patient Assistance Program (Spanish Application)
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On-line Application
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No on-line application available at this time |
| Web Site |
Click to go to program's web site |
| Eligibility Guidelines and Notes |
Patient must not have affordable coverage for the prescription. The patient must meet the required income guideline of 200% of the FPL. Medical diagnosis necessary for this program is not specified. The patient must also be a US resident. If the patient is eligible to enroll in a Medicare prescription drug plan and has an income below 150% FPL, they must document that s/he doesn't qualify for a Medicare drug subsidy.
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| Application Process |
With the patient's permission, anyone concerned can call for an application. The application is sent to either the doctor or the patient. The completed application must be faxed or mailed from the doctor's office.
Both the patient and doctor are notified in writing of acceptance or denial. The decision is usually made within 2 weeks. The medication is shipped out within 5-7 business days.
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| Application Requirements |
The doctor must fill out a section, sign the application and attach a prescription. The patient must fill out a section, sign the application and attach proof of income.
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| 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. Once a year a new application with financial documentation is needed.
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| Last Updated |
October 06, 2009 |
