Program

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Program 1 of 2 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	Nicotrol (nicotine)
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 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	Nicotrol Patch (nicotine transdermal)
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