Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Updated December 19, 2014
 

Oxycontin

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Purdue Pharma Patient Assistance Program

This program provides brand name medications at no or low cost.

Provided by: Purdue Pharma L.P.

PO Box 66547
St Louis, MO 63166-6547

TEL: 800-599-6070


ALT PHONE:
FAX:
Languages Spoken:

English, Spanish

Program Website

 

Patient Assistance Applications

 Purdue Pharma Patient Assistance Program: Contact program

 

Medications

  • OxyContin Tablet 10mg, 15mg, 20mg, 30mg, 40mg, 60mg, 80mg (oxycodone)
 

Eligibility Requirements   

Insurance Status Must have no prescription insurance, be ineligible for any state and federal programs
Those with Part D Eligible? No
Income At or below 100% of FPL
Diagnosis/Medical Criteria Not specified
US Residency Required? Must be US citizen or legal entrant
   

Application

Obtaining Doctor/Doctor's office must call
Receiving Faxed to Doctor's office
Returning Mail
Doctor's Action Complete section, sign, attach prescription
Applicant's Action Complete section, sign, attach proof of income and residency
Decision Communicated Patient notified in writing
Decision Timeframe 7-10 business days
   

Medication

Amount/Supply Up to 30 day supply
Sent To Patient's home
Delivery Time Shipped overnight
Refill Process Varies per medication
Limit Varies per medication
Re-application New application, new documentation yearly
   

Additional Information