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


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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

Languages Spoken:

English, Spanish

Program Website


Program Applications and Forms

 Purdue Pharma Patient Assistance Program: Contact program



  • OxyContin tablet (oxycodone)

Eligibility Requirements   

Insurance Status Must have no prescription insurance, be ineligible for any state and federal programs
Those with Part D Eligible? Considered on exception basis
Income At or below 139% of FPL
Diagnosis/Medical Criteria Not specified
US Residency Required? Must be US citizen or legal entrant


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


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

Updated August 03, 2015