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Updated February 21, 2014
Oxycontin

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 Tablets 10mg, 15mg, 20mg, 30mg, 40mg, 60mg, 80mg (oxycodone HCl)
 

Eligibility Requirements

Insurance Status Must have no prescription coverage for the requested medication, be ineligible for federal or state programs
Those with Part D Eligible? No
Income At or below 100% of FPL
Diagnosis/Medical Criteria Not specified
US Residency Required? Yes
   

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

MS Contin is only available for patients already on the program, not to new patients.