Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Updated January 14, 2015


Lilly Cares Patient Assistance Program

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

Provided by: Eli Lilly & Company

Lilly Cares Program
PO Box 230999
Centreville, VA 20120

TEL: 800-545-6962

FAX: 703-310-2534
Languages Spoken:


Program Website


Patient Assistance Applications

Lilly Cares Patient Assistance Program Application

Lilly Cares Refill Authorization Form



  • Strattera Capsule 10mg, 18mg, 25mg, 40mg, 60mg, 80mg, 100mg (atomoxetine)

Eligibility Requirements   

Insurance Status Must have no prescription coverage
Those with Part D Eligible? No, must be ineligible
Income At or below 300% of FPL
Diagnosis/Medical Criteria Not specified
US Residency Required? Puerto Rico & US Virgin Island residents are not eligible


Obtaining Call or download
Receiving Faxed
Returning Fax or mail
Doctor's Action Complete section and sign
Applicant's Action Complete section, sign, attach a copy of proof of income
Decision Communicated Doctor notified
Decision Timeframe Not specified


Amount/Supply Up to 120 day supply
Sent To Doctor's office
Delivery Time Within 4 weeks
Refill Process Refill/reorder form included with shipment
Limit Not specified
Re-application New application, new documentation yearly

Additional Information