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Visit the DBAs to look for financial assistance based on your diagnosis.

Program 1 of 3.
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Updated April 14, 2014

Pfizer RxPathways Patient Assistance Program

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

Provided by: Pfizer, Inc.

PO Box 66585
St. Louis, MO 63166-6585

TEL: 866-706-2400


ALT PHONE:
FAX: 866-470-1748
Languages Spoken:

English, Spanish

Program Website
 

Patient Assistance Applications

Pfizer Group A Application for Primary Care medicines

Pfizer Group B Application for Oncology and Specialty medicines

Pfizer Group C Application for Vaccines

Pfizer Group A Application for Primary Care medicines (Spanish)

Pfizer Group B Application for Oncology and Specialty medicines (Spanish)

Pfizer Group C Application for Vaccines (Spanish)

 

Medications

  • sildenafil Tablet 20mg (Revatio)
 

Eligibility Requirements

Insurance Status Uninsured or Underinsured
Those with Part D Eligible? Yes
Income Varies
Diagnosis/Medical Criteria Not specified
US Residency Required? Must reside in the US, Puerto Rico or the USVI
   

Application

Obtaining Call or download
Receiving Mailed or downloaded from website
Returning Mail or fax
Doctor's Action Complete section, sign
Applicant's Action Complete section, sign, attach a copy of proof of income
Decision Communicated Patient and Doctor notified in writing
Decision Timeframe Within 4 weeks
   

Medication

Amount/Supply Varies
Sent To Address of shipment varies by medication *See Additional Information section below
Delivery Time Within 2-4 weeks
Refill Process Patient or Doctor must contact company
Limit None
Re-application New application, new documentation yearly
   

Additional Information

*Lyrica, oral oncology, and specialty products are shipped to the patient's home, other medications to Doctor's office

For help with Prevnar 13, please contact customer service and talk to your health care provider. This program was formerly known as Pfizer Helpful Answers



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

Program 2 of 3.
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Updated February 12, 2014

Pfizer RSVP Co-Pay Program

This is a copay assistance program.

Provided by: Pfizer, Inc.

PO Box 220574
Charlotte, NC 28222-0574

TEL: 888-327-7787


ALT PHONE:
FAX: 888-773-0121
Languages Spoken:

English, Spanish, Others By Translation Service

Program Website
 

Patient Assistance Applications

 Pfizer RSVP Co-Pay Program: Contact program

 

Medications

  • sildenafil Tablet 20mg/mL (Revatio)
 

Eligibility Requirements

Insurance Status Must not have public insurance, may have private insurance
Those with Part D Eligible? No
Income Not disclosed
Diagnosis/Medical Criteria Not specified
US Residency Required? MA residents are not eligible
   

Application

Obtaining Call for prescreening
Receiving Sent to Doctor's office
Returning Mail or fax
Doctor's Action Complete section, sign, attach prescription
Applicant's Action Complete section, sign
Decision Communicated Patient and Doctor are notified
Decision Timeframe Within 24-48 hours
   

Medication

Amount/Supply Varies
Sent To Patient sent card to be used at pharmacy
Delivery Time ID number given over the phone or card shipped within 7-10 business days
Refill Process Patient presents voucher/card to pharmacy for each refill
Limit Not specified
Re-application Must re-enroll at end of calendar year
   

Additional Information

The program will cover copay costs up to $7,500 for the medication Revatio, and up to $10,000 for the medications Xyntha and Benefix.



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

Program 3 of 3. Updated April 14, 2014

Pfizer RxPathways Savings Card

This is a discount card program.

Provided by: Pfizer, Inc.


TEL: 866-706-2400


ALT PHONE:
FAX:
Languages Spoken:

English

Program Website
 

Patient Assistance Applications

 Pfizer RxPathways Savings Card: Contact program

 

Medications

  • sildenafil Tablet 20mg (Revatio)
 

Eligibility Requirements

Insurance Status Must have no prescription coverage
Those with Part D Eligible? No
Income Not Required
Diagnosis/Medical Criteria Medically appropriate condition
US Residency Required? Must reside in the US, Puerto Rico or the USVI
   

Application

Obtaining No application
Receiving Not applicable
Returning Not applicable
Doctor's Action Give prescription to patient
Applicant's Action Call to enroll
Decision Communicated Not specified
Decision Timeframe Not specified
   

Medication

Amount/Supply Not applicable
Sent To Card sent to doctor's office or to patient's home
Delivery Time Not specified
Refill Process Not specified
Limit Not specified
Re-application Not specified
   

Additional Information