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This program provides brand name medications at no or low cost.
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| Pharmaceutical Company |
GlaxoSmithKline |
| Program Name |
GSK Access |
| Program Address |
PO Box 52046
Phoenix, AZ 85072-2046 |
| Phone Number |
866-518-4357
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| Fax Number |
866-518-3994 |
| Medications on Program |
Advair Diskus Inhalation Powder 100/50, 250/50, 500/50 (fluticasone/salmeterol)
Advair HFA Inhalation Aerosol 45/21, 115/21, 230/21 (fluticasone propionate)
Albenza Tablets 200mg (albendazole)
Alkeran Injection (melphalan)
Alkeran Tablets (melphalan)
Altabax Ointment 1% (retapmulin topical)
Amerge Tablets 1mg, 2.5mg (naratriptan)
Arixtra Injection 5mg, 7.5mg, 10mg (fondaparinux)
Augmentin Tablets 250mg, 500mg (amoxicillin/clavulanate)
Augmentin Tablets-Chewable 200mg, 250mg, 400mg (amoxicillin/clavulanate)
Augmentin XR Tablets (amoxicillin/clavulanate)
Avandamet Tablets 2mg/1000mg, 4mg/1000mg (metaformin/rosiglitazone)
Avandaryl Tablets 4mg/1mg, 4mg/2mg, 4mg/4mg (rosiglitazon/glimepiride)
Avandia Tablets 2mg, 4mg, 8mg (rosiglitazone)
Avodart Soft Gelatin Tablets 0.5mg (dutasteride)
Bactroban Cream (mupirocin topical)
Bactroban Nasal Ointment (mupirocin topical)
Bactroban Ointment (mupirocin topical)
Beconase AQ Nasal Spray 0.042% (beclomethasone nasal)
Ceftin Oral Suspension 125mg/5ml, 250mg/ml (cefuroxime axetil)
Ceftin Tablets 125mg, 250mg, 300mg, 500mg, 600mg (cefuroxime axetil)
Combivir Tablets 60mg (lamivudine/zidovudine)
Coreg Tablets 3.125mg, 6.25mg, 12.5mg, 25mg (carvedilol)
Coreg CR Tablets 10mg, 20mg, 40mg, 80mg (carvedilol)
Daraprim Tablets 25mg (pyrimethamine)
Dexedrine Spansule Capsules 5mg, 10mg, 25mg (dextroamphetamine)
Dyazide Capsules 37.5mg/25mg (hydrochlorothiazide/triamterene)
Dynacirc CR 5mg, 10mg 2 (isradipine)
Epivir Oral Solution (lamivudine)
Epivir Tablets 150mg, 300mg (lamivudine)
Epivir-HBV Oral Solution (lamivudine)
Epivir-HBV Tablets (lamivudine)
Epzicom Tablets (abacavir/lamivudine)
Evoclin Foam 1% (clindamycin)
Extina Foam 2% (ketoconazole)
Flonase Nasal Spray 50mcg (fluticasone nasal spray)
Flovent Diskus Inhalation Powder 50mcg, 100mcg, 250mcg (fluticasone)
Flovent HFA Inhalation Aerosol 44mcg, 110mcg, 220mcg (fluticasone)
Fortaz Injection 1gm/vial, 2gm/vial, 6gm/vial, 500mg/vial (ceftazidime)
Imitrex Injection (sumatriptan)
Imitrex Nasal Spray 5mg/unit, 25mg/unit (sumatriptan nasal)
Imitrex Tablets 25mg, 50mg, 100mg (sumatriptan)
InnoPran XL Capsules 80mg (propranolol)
Jalyn Capsules (dutasteride and tamsulosin hydrochloride)
Lamictal Orally Disinegrating tablets 1 (lamotrigine)
Lamictal Tablets 25mg, 100mg, 200mg (lamotrigine)
Lamictal Tablets-Chewable 2mg, 5mg, 25mg, 150mg (lamotrigine)
Lamictal XR Extended Release Tablets 1 (lamotrigine)
Lanoxin Tablets 0.25mg, 0.125mg (digoxin)
Lexiva Oral Suspension (fosamprenavir)
Lexiva Tablets 700mg (fosamprenavir)
Lovaza Capsules (omega-3-acid ethyl esters)
Luxiq Foam 0.12% (betamethasone valerate)
Malarone Tablets 62.5mg/25mg, 250mg/100mg (atovaquone and proguanil hydrochloride)
Mepron Suspension (atovaquone)
Olux Foam 0.05% (clobetasol)
Olux-E Foam 0.05% (clobetasol)
Olux/Olux-E Complete Pack Foam 50g/10g, 50g/50g, 100g/10g (clobetasol propionate/clobetasol emulsion)
Parnate Tablets 10mg (tranylcypromine)
Relenza Powder for Inhalation (zanamivir)
Requip Tablets 0.5mg, 0.25mg, 1mg, 2mg, 3mg, 4mg, 5mg (ropinirole)
Requip XL Tablets (ropinirole extended release)
Rescriptor Tablets 1 (delavirdine mesylate)
Retrovir Capsules (zidovudine)
Retrovir Syrup (zidovudine)
Retrovir Tablets (zidovudine)
Rythmol Tablets 150mg, 225mg, 300mg (propafenone)
Rythmol SR Capsules 225mg, 325mg, 425mg (propafenone)
Selzentry Tablets 1 (maraviroc)
Serevent Diskus Powder for Inhalation 50mcg (salmeterol inhaled)
Soriatane Capsules 10mg (acitretin)
Timentin Injection 1 (ticarcillin/clavulanate)
Timentin IV 1 (ticarcillin/clavulanate)
Treximet Tablets (sumatriptan/naproxen sodium)
Trizivir Tablets 300mg/150mg/300mg (abacavir/lamivudine/zidovudine)
Valtrex Caplets (valacyclovir)
Ventolin HFA Inhalation Aerosol (albuterol inhalers)
Veramyst Nasal Spray (fluticasone nasal spray)
Verdeso Foam 0.05% (desonide)
VESIcare Tablets 5mg, 10mg (solifenacin)
Viracept Oral Powder 1 (nelfinavir mesylate)
Viracept Tablets 1 (nelfinavir mesylate)
Wellbutrin Tablets 100mg (bupropion)
Zantac Injection (ranitidine)
Zantac Injection Premixed (ranitidine)
Zantac Syrup (ranitidine)
Zantac Tablets 150mg, 300mg (ranitidine)
Zantac EFFERdose Tablets 25mg (ranitidine)
Ziagen Oral Solution (avacavir sulfate)
Ziagen Tablets (avacavir sulfate)
Zinacef Injection (cefuroxime for injection)
Zovirax Capsules (acyclovir)
Zovirax Suspension (acyclovir)
Zovirax Tablets 400mg (acyclovir)
Zyban Tablets (bupropion)
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| Application Forms |
GSK Access
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On-line Application
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| Web Site |
Click to go to program's web site |
| Eligibility Guidelines and Notes |
The patient must have Medicare Part D, and have a low income based on the Federal Poverty Guidelines. Medical diagnosis necessary for this program is not specified. The patient must also be residing in the US. The patient must also have spent $600 dollars on medications through the Medicare Part D plan in the current year.
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| Application Process |
Anyone requesting assistance can call the above number to request an application be mailed or faxed out or download it from the website. The application will be faxed out. The completed application can be faxed or mailed back.
The patient is notified of eligibility for the program.
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| Application Requirements |
Not applicable.
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| Program Details |
The patient is sent a pharmacy card. The pharmacy card is good for one year. Every year a new application is needed.
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| Last Updated |
June 04, 2010 |
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