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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 (fluticasone propionate)
Albenza Tablets 200mg (albendazole)
Alkeran Injection (melphalan)
Alkeran Tablets (melphalan)
Altabax Ointment 1% (retapmulin topical)
Amerge Tablets 1mg, 2.5mg (naratriptan)
Amoxil Capsules 500mg (amoxicillin)
Amoxil Oral Solution 250mg/5ml, 400mg/5ml (amoxicillin)
Amoxil Powder for Oral Suspension 50mg/ml, 125mg/5ml, 250mg/5ml (amoxicillin)
Amoxil Tablets 400mg, 500mg, 875mg (amoxicillin)
Amoxil Tablets-Chewable 200mg, 250mg (amoxicillin)
Arixtra Injection 5mg, 7.5mg, 10mg (fondaparinux)
Arranon injection (nelarabine)
Augmentin Oral Solution (amoxicillin/clavulanate)
Augmentin Powder for Oral Suspension 125mg/5ml, 200mg/5ml, 250mg/5ml, 400mg/5ml (amoxicillin/clavulanate)
Augmentin Tablets 250mg, 500mg (amoxicillin/clavulanate)
Augmentin Tablets-Chewable 200mg, 250mg, 400mg (amoxicillin/clavulanate)
Augmentin ES-600 Powder for Oral Suspension 600mg/5ml (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)
Axid Capsules 150mg, 300mg (nizatidine)
Bactroban Cream (mupirocin topical)
Bactroban Nasal Ointment (mupirocin topical)
Bactroban Ointment (mupirocin topical)
Beconase AQ Nasal Spray 0.042% (beclomethasone nasal)
Bexxar (tositumomab)
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)
Flonase Nasal Spray 50mcg (fluticasone nasal spray)
Flovent Inhalation Aerosol 44mcg, 110mcg, 220mcg (fluticasone)
Flovent HFA Inhalation Aerosol 44mcg, 110mcg, 220mcg (fluticasone)
Fortaz Injection 1gm/vial, 2gm/vial, 6gm/vial, 500mg/vial (ceftazidime)
Hycamtin Capsules (topotecan)
Hycamtin Injection (topotecan)
Imitrex Injection (sumatriptan)
Imitrex Nasal Spray 5mg/unit, 25mg/unit (sumatriptan nasal)
Imitrex Tablets 25mg, 50mg, 100mg (sumatriptan)
InnoPran XL Capsules 80mg (propranolol)
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)
Leukeran Tablets 2mg (chlorambucil)
Lexiva Oral Suspension (fosamprenavir)
Lexiva Tablets 700mg (fosamprenavir)
Lovaza Capsules (omega-3-acid ethyl esters)
Malarone Tablets 62.5mg/25mg, 250mg/100mg (atovaquone and proguanil hydrochloride)
Malarone Pediatric Tablets (atovaquone and proguanil hydrochloride)
Mepron Suspension (atovaquone)
Myleran Tablets 2mg (busulfan)
Parnate Tablets 10mg (tranylcypromine)
Paxil Tablets 10mg, 20mg, 30mg, 40mg ( paroxetine)
Paxil CR Tablets 12.5mg, 25mg, 37.5mg ( paroxetine)
Promacta Tablets (eltrombopaq)
Relenza Powder for Inhalation (zanamivir)
Requip Tablets 0.5mg, 0.25mg, 1mg, 2mg, 3mg, 4mg, 5mg (ropinirole)
Requip XL Tablets (ropinirole extended release)
Retrovir Capsules (zidovudine)
Retrovir Syrup (zidovudine)
Retrovir Tablets (zidovudine)
Rythmol Tablets 150mg, 225mg, 300mg (propafenone)
Rythmol SR Capsules 225mg, 325mg, 425mg (propafenone)
Serevent Diskus Powder for Inhalation 50mcg (salmeterol inhaled)
Tabloid Tablets 40mg (thioguanine)
Timentin Injection (ticarcillin/clavulanate)
Treximet Tablets (sumatriptan/naproxen sodium)
Trizivir Tablets 300mg/150mg/300mg (abacavir/lamivudine/zidovudine)
Tykerb Tablets (lapatinib)
Valtrex Caplets (valacyclovir)
Ventolin HFA Inhaler (albuterol inhalers)
Veramyst Nasal Spray (fluticasone nasal spray)
VESIcare Tablets 5mg, 10mg (solifenacin)
Wellbutrin Tablets 100mg (bupropion)
Wellbutrin SR Tablets 300mg (bupropion)
Zantac Injection (ranitidine)
Zantac Injection Premixed (ranitidine)
Zantac Syrup (ranitidine)
Zantac Tablets 150mg, 300mg (ranitidine)
Zantac EFFERdose Tablets 150mg (ranitidine)
Ziagen Oral Solution (avacavir sulfate)
Ziagen Tablets (avacavir sulfate)
Zinacef Injection (cefuroxime for injection)
Zofran Tablets 4mg, 8mg (ondansetron)
Zofran ODT Tablets-Orally Disintergrating 4mg, 8mg (ondansetron)
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 an income at or below 250% of the Federal Poverty Level. Medical diagnosis necessary for this program is not specified. US residency requirements are
not specified. The patient must also have spent $600 dollars on medications through the Medicare Part D plan
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| Application Process |
Anyone requesting assistance can call to request a faxed application 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 |
September 09, 2009 |
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