Program of 2 Scroll down to see them all.
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This program provides brand name medications at no or low cost.
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| Pharmaceutical Company |
Pfizer, Inc. |
| Program Name |
Pfizer Connection to Care |
| Program Address |
PO Box 66585
St. Louis, MO 63166-6585 |
| Phone Number |
866-706-2400
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| Fax Number |
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| Medications on Program |
Accupril Tablets 5mg, 10mg, 20mg, 40mg (quinapril)
Accuretic Tablets 12.5mg/10mg, 12.5mg/20mg, 25mg/20mg (hydrochlorothiazide/quinapril)
Aldactazide Tablets 25mg/25mg (hydrochlorthiazide/spironolactone)
Aldactone Tablets-Film Coated 25mg, 50mg, 100mg (spironolactone)
Antivert Tablets 12.5mg, 50mg (meclizine)
Arthrotec Tablets 50mg/200mcg, 75mg/200mcg (diclofenac/nisoprostol)
Azulfidine EN-Tabs Delayed Release (sulfasalazine)
Azulfidine Tablets 500mg (sulfasalazine)
Caduet Tablets 5mg/10mg, 5mg/20mg, 5mg/40mg, 5mg/80mg, 10mg/10mg, 10mg/20mg, 10mg/40mg, 10mg/80mg (amlodipine/atorvastatin)
Calan Tablets 40mg, 80mg, 120mg (verapamil)
Calan SR Tablets 240mg (verapamil)
Cardura Tablets 1mg, 2mg, 4mg, 8mg (doxazosin)
Caverject Injection (alprostadil injection- aqueous)
Celebrex Capsules 100mg, 200mg, 400mg (celecoxib)
Celontin Capsules (methsuximide)
Cleocin Capsules 2% (clindamycin)
Cleocin Capsules 75mg, 150mg, 300mg (clindamycin)
Cleocin Vaginal Cream (clindamycin)
Cleocin T Capsules 10mg/ml (clindamycin)
Cleocin T Lotion (clindamycin)
Colestid Granules 5gm (colestipol)
Colestid Oral Suspension 7.5gm (colestipol)
Cortef Tablets 5mg, 10mg, 20mg (hydrocortisone)
Covera HS Tablets 180mg, 240mg (varapamil)
Cytotec Tablets (misoprostol)
Daypro Capsules 600mg (oxaprozin)
Depo SubQ Provera Injection (medroxyprogesterone acetate)
Depo-Estradiol Injection 5mg/ml (estradiol cypionate)
Depo-Medrol Injection 20mg/ml, 40mg/ml, 80mg/ml (methylprednisolone acetate)
Depo-Provera Injection 150mg/ml (medroxyprogesterone acetate)
Detrol Tablets 1mg (tolterodine)
Detrol LA Capsules 2mg, 4mg (tolterodine)
Diflucan Injection (fluconazole)
Diflucan Oral Suspension (fluconazole)
Diflucan Tablets 100mg, 200mg (fluconazole)
Dilantin Capsules 30mg, 50mg, 100mg (phenytoin)
Estring Vaginal Ring 2mg (estradiol vaginal ring)
Feldene Capsules 10mg, 20mg (piroxicam)
Flagyl Capsules 250mg, 500mg (metronidazole)
Geodon Capsules 20mg, 40mg, 60mg, 80mg (ziprasidone)
Glucotrol Tablets 5mg, 10mg (glipizide)
Glucotrol XL Tablets 5mg (glipizide)
Glynase PresTab (micronized glyburide)
Glyset Tablets 25mg, 50mg, 100mg (miglitol)
Inspra Tablets 25mg (eplerenone)
Lincocin 300mg/ml (lincomycin)
Lipitor Tablets 10mg, 20mg, 40mg, 80mg (atorvastatin)
Lyrica Capsules 25mg, 50mg, 75mg, 100mg, 150mg, 200mg, 225mg, 300mg (pregabalin)
Medrol Tablets 2mg, 4mg, 8mg, 16mg, 32mg (methylprednisolone)
Mycobutin Tablets (rifabutin)
Nardil Tablets 15mg (phenelzine)
Navane Capsules (thiothixene)
Neurontin Capsules 100mg, 300mg, 400mg (gabapentin)
Neurontin Oral Solution 250mg/ml (gabapentin)
Neurontin Tablets 600mg, 800mg (gabapentin)
Nicotrol Inhaler (nicotine inhaled)
Nicotrol NS Nasal Spray (nicotine nasal)
Nitrostat Sublingual (nitroglycerin)
Norpace Capsules 100mg, 150mg (disopyramide)
Norpace CR (disopyramide)
Norvasc Tablets 2.5mg, 5mg, 10mg (amlodipine)
Procardia Capsules 10mg (c)
Procardia XL Capsules 30mg, 60mg, 90mg (nifedipine)
Provera Tablets 2.5mg, 5mg, 10mg (medroxyprogesterone acetate)
Relpax Tablets 20mg, 40mg (eletriptan)
Synarel Nasal Spray 2mg/ml (nafarelin nasal spray)
Tikosyn Tablets 125mcg, 250mcg, 500mcg (dofetilide)
Toviaz 1 (fesoterodine fumarate)
Viagra Tablets 25mg, 50mg, 100mg (sildenafil)
Vistaril Capsules 25mg, 100mg (hydroxyzine)
Xalatan (latanoprost)
Zarontin (ethosuximide)
Zithromax Tablets 250mg, 600mg (azithromycin)
Zoloft Oral Concentrate (sertraline)
Zoloft Tablets 25mg, 50mg, 100mg (sertraline)
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| Application Forms |
Pfizer Connection to Care
Pfizer Connection to Care (Spanish)
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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 no prescription coverage for any medications and and have an income at or below 200% of the Federal Poverty Level, adjusted for family size. Medical diagnosis necessary for this program is not specified. The patient must also reside in the US.
If a patient has insurance, including Medicare Part D,meets the income guidelines and has a prescription to a medication on this program and cannot afford the co-pay due to extreme medical or financial hardship, s/he may qualify to get assistance and should call the program. For Lyrica only: the prescription for Lyrica, as well as a copy of the patient's driver's license or other picture ID must be sent with the application. Please note, Lopid is on back order and will be added back to the program when it is available.
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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 can be faxed, mailed out or downloaded from website. The completed application must be mailed back.
Both the patient and the health care professional are notified in writing of acceptance or denial. Allow 4 weeks for processing and delivery of medication.
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| Application Requirements |
The doctor must fill out a section and sign the application. The patient must fill out a section, sign the application and attach proof of income.
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| Program Details |
Up to a 90 day supply is sent to the doctor's office, except for Lyrica which is sent to the patient's home. The doctor can refill prescriptions or add new Pfizer medicines by calling 866-706-2400. Once a year a new application with financial documentation is needed.
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| Last Updated |
July 19, 2010 |
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