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

This program provides medication at no cost.

Provided by: Pfizer, Inc.

PO Box 66585
St. Louis, MO 63166-6585

TEL: 866-706-2400


FAX: 866-470-1748
Languages Spoken:

English

Program Website

 

Patient Assistance Applications

Pfizer Group A Application for Primary Care Medicines

Pfizer Group A Application for Primary Care Medicines (Spanish)

Pfizer Group B Application for Oncology and Specialty Medicines

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

Pfizer Group C Application for Vaccines

Pfizer Group C Application for Vaccines (Spanish)

Pfizer Group D Application for Lyrica

Pfizer Group D Application for Lyrica (Spanish)

Pfizer Patient Assistance Program Medication List

 

Brand Name Medications Covered

 
  • Aromasin tablet
  • Menest
  • Arthrotec
  • Mycobutin
  • Benefix injection
  • Nicotrol inhalation system
  • Bosulif
  • Nitrostat
  • Caduet
  • Norpace
  • Camptosar injection
  • Phospholine Iodide ophthalmic solution
  • Caverject Impulse injection
  • Premarin
  • Celebrex capsule
  • Premarin cream; vaginal
  • Celontin capsule
  • Premphase tablet
  • Chantix
  • Prempro tablet
  • Cleocin
  • Prevnar 13
  • Depo-Estradiol injection
  • Pristiq
  • Depo-Provera
  • Quillichew ER tablet; chewable extended release
  • Depo-SubQ Provera 104
  • Quillivant XR suspension; extended release
  • Detrol
  • Rapamune
  • Detrol LA capsule; extended release
  • Relpax
  • Dilantin
  • Revatio
  • Duavee
  • Skelaxin
  • Ellence injection
  • Sutent
  • Emcyt
  • Synarel
  • Estring vaginal insert
  • Tikosyn
  • Feldene
  • Torisel
  • Flector Patch patch
  • Toviaz
  • Fragmin injection
  • Trecator
  • Glyset
  • Tygacil
  • Ibrance
  • Vfend
  • Idamycin PFS injection
  • Viagra
  • Inlyta
  • Xalkori
  • Inspra
  • Xyntha Solofuse iv
  • Lincocin
  • Zarontin
  • Lyrica
  • Zinecard injection
 

Generic Name

 
  • alprostadil injection
  • factor IX injection
  • amlodipine besylate/atorvastatin calcium
  • fesoterodine fumarate
  • antihemophilic factor (recombinant) iv
  • heparin sodium injection
  • axitinib
  • idarubicin injection
  • bazedoxifene acetate/conjugated estrogens
  • irinotecan injection
  • bosutinib monohydrate
  • lincomycin
  • celecoxib capsule
  • medroxyprogesterone acetate
  • clindamycin
  • metaxalone
  • conjugated estrogens
  • methsuximide capsule
  • conjugated estrogens cream; vaginal
  • methylphenidate suspension; extended release
  • conjugated estrogens/medroxyprogesterone acetate tablet
  • methylphenidate tablet; chewable extended release
  • crizotinib
  • miglitol
  • dalteparin injection
  • nafarelin acetate
  • desvenlafaxine succinate
  • nicotine cartridge inhalation system
  • dexrazoxane injection
  • nitroglycerin
  • diclofenac epolamine patch
  • palbociclib
  • diclofenac sodium/misoprostol
  • phenytoin sodium
  • disopyramide
  • piroxicam
  • dofetilide
  • pneumococcal 13-valent diphtheria CRM197 protein
  • echothiophate ophthalmic solution
  • pregabalin
  • eletriptan hydrobromide
  • rifabutin
  • epirubicin injection
  • sildenafil citrate
  • eplerenone
  • sirolimus
  • estradiol cypionate injection
  • sunitinib malate
  • estradiol vaginal insert
  • temsirolimus
  • estramustine phosphate sodium
  • tigecycline
  • estrogens/esterified
  • tolterodine tartrate
  • ethionamide
  • tolterodine tartrate capsule; extended release
  • ethosuximide
  • varenicline tartrate
  • exemestane tablet
  • voriconazole
 

Eligibility Requirements   

Insurance Status Uninsured or Underinsured
Those with Part D Eligible? Yes
Income Varies
Diagnosis/Medical Criteria Not specified
US Residency Required? Must be residing in the US or US territory
   

Application

Obtaining Call or download
Receiving Mailed or downloaded from website
Returning Fax or mail
Doctor's Action Complete section and sign
Applicant's Action Complete section, sign, attach required documents
Decision Communicated Patient and Doctor are notified
Decision Timeframe Varies
   

Medication

Amount/Supply Varies
Sent To Varies
Delivery Time Varies
Refill Process Varies per medication
Limit None
Re-application New application, new documentation yearly
   

Additional Information

Pfizer also has programs that provide eligible patients with insurance, support assistance, and medicines at a savings. Contact Pfizer RxPathways for details (844-989-7284).


Updated August 18, 2017