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

Pfizer Patient Assistance Program

This program provides medication at no cost.

Provided by: Pfizer, Inc.


TEL: 866-706-2400


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

 
  • Arthrotec
  • Nicotrol inhalation system
  • Caduet
  • Nitrostat
  • Caverject Impulse injection
  • Norpace
  • Celebrex capsule
  • Phospholine Iodide ophthalmic solution
  • Celontin capsule
  • Premarin
  • Chantix
  • Premarin cream; vaginal
  • Cleocin
  • Premphase tablet
  • Depo-Estradiol injection
  • Prempro tablet
  • Depo-Provera
  • Prevnar 13
  • Depo-SubQ Provera 104
  • Pristiq
  • Detrol
  • Quillichew ER tablet; chewable extended release
  • Detrol LA capsule; extended release
  • Quillivant XR suspension; extended release
  • Dilantin
  • Rapamune
  • Duavee
  • Relpax
  • Estring vaginal insert
  • Revatio
  • Feldene
  • Skelaxin
  • Flector Patch patch
  • Synarel
  • Fragmin injection
  • Tikosyn
  • Glyset
  • Toviaz
  • Inspra
  • Trecator
  • Lincocin
  • Trumenba
  • Lyrica
  • Tygacil
  • Lyrica CR
  • Vfend
  • Menest
  • Viagra
  • Mycobutin
  • Zarontin
 

Generic Name

 
  • alprostadil injection
  • lincomycin
  • amlodipine besylate/atorvastatin calcium
  • medroxyprogesterone acetate
  • bazedoxifene acetate/conjugated estrogens
  • meningococcal group B vaccine
  • celecoxib capsule
  • metaxalone
  • clindamycin
  • methsuximide capsule
  • conjugated estrogens
  • methylphenidate suspension; extended release
  • conjugated estrogens cream; vaginal
  • methylphenidate tablet; chewable extended release
  • conjugated estrogens/medroxyprogesterone acetate tablet
  • miglitol
  • dalteparin injection
  • nafarelin acetate
  • desvenlafaxine succinate
  • nicotine cartridge inhalation system
  • diclofenac epolamine patch
  • nitroglycerin
  • diclofenac sodium/misoprostol
  • phenytoin sodium
  • disopyramide
  • piroxicam
  • dofetilide
  • pneumococcal 13-valent diphtheria CRM197 protein
  • echothiophate ophthalmic solution
  • pregabalin
  • eletriptan hydrobromide
  • rifabutin
  • eplerenone
  • sildenafil citrate
  • estradiol cypionate injection
  • sirolimus
  • estradiol vaginal insert
  • tigecycline
  • estrogens/esterified
  • tolterodine tartrate
  • ethionamide
  • tolterodine tartrate capsule; extended release
  • ethosuximide
  • varenicline tartrate
  • fesoterodine fumarate
  • 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 July 09, 2018