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

Bausch Health Patient Assistance Program

This program provides brand name medications at no or low cost

Provided by: Bausch Health Companies, Inc.

PO Box 6122
Lawrenceville, NJ 08648

TEL: 833-862-8727

FAX: 844-705-0160
Languages Spoken:


Program Website


Program Applications and Forms

Bausch Health Patient Assistance Program Application



  • metronidazole topical cream; topical (Noritate)

Eligibility Requirements   

Insurance Status Must have no prescription coverage for needed medication
Those with Part D Eligible? Determined case by case
Income Based on FPL
Diagnosis/Medical Criteria FDA-approved diagnosis
US Residency Required? Must be a US resident and treated by a US licensed healthcare provider


Obtaining Call
Receiving Faxed
Returning Fax or mail
Doctor's Action Complete section, sign, attach required documents
Applicant's Action Complete section, sign, attach required documents
Decision Communicated Patient and Doctor are notified
Decision Timeframe Not specified


Amount/Supply Varies
Sent To Doctor's office or patient's home
Delivery Time Not specified
Refill Process Not specified
Limit One year
Re-application New application yearly

Additional Information

Hardship appeals for patients residing in Puerto Rico will be reviewed on a case-by-case basis.

Call for information on the most recent medications as the list is subject to change.

Updated May 11, 2022