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 brand name medications at no or low cost

Provided by: Pfizer, Inc.


TEL: 866-706-2400


Languages Spoken:

English, Spanish

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
  • Mycobutin
  • Caduet
  • Nicotrol inhalation system
  • Caverject
  • Norpace
  • Celebrex capsule
  • Phospholine Iodide
  • Celontin
  • Premarin
  • Chantix tablet
  • Premarin cream; vaginal
  • Cleocin
  • Premphase
  • Depo-Estradiol
  • Prempro
  • Depo-Provera
  • Prevnar 13
  • Depo-SubQ Provera 104
  • Pristiq
  • Detrol
  • Rapamune
  • Detrol LA
  • Relpax
  • Dilantin
  • Revatio
  • Duavee
  • Skelaxin
  • Estring
  • Synarel
  • Feldene
  • Tikosyn
  • Flector
  • Toviaz
  • Fragmin
  • Trecator
  • Glyset
  • Trumenba
  • Inspra
  • Tygacil
  • Lincocin
  • Vfend
  • Lyrica
  • Viagra
  • Lyrica CR
  • Zarontin
  • Menest
 

Generic Name Medications Covered

 
  • alprostadil
  • fesoterodine fumarate
  • amlodipine besylate/atorvastatin calcium
  • heparin sodium
  • bazedoxifene acetate/conjugated estrogens
  • lincomycin
  • celecoxib capsule
  • medroxyprogesterone acetate
  • clindamycin
  • meningococcal group B vaccine
  • conjugated estrogens
  • metaxalone
  • conjugated estrogens cream; vaginal
  • methsuximide
  • conjugated estrogens/medroxyprogesterone acetate
  • miglitol
  • dalteparin
  • nafarelin acetate
  • desvenlafaxine succinate
  • nicotine cartridge inhalation system
  • diclofenac epolamine
  • phenytoin sodium
  • diclofenac sodium/misoprostol
  • piroxicam
  • disopyramide
  • pneumococcal 13-valent diphtheria CRM197 protein vaccine
  • dofetilide
  • pregabalin
  • echothiophate iodide
  • rifabutin
  • eletriptan hydrobromide
  • sildenafil citrate
  • eplerenone
  • sirolimus
  • estradiol
  • tigecycline
  • estradiol cypionate
  • tolterodine tartrate
  • estrogens/esterified
  • varenicline tablet
  • ethionamide
  • voriconazole
  • ethosuximide
 

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 15, 2019