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 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

 
  • Aromasin
  • Mycobutin
  • Arthrotec
  • Mylotarg
  • Benefix
  • Nicotrol inhalation system
  • Besponsa
  • Nitrostat
  • Bosulif
  • Nivestym
  • Caduet
  • Norpace
  • Camptosar
  • Norpace CR
  • Caverject Impulse injection
  • Phospholine Iodide ophthalmic solution
  • Celebrex capsule
  • Premarin
  • Celontin capsule
  • Premarin cream; vaginal
  • Chantix
  • Premphase tablet
  • Cleocin
  • Prempro tablet
  • Depo-Estradiol injection
  • Prevnar 13
  • Depo-Provera
  • Pristiq
  • Depo-SubQ Provera 104
  • Rapamune
  • Detrol
  • Relpax
  • Detrol LA capsule; extended release
  • Retacrit
  • Dilantin
  • Revatio
  • Duavee
  • Skelaxin
  • Elelyso
  • Somavert
  • Ellence
  • Sutent
  • Emcyt
  • Synarel
  • Estring vaginal insert
  • Talzenna
  • Eucrisa
  • Tikosyn
  • Feldene
  • Torisel
  • Flector Patch patch
  • Toviaz
  • Fragmin injection
  • Trecator
  • Genotropin
  • Trumenba
  • Glyset
  • Tygacil
  • Heparin injection; iv
  • Vfend
  • Ibrance
  • Viagra
  • Idamycin PFS
  • Vizimpro
  • Inflectra
  • Xalkori
  • Inlyta
  • Xeljanz
  • Inspra
  • Xeljanz XR
  • Lincocin
  • Xyntha
  • Lyrica
  • Zarontin
  • Lyrica CR
  • Zinecard
  • Menest
  • Zyvox
 

Generic Name Medications Covered

 
  • alprostadil injection
  • gemtuzumab ozogamicin
  • amlodipine besylate/atorvastatin calcium
  • idarubicin
  • antihemophilic factor (recombinant)
  • infliximab-dyyb
  • axitinib
  • inotuzumab ozogamicin
  • bazedoxifene acetate/conjugated estrogens
  • irinotecan
  • bosutinib monohydrate
  • lincomycin
  • celecoxib capsule
  • linezolid
  • clindamycin
  • medroxyprogesterone acetate
  • conjugated estrogens
  • meningococcal group B vaccine
  • conjugated estrogens cream; vaginal
  • metaxalone
  • conjugated estrogens/medroxyprogesterone acetate tablet
  • methsuximide capsule
  • crisaborole
  • miglitol
  • crizotinib
  • nafarelin acetate
  • dacomitinib
  • nicotine cartridge inhalation system
  • dalteparin injection
  • nitroglycerin
  • desvenlafaxine succinate
  • palbociclib
  • dexrazoxane
  • pegvisomant
  • diclofenac epolamine patch
  • phenytoin sodium
  • diclofenac sodium/misoprostol
  • piroxicam
  • disopyramide
  • pneumococcal 13-valent diphtheria CRM197 protein vaccine
  • dofetilide
  • pregabalin
  • echothiophate ophthalmic solution
  • rifabutin
  • eletriptan hydrobromide
  • sildenafil citrate
  • epirubicin
  • sirolimus
  • eplerenone
  • sodium injection; iv
  • epoetin alfa
  • somatropin recombinant
  • estradiol cypionate injection
  • sunitinib malate
  • estradiol vaginal insert
  • talazoparib
  • estramustine phosphate sodium
  • taliglucerase alfa
  • estrogens/esterified
  • temsirolimus
  • ethionamide
  • tigecycline
  • ethosuximide
  • tofacitinib
  • exemestane
  • tolterodine tartrate
  • factor IX
  • tolterodine tartrate capsule; extended release
  • fesoterodine fumarate
  • varenicline tartrate
  • filgrastim
  • 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 March 11, 2019