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

Arbor Patient Assistance Program

This program provides brand name medications at no or low cost

Provided by: Arbor Pharmaceuticals, LLC.

PO Box 6123
Lawrenceville, NJ 08648

TEL: 844-884-8700

FAX: 844-287-5417
Languages Spoken:

English Others By Translation Service

Program Website


Patient Assistance Applications

Arbor Patient Assistance Program Application


Brand Name Medications Covered

  • BiDil tablet
  • EryPed granule; oral
  • E.E.S. granule; oral
  • Horizant
  • Edarbi tablet
  • PCE
  • Edarbyclor tablet
  • Sotylize oral solution

Generic Name

  • azilsartan kamedoxomil/chlorthalidone tablet
  • erythromycin tablet
  • azilsartan medoxomil tablet
  • gabapentin enacarbil
  • erythromycin
  • isosorbide dinitrate/hydralazine tablet
  • erythromycin ethylsuccinate granule; oral
  • sotalol oral solution

Eligibility Requirements   

Insurance Status Determined case by case
Those with Part D Eligible? No
Income Varies. **See below for details
Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
US Residency Required? Must be US citizen or permanent resident


Obtaining Call or download
Receiving Mailed
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 2 business days, once application process is complete


Amount/Supply Up to 90 day supply
Sent To Doctor's office
Delivery Time Within 48 hours
Refill Process Patient must contact company
Limit Maximum of 3 refills through 12/31 of current calendar year
Re-application New application yearly

Additional Information

Must be at or below 300% FPL for BiDil.
Must be at or below 200% FPL for all other medications.

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

This program also provides copay assistance.

Updated September 17, 2018