Pharmaceutical, Medicare,
and Indigent Programs

Lilly (1-877-795-4559)

• $12 per 30 day supply

• Medicare or annual income $18,000 single/$24,000 household

• Evista, Humalog, Humalog 75/25, Humulin, Keflex, Prozac, Prozac Weekly, Zyprexa

Pfizer Share Card (1-800-717-6005 )

• $15 per 30 day supply

• Medicare

• No Rx Drug Coverage

• Income $18,000 single/ $24,000 couple

• Accupril, Accuretic, Antivert, Aricept, Atarax, Cardura, Celontin, Diabinese, Diflucan, Dilantin, Estrostep Fe, Feldene, Femhrt, Geocillin, Geodon, Glucotrol, Glucotrol XL, Lipitor, Loestrin, Lopid, Minipress, Minizide, Nardil, Navane, Neurontin, Nitrostat, Norvasc, Procardia, Procardia XL, Renese, Rescriptor, Sinequan, TAO, Terramycin Opthalmic Ointment, Viagra, Vibramycin, Viracept, Vistaril, Zarontin, Zithromax, Zoloft, Zyrtec, Zyrtec D 12 Hr

Merck Patient Assistance Program (1-800-994-2111)

• Up to 3 month supply with 3 refills

• Physician’s office to call for application/ have DEA #

• No pharmaceutical coverage

• Cannot afford Rx

• Do not photocopy application

Together RX Card (1-800-865-7211)

• Medicare

• $28,000 single/$38,000 couple

• No public or private RX insurance

• 20-40% savings

• Abbott, Aventis, Bristol-Myers, GlaxoSmith, Jenssen, Novartis, Ortho-McNeil, AstraZeneca

Orange Card (fill out application)

• Used like a coupon, average savings 30%

• Medicare

• Income $26,000 single/$35,000 couple

• No private or public Rx coverage

• GlaxoSmithKline – Advair, Augmentin, Avandia, Bactroban Cream, Combivir, Coreg, Epivir, Epivir-HBV, Eskalith Cr, Flonase, Flovent, Imitrex, Lamictal, Lanoxin, Paxil, Requip, Serevent, Trizivir, Valtrex, Wellbutrin SR, Ziagen, Zofran

Parke-Davis (fill out form)

• $16,000 single/$25,000 family

• No Rx coverage

• Accupril, Accuretic, Dilantin, Estrostep, Femhrt, Lipitor, Loestrin, Neurotin, Zarontin

GlaxoWellcome (1-800-722-9294)

• Call prior to sending form

Actos Patient Assistance Program (1-877-825-3327)

• May receive up to 1 year of Actos

Bristol-Meyers Squibb Patient Assistance (1-800-736-0003)

• Based on income

• Receive 3 month supply, which is sent to physician’s office

• Coumadin, Sinemet, Revia, Lodosyn, Avalide Avapro, Buspar, Capoten, Cefxil, Desyrel, Glucophage, Glucovance, Monopril, Plavix, Proavachol, Serzone, Tequin  (these are only a few listed)

Wyeth-Ayerst (1-800-568-9938)

Aventis Patient Assistance Program (1-800-221-4025)

Reminyl Assistance (1-866-736-4695)

Astrazenica Foundation Patient Assistance Program (1-800-424-3727)

• Accolate, Armidex, Atacand, Atacand HCT, Casodex, Emla, Lexxel, Nexium, Nolvadex, Plendil, Prilosec, Pulmicort Respules, Seroquel, Sular, Tenormin, Tenoretic, Tonocard, Toprol XL, Zestoretic, Zestril, Zoladex, Zomig

Novartis Care Card (1-866-974-2273)

• Medicare

• $26,000 single/$35,000 couple

• No Rx coverage

• Micalcin, Famvir, Lamisil, Tegretol XR, Voltaren XR, Starlix, Parlodel, Lotensin, Lotrel

Abbott Lab (1-800-222-6885)

Sankyo Pharma Open Care Program (1-866-268-7327)

• Welchol

Aciphex Patient Assistance (1-800-523-5870)

Patient In Need Program (1-800-542-2526)

• Aldactone, Aldactazide, Arthrotec, Calan, Celebrex, Covera HS, Cytotec, Norpace

www.needymeds.com

• For non-medicare patients, brings up all the different drugs/plans available.