Patient Assistance Programs
These are Patient Assistance programs that we are aware of, including those run by pharmaceutical companies. We attempt to keep this list up to date, but companies may create or discontinue programs without us being aware of it so this list may include discontinued programs or not list existing programs.
General Assistance Programs
American Cancer Society
Contact Information:
Website: http://www.cancer.org
Additional Contact Information: 1-800-ACS-2345
The Healthwell Foundation
Contact Information:
Website: http://www.healthwellfoundation.org
Eligbility: To apply, patients should click here. The Healthwell Foundation assists patients with out of pocket expenses, such as copays, deductibles, medicines, and more. The program is for patients receiving treatment within the United States. Individuals may be eligible for assistance regardless of insurance status. Patients will also need to meet income and cost of living requirements.
NeedyMeds.com
Contact Information:
Website: http://www.needymeds.com/
This is not a patient assistance program, but is an important resource for finding appropriate assistance to meet your needs.
Patient Access Network Foundation
Contact Information:
Website: https://www.panfoundation.org/
Eligibility: To apply, patients should click here. The Patient Access Network Foundation (PANF) assists patients with out-of-pocket expenses such as medicine, copays, and coinsurance. As per their website, PANF's requirements for eligbility are:
To be eligible for assistance, patients must be U.S. residents and meet certain financial, medical and insurance criteria as set by the Foundation's board of directors. All applications must be verified by patients and their physicians and be supported by appropriate documentation as defined by each disease fund.
Patient Advocate Foundation
Program Name: Patient Advocate Foundation Co-Pay Relief
Contact Information:
Website: http://www.copays.org/ and http://www.patientadvocate.org/
Eligbility: To apply, patients should call 1-866-512-3861. The Co-Pay Relief program assists patients with co-payments for prescription medicines and deductibles, and is able to assist patients with a variety of diagnoses. Patients applying for relief must be covered by health insurance, who must pay a portion of the bill that the patient needs assistance on.
Patient Services Incorporated
Contact Information:
Website: https://www.patientservicesinc.org/
Eligbility: To apply, patients should call 1-800-366-7741 or apply online. Patient Services Inc (PSI) offers out-of-pocket expense assistance for a variety of illnesses. Eligbility is determined on a case-by-case basis.
Disease-specific Assistance Programs
National Organization for Rare Diseases
Eligible Diagnoses: PKU, Cystinuria, pheochromocytoma, edema associated with congestive heart failure, cirrhosis of the liver, renal disease, idiopathic edema, & lymphedema, APL, multiple myeloma, Homocystinuria, Hodgkin's disease & other lymphomas, renal cell carcinoma, & Hepatocellular Carcinoma.
Contact Information:
Website: http://www.rarediseases.org/
Additional Contact Information: They can be contacted with this form for further information.
The Chronic Disease Fund
Eligible Diagnoses: Breast cancer, colorectal cancer, multiple myeloma, MDS, and lung cancer non-small cell lung cancer.
Contact Information:
Website: http://www.cdfund.org/
Komen Patient Assistance Fund
Eligible Diagnoses: Breast cancer.
Contact Information:
Website: http://www.cancerlifeline.org/services/komen
Drug-specific Assistance Programs
Please note that not all drugs are listed in our navigation bar below - some companies did not specify certain drugs when they forwarded information on their assistance plan. If you know the name of the company who manufactures your medication, please feel free to scroll down and check if they have a general assistance program.
Abbott
Program Name: Patient Assistance Program
Contact Information:
Abbott Laboratories
Patient Assistance Program
Phone: (800) 222-6885
Website: http://www.pparx.org/
Eligible drugs: Any medication manufactured by Abbott.
Eligibility: Abbott Laboratories patient assistance program is available to outpatients who do not have insurance reimbursement for prescriptions, and are not eligible for governmental assistance programs. Some Medicare patients may also be eligible.
Abraxis Oncology
Program Name: ARC of Support
Eligible drugs: Abraxane
Contact Information:
Website: http://www.abraxane.com - click on "Patient Assistance."
Amgen, Inc.
Program Name: SAFETY NET Program
Contact Information: 1-800-272-9376
Eligible drugs: Vectibix, aranesp, neulasta, neupogen, epogen, and nplate.
Eligibility: Amgen’s SAFETY NET Program is designed to assist those patients who are medically indigent (patients may be uninsured or underinsured). Eligibility is based on patient’s insurance status and income level. Annual income is below $60,000 for an individual and has no health insurance or Medicaid. If insured, the patient must demonstrate difficulty with making co-payments for the drug by showing that at least 5% of their annual income is spent on the drug.
Program Name: Amgen Oncology Reimbursement Resource
AstraZeneca
Program Name: AZ&Me Prescription Savings Programs
Eligible drugs: Any AstraZeneca medications
Contact Information:
Website: http://www.astrazeneca-us.com/help-affording-your-medicines/prescription-saving-program/.
Berlex
Program Name: CamCare
Contact Information:
CamCare
P.O. Box 221289
Charlotte, NC 28222-1289
Phone: (877) 422-6728 #3
Fax: (800) 513-1824
Eligible drugs: Campath.
Eligibility: The CamCare Program provides patient assistance to financially needy individuals who meet eligibility criteria. Patients may be uninsured or be insured and experiencing difficulty accessing Campath. Patient Assistance Program eligibility is based on patient's insurance status and income level. To seek more information or to enroll a patient, providers should contact the CamCare Program by calling (877) 422-6728 #3. Trained reimbursement consultants will provide you with personalized assistance to help determine eligibility, facilitate reimbursement or patient assistance for Campath.
Bristol-Myers Squibb Company
Program Name: Bristol-Myers Squibb Oncology/Immunology Access
Contact Information: 1-800-736-0003
Eligible drugs: Plavix, coumadin, and abilify.
Eligibility: Must be low-income patient, without insurance.
Cephalon Oncology
Program Name: Cephalon Oncology Patient Assistance Program (PAP)
Contact Information:
Cephalon Oncology
Patient Assistant Program (PAP)
Phone: (800) 896-5855
Follow phone prompt instructions (press 2 for PAP and press 4 for TRISENOX®)
Eligible drugs: Provigil, fentura, trianda, trisenox, and gabatril.
Eligibility: Patients who do not have medical coverage could be eligible for the TRISENOX® Patient Assistance Program. The patient must not be eligible for public or private insurance reimbursement, and must meet income restrictions and medical eligibility.
Other Information: This program is administered by NORD and faxed applications are accepted.
Dendreon
Program Name: Dendreon On Call
Contact Information: 1-877-336-3736
Eligible drugs: Provenge
Website: http://www.provenge.com/patient-resources.aspx.
Genentech, Inc.
Program Name: Genentech Access to Care Foundation
Contact Information:
Genentech Access to Care Foundation
1 DNA Way MS #13A
South San Francisco, CA 94080
Phone: (866) 4ACCESS
Fax: (650) 225-1366
Eligible drugs: Tarceva, caphlo, herceptin, rituxan, avastin, activase, tienkease, raptiva, xobair, lucentis, nutropin, boniva, xelodaand pulmozyme.
Eligibility: The patient must not be eligible for public or private insurance reimbursement, and must meet income restrictions and medical eligibility. For reimbursement assistance for Herceptin® or Rituxan®, an application must be completed and signed by the treating physician. Patient's annual gross income must be less than $30,000.
Program Name: SPOC Online Reimbursement Service:
Contact Information:
Website: http://www.genetechaccesssolutions.com/index.jsp
Glaxo
Program Name: Glaxo Wellcome Patient Assistance Program
Contact Information:
Glaxo Wellcome Inc.
Patient Assistance Program
P.O. Box 52185
Phoenix, AZ 85072-2185
Phone: (800) 699-3806
Eligibility: The Glaxo Wellcome Patient Assistance Program has been established to provide short-term assistance to eligible patients until alternative funding can be found. All Glaxo Wellcome medications used in an outpatient setting are available. Program serves patients who do not have drug benefits through private insurance or government-funded programs.
Eligible drugs: Any drugs manufactured by Glaxo.
Program Name: Oncology Access to Care Program
Contact Information:
Phone: (800) 699-3806
Jannsen
Program Name: ZytigaOne Support
Contact Information: 1-855-998-4421
Eligible drugs: Zytiga
Website: http://http://www.zytiga.com. Please note that this website and phone number are for general support for Zytiga patients; please ask about the "ZytigaOne Instant Savings" program listed in their patient brochure.
Lilly
1st Program Name: Lilly Cares
Contact Information:
Lilly Cares Program Administrator
Lilly Cares
P.O. Box 230999
Centreville, VA 20120
Phone: (800) 545-6962
Eligible drugs: Any drugs manufactured by Lilly.
Eligibility: Program is only available for NON Medicare patients with no prescription coverage. Medicare patients are funneled into the new Lilly Answers discount program which provides drug at a cost of $12 for a 30 day prescription (1-877-RX-LILLY or www.lillyanswers.com). Applicant needs to specify exact income and source -- if ZERO specify what the situation is and make clear how person is surviving! Otherwise, the application will be sent back.
2nd Program Name: Lilly Oncology’s Patience Assistance Program (PAP)
Contact Information:
Phone: (888) 443-6927 Option #1
Program Name: Alimta® Compassionate Use Program
Eligible drugs: Alimta.
Eligibility: Alimta® will be available free of charge to patients with MPM who meet medical eligibility criteria. Lilly will make Alimta® (pemetrexed), an investigational compound, available on an expanded access, or compassionate use, basis to medically eligible patients with malignant pleural mesothelioma (MPM), a devastating cancer usually associated with exposure to asbestos. Alimta® will be available free of charge to patients with MPM who meet medical eligibility criteria.
MedImmune Oncology, Inc.
1st Program Name: Ethyol® Protect Program
Contact Information:
Phone: (877) 633-4411 #4
Eligible drugs: Ethyol.
Eligibility: The Ethyol Protect Program is a toll-free service that provides assistance to healthcare providers with coding and coverage verification, claims submissions, and appeals for Ethyol® (amifostine). As part of the reimbursement assistance services, reimbursement counselors will help physicians and patients assess their individual reimbursement situation by helping to verify their current insurance coverage, find out how individuals can access that coverage, and help to identify alternate insurance sources. For those patients who have followed the appropriate appeal procedures and are still denied coverage, assistance may be available to physicians in the form of product replacement. Additionally, product assistance in the form of free drug is available to financially needy individuals who meet the program's criteria. Pre-registration is required for both programs.
2nd Program Name: Synagis Secure Plus Program
Contact Information:
Synagis Secure Plus Program
PO Box 222197
Charlotte NC 28222-2197
Phone: (877) 480-8082, option 5
Eligible drugs: Ethyol.
Eligibility: There are two programs with the same application. One is The Insurance Patient Program which is a safety net for physicians if the patient's insurance denies the claim. It also acts as a benefits verification program. If the patient is denied coverage and the decision is appealed and still holds up, the company will send replacement medication to the physician’s office. The Second program is for uninsured patients, and provides medication to patients who met their requirements. Patients must have no health insurance, and meet the income/asset expense parameters of the program, which are not disclosed.
Millennium Pharmaceuticals, Inc.
Program Name: VELCADE® Reimbursement Assistance Program
Contact Information:
Monday-Friday, 9 a.m. - 8 p.m., EST
Phone: 1-866-VELCADE, 866-835-2233 option 2
The VELCADE Reimbursement Assistance Program is a full-service hotline for health care providers, patients and caregivers. Reimbursement specialists can verify health insurance coverage and eligibility; obtain pre-authorization; assess each patient’s drug coverage; and clarify any co-payment obligations patients may have relative to VELCADE® (bortezomib) for injection. In addition, coding and billing questions can be discussed with reimbursement specialists to facilitate appropriate payment for VELCADE® and related services.
Eligible drugs: Velcade.
Eligibility: In cases where patients have insufficient health insurance coverage, reimbursement specialists will help determine if alternative funding sources for VELCADE® are available. If no other sources of drug coverage can be identified, patients will be evaluated for the VELCADE® Patient Assistance Program and if eligible, will receive VELCADE® free of charge.
Novartis Oncology Pharmaceuticals
Program Name: Novartis Patient Assistance Program
Contact Information:
Novartis Pharmaceuticals
Patient Assistance Program
P.O. Box 66556
St. Louis, MO 63166
Phone: (800) 277-2254 #2
Fax: (888) 891-4924
Eligible drugs: Femara, gleevec, sandostatin, and zometa.
Eligibility: Patients must be U.S. residents. The Patient Assistance Program provides temporary assistance to patients who are experiencing financial hardship, and who have no prescription drug insurance. Patients are required to complete an application along with their physicians, and return it for evaluation.
Reimbursement Information:
Oncology-Specific Contact Info: 1-800-282-7630
Pfizer Oncology
Program Name: Pfizer FirstResource Patient Assistance Program
Contact Information:
FirstResource
P.O Box 220582
Charolette, KS 28222-0582
Phone: (877) 744-5675
Fax: (800) 708-3430
Eligible drugs: Aromasin, camptosar, ellence, emcyt, idamycin, and zinecard.
Eligibility:The FirstRESOURCE Patient Assistance Program is a support program designed to provide eligible patients with access to certain Pfizer oncology products. The patient may not have coverage for the drug requested under private insurance, a public program, or other assistance programs that may be available. The patient must be a U.S. resident being treated in the U.S. and meet FirstRESOURCE financial guidelines. Patients or their physicians should call FirstRESOURCE to complete an initial Patient Assistance eligibility screening.
AROMASIN® (exemestane tablets)
CAMPTOSAR® (irinotecan HCI injection)
ELLENCE® (epirubicin hydrochloride injection)
EMCYT® (estramustine phosphate sodium capsules)
IDAMYCIN® (idarubicin hydrochloride for injection, USP)
ZINECARD® (dexrazoxane for injection)
Sanofi-Aventis
1st Program Name: Eloxatin Reimbursement Hotline
Contact Information:
Monday-Friday, 9:00 A.M. to 8:00 P.M., EST
Phone: (877) 4-ELOXATIN or (877) 435-6928, option 2, then option 3
Fax: (877) 366-0584
Eligible drugs: Eloxatin.
Eligibility: Patients who do not have medical coverage could be eligible for the Eloxatin Patient Assistance Program. Patients must meet the financial criteria, be a U.S. Citizen or legal resident of the United States, and not qualify or be enrolled in any other reimbursement programs.
2nd Program Name: Eligard Reimbursement Hotline
Contact Information:
Monday-Friday, 9:00 A.M. to 8:00 P.M., EST
Phone: (877) 354-4273 #1
Fax: (866) 354-4273
Website: https://www.injectablehotline.com/
Eligible drugs: Eligard.
Eligibility: The hotline can check eligibility for patients, in various programs, who do not have medical coverage for Eligard™. If no alternative funding sources are able, patients will be evaluated for the Eligard™ Patient Assistance Program. The patient’s household income must be less than 150% of the federal poverty level, for a household of (1) $14,355; (2) $19,245; (3) $24,135; (4) 29,025; (5) 33,915; (6) 38,805.