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Patient Assistance Information

 
1 Program for Lyrica Capsules
 
 
Pfizer RxPathways Patient Assistance Program

PO Box 66585
St. Louis, MO 63166-6585
Phone : (866)706-2400
Fax: (866)470-1748
Eligibility
> The patient must either have no prescription coverage, or not enough coverage, to pay for their prescribed Pfizer medicine(s). Income requirements for this program have not been disclosed. Patients must reside in the US, Puerto Rico or USVI.
Who Can Apply
> Anyone who has been prescribed a Pfizer medicine and is in need of assistance can call or download an application.
Required
> The doctor must fill out a section and sign. The patient must fill out a section, sign the application and attach proof of income.
Supply
> Varies
Ship To
> Varies
Note
>
 
Includes Support for This Drug
NOTE: Linked drugs are available for Prescribers to Apply Online now.
Click drug logo or drug name to start online application.
 
Lyrica Capsules
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form
Download printable Form
Download printable Form
Download printable Form
Download printable Form
Download printable Form
(Requires Acrobat Reader