Program Details

PFIZER, INC.
Pfizer Patient Assistance Program

Lyrica (pregabalin)
 
CONTACT INFO
Address:
,
Phone: 1-866-706-2400 Provider Phone:
Fax: 1-866-470-1748 Website: Program Website
ELIGIBILITY
Eligibility Info:
  • To apply, please visit the program interactive forms at: Pfizer RxPathways
  • The Pfizer Patient Assistance Program provides eligible patients with select Pfizer medicines for free. To qualify:
  • Note: Commercially insured patients are not eligible for the PAP, regardless of their income status or medicine's formulary status.
  • Patients must meet program income guidelines, which vary by product and household size.
  • Medicines accessed through the PAP must be for an FDA approved indication. 
  • Patients must reside in the US or any of the US territories.
  •   Couple % FPL
    Income at or below: Not Published
    Other Income Requirements:
  • Income varies by medication needed.
  • Adjusted for family size.
  • NOTE: If patient has no income and does not file taxes, a letter from the physician stating the patient has no income OR a notarized letter from a family member is required.
  • Medical expenses can be deducted from reported income: Not Published
    Social security requested on form: No
    US citizenship/residency specified: Yes
    APPLICATION
    Attachments Required: Financial
    Physician License #
    Required:
    Either DEA or State
    Prescriber Signature
    Allowed:
    Physician
    Application may be
    faxed:
    Yes
    Eligibility determination
    letter sent:
    Both Provider and Patient
    MEDICATION
    Receives: Medication
    Shipped To: Provider
    Quantity in Shipment: 90 days
    Delivery Time: 2-4 weeks
    Re-application Policy: New application every 12 months
    New financial information every 12 months
    Refill Policy: Varies
    Other Information:

    Last Updated: 12/15/2023


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