Prescription Drug Program

The Prescription Drug Program (PDP) is a privately funded program run by pharmaceutical companies. These companies provide prescriptions at little or no cost to people who qualify. Application must be made to individual companies as each company has its own application form, guidelines, and procedures.

How To Use This Program

Patient Assistance Programs are available from more that 100 pharmaceutical manufactures. These programs usually offer a limited supply of free prescription medications to eligible patients.

Application forms are available on-line for 40+ programs that allow their forms to be copied freely. You can view, fill out and print the forms in most browser versions from the website below:

www.RxAssist.org

1. Click on the brand name drug to find out the name of the company that manufactures it.
2. Click on the name of the company to access their patient assistance page.
3. Print the application form if available of follow the directions as presented.
4. Fill out the form and take it to your doctor who must sign and send it to the company.

Website that provide other prescription in formation are:

• www.rxassist.org
• www.rxhope.com
• www.needymeds.com
• www.pparx.org

Medicare beneficiaries who need help getting application forms for the Prescription Drug Progam may call the SHICK Coordinator in their area.