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MEDICATION HELP


Asthma inhalers


Drug Manufacturer Ships to PAP info Application
Advair® diskus and HFA (fluticasone + salmeterol) GlaxoSmithKline Patient or other Link Link
Arnuity Ellipta® (Fluticasone) GlaxoSmithKline Patient or other Link Link
Asmanex® HFA and Twisthaler (mometasone) Merck Patient or doctor Link Link
Breo Ellipta® (fluticasone + vilanterol) GlaxoSmithKline Patient or other Link Link
Dulera® (mometasone + formoterol) Merck Patient or doctor Link Link
Flovent® Diskus and HFA (fluticasone) GlaxoSmithKline Patient or other Link Link
ProAir® HFA and RespiClick (albuterol) Teva Patient or doctor Link Link
Proventil® HFA (albuterol) Merck Patient or doctor Link Link
Pulmicort® Flexhaler (budesonide) AstraZeneca Patient or doctor Link Link
Qvar® (Beclomethasone) Teva Patient or doctor Link Link
Serevent® (salmeterol) GlaxoSmithKline Patient or other Link Link
Spiriva® handihaler and Respimat (tiotropium) Boehringer Ingelheim Patient Link Link
Symbicort® (budesonide + formoterol) AstraZeneca Patient or doctor Link Link
Ventolin® (albuterol) GlaxoSmithKline Patient or other Link Link

Atrial fibrillation


Drug Manufacturer Ships to PAP info Application
Apixaban (Eliquis®) Bristol-Myers Squibb Patient or doctor Link Link
Dabigatran (Pradaxa®) Boehringer Ingelheim Patient Link Link
Edoxaban (Savaysa®) Daiichi Sankyo N/A N/A N/A
Rivaroxaban (Xarelto®) Johnson and Johnson Pharmacy Link Link

COPD inhalers


Drug Manufacturer Ships to PAP info Application
Advair® diskus and HFA (fluticasone + salmeterol) GlaxoSmithKline Patient or other Link Link
Anoro Ellipta® (vilanterol + umeclidinium) GlaxoSmithKline Patient or other Link Link
Atrovent® HFA (ipratropium) Boehringer Ingelheim Patient Link Link
Bevespi Aerosphere® (formoterol + glycopyrrolate) AstraZeneca Patient or doctor Link Link
Breo Ellipta® (fluticasone + vilanterol) GlaxoSmithKline Patient or other Link Link
Combivent® (albuterol + ipratropium) Boehringer Ingelheim Patient Link Link
Duaklir Pressair® (aclidinium + formoterol) Circassia N/A N/A N/A
Incruse Ellipta® (umeclidinium) GlaxoSmithKline Patient or other Link Link
Proventil® HFA (albuterol) Merck Patient or doctor Link Link
ProAir® HFA and RespiClick (albuterol) Teva Patient or doctor Link Link
Serevent® (salmeterol) GlaxoSmithKline Patient or other Link Link
Spiriva® handihaler and Respimat (tiotropium) Boehringer Ingelheim Patient Link Link
Stiolto Respimat® (olodaterol + tiotropium) Boehringer Ingelheim Patient Link Link
Striverdi Respimat® (olodaterol) Boehringer Ingelheim Patient Link Link
Symbicort® (budesonide + formoterol) AstraZeneca Patient or doctor Link Link
Trelegy Ellipta® (fluticasone + umeclidinium + vilanterol) GlaxoSmithKline Patient or other Link Link
Tudorza Pressair® (aclidinium) Circassia N/A N/A N/A
Utibron Neohaler® (indacaterol and glycopyrrolate) Sunovion Pharmacy Link Link
Ventolin® (albuterol) GlaxoSmithKline Patient or other Link Link

Crohn's disease


Patient Assistance Programs for Biologics in Crohn's Disease
Drug Manufacturer Ships to FPL limit PAP info Application
Adalimumab (Humira®) Abbvie Patient or doctor < 600% Link Link (online and pdf)
Certolizumab (Cimzia®) UHC Patient < 500% Link Link (online)
Ustekinumab (Stelara®) Janssen Pharmacy or Doctor < 400% Link Link (pdf)

Deep vein thrombosis (DVT)


Drug Manufacturer Ships to PAP info Application
Apixaban (Eliquis®) Bristol-Myers Squibb Patient or doctor Link Link
Dabigatran (Pradaxa®) Boehringer Ingelheim Patient Link Link
Edoxaban (Savaysa®) Daiichi Sankyo N/A N/A N/A
Rivaroxaban (Xarelto®) Johnson and Johnson Pharmacy Link Link

Diabetes - insulin


Insulin Reduced cost programs Free programs
Basaglar, Humalog,
Humulin N, Humulin R,
Humalog Mix 50/50, Humalog Mix 75/25
Lilly Insulin Value Program
  • Insurance: with and without
  • Cost: $35 for a month supply
  • Eligibility requirements: none
Lilly Cares program
  • Income < 400% of federal poverty level
  • U.S. legal resident
  • No insurance
Lantus, Toujeo, Admelog, Apidra Sanofi Insulin Value Savings Program
  • Insurance: without
  • Cost: $99/month for up to 10 packs of pens and/or vials
  • Eligibility requirements: none
Sanofi Patient Connection
  • Income < 400% of federal poverty level
  • U.S. legal resident
  • No insurance
Levemir, Tresiba, Novolog, Fiasp
Novolin N, Novolin R,
Novolin 70/30, Novolog Mix 70/30
My$99Insulin Program
  • Insurance: with and without
  • Cost: $99/month for up to 3 vials or 2 packs of pens
  • Eligibility requirements: none

Walmart (Novolin N, Novolin R, Novolin 70/30, Novolog)
  • Insurance: with and without
  • Cost:
    • Novolin N: $25/vial | $43/5 pens
    • Novolin R: $25/vial | $43/5 pens
    • Novolin 70/30: $25/vial | $43/5 pens
    • Novolog: $72.88/vial | $86/5 pens
NovoCare Patient Assistance Program
  • Income < 400% of federal poverty level
  • U.S. legal resident
  • No insurance

Diabetes - SGLT2 inhibitors


Drug Manufacturer Ships to PAP info Application
Canagliflozin (Invokana®, Invokamet®, Invokamet® XR) Johnson and Johnson Pharmacy Link Link
Dapagliflozin (Farxiga®, Qtern®, Xigduo XR®) AstraZeneca Patient or doctor Link Link
Empagliflozin (Jardiance®, Glyxambi®,Synjardy®, Synjardy® XR) Boehringer Ingelheim Patient Link Link
Ertugliflozin (Steglatro®) Merck N/A N/A N/A

Diabetes - GLP-1 analogs


Drug Manufacturer Ships to PAP info Application
Albiglutide (Tanzeum™) GlaxoSmithKline Patient or other Link Link
Dulaglutide (Trulicity™) Lilly Patient or doctor Link Link
Exenatide (Bydureon®, Byetta®) AstraZeneca Patient or doctor Link Link
Liraglutide (Victoza®) Novo Nordisk Doctor Link Link
Liraglutide (Saxenda®) Novo Nordisk Doctor Link Link
Lixisenatide (Adlyxin®) Sanofi Doctor Link Link
Semaglutide (Ozempic®) Novo Nordisk Doctor Link Link
Semaglutide (Rybelsus®) Novo Nordisk Doctor Link Link

Diabetes - DPP-4 inhibitors


Drug Manufacturer Ships to PAP info Application
Alogliptin (Nesina®, Oseni®, Kazano®) Takeda Patient or doctor Link Link
Linagliptin (Tradjenta®, Glyxambi®,Jentadueto®,Jentadueto® XR) Boehringer Ingelheim Patient Link Link
Saxagliptin (Onglyza®, Kombiglyze® XR, Qtern®) AstraZeneca Patient or doctor Link Link
Sitagliptin (Januvia®, Janumet®, Janumet® XR) Merck Patient or doctor Link Link

High cholesterol


Drug Manufacturer Ships to PAP info Application
Alirocumab (Praluent®) Regeneron Patient or pharmacy Link Link
Evolocumab (Repatha®) Amgen Patient Link Link

Hepatitis C


Drug Manufacturer Ships to PAP info Application
Epclusa® (sofosbuvir + velpatasvir) Gilead Patient or doctor Link Link
Harvoni® (sofosbuvir + ledipasvir) Gilead Patient or doctor Link Link
Mavyret™ (glecaprevir + pibrentasvir) Abbvie Patient or doctor Link Link
Viekira Pak™ (ombitasvir + paritaprevir + dasabuvir + ritonavir) Abbvie N/A N/A N/A
Vosevi™ (sofosbuvir + velpatasvir + voxilaprevir) Gilead Patient or doctor Link Link
Zepatier® (elbasvir + grazoprevir) Merck Patient or doctor Link Link

Migraine headache


Drug Manufacturer Ships to PAP info Application
Erenumab (Aimovig®) Amgen Patient Link Link
Galcanezumab (Emgality™) Lilly Patient or doctor Link Link
Lasmiditan (Reyvow®) Lilly Patient or doctor Link Link
Sumatriptan (Imitrex® nasal spray) GlaxoSmithKline Patient or other Link Link
Rizatriptan (Maxalt®) Merck Patient or doctor Link Link
Ubrogepant (Ubrevly®) Allergen Doctor Link Link

Pulmonary embolism (PE)


Drug Manufacturer Ships to PAP info Application
Apixaban (Eliquis®) Bristol-Myers Squibb Patient or doctor Link Link
Dabigatran (Pradaxa®) Boehringer Ingelheim Patient Link Link
Edoxaban (Savaysa®) Daiichi Sankyo N/A N/A N/A
Rivaroxaban (Xarelto®) Johnson and Johnson Pharmacy Link Link

Pre-exposure prophylaxis (PrEP) for HIV


Drug Manufacturer Ships to PAP info Application
Truvada® and Descovy® (emtricitabine and tenofovir) Gilead Pharmacy Link PDF
Online

Psoriasis and Psoriatic arthritis


Patient Assistance Programs for Tumor Necrosis Factor Inhibitors
Drug Manufacturer Approval Ships to FPL limit PAP info Application
Adalimumab (Humira®) Abbvie PP/PA Patient or doctor < 600% Link Link (online and pdf)
Certolizumab (Cimzia®) UHC PP/PA Patient < 500% Link Link (online)
Etanercept (Enbrel®) Amgen PP/PA Patient < 500% Link Link (pdf)
Golimumab (Simponi®) Janssen PA Pharmacy < 400% Link Link (pdf)
Infliximab (Remicade®) Janssen PP/PA IV infusion
Doctor's office
< 400% Link Link (pdf)

Patient Assistance Programs for IL-17, IL-23, and IL-12/23 Inhibitors
Drug Manufacturer Approval Ships to FPL limit PAP info Application
Brodalumab (Siliq®) Ortho PP Patient < 400% Link Link (pdf)
Ixekizumab (Taltz®) Lilly PP/PA Patient or Doctor < 500% Link Link (online and pdf)
Secukinumab (Cosentyx®) Novartis PP/PA Patient < 570% Link Link (pdf)
Guselkumab (Tremfya®) Janssen PP/PA Pharmacy < 400% Link Link (pdf)
Risankizumab (Skyrizi®) Abbvie PP Patient or Doctor < 600% Link Link (online and pdf)
Tildrakizumab (Ilumya™) Sun Pharma PP Doctor < 400% Link Link (pdf)
Ustekinumab (Stelara®) Janssen PP/PA Pharmacy or Doctor < 400% Link Link (pdf)

Apremilast (Otezla®) Patient Assistance Program
Drug Manufacturer Approval Ships to FPL limit PAP info Application
Apremilast (Otezla®) Amgen PP/PA Patient < 392% Link Link (pdf)