Allergan
Allergan Patient Assistance Program (PAP)
Sponsor Organization
Allergan
Prescription Medication Assistance Organization Contact
Allergan Patient Assistance Program (PAP)
PO Box 1003
Wayne, NJ 07474
Phone: (800) 553-6783
Fax: (973) 646-7678
Medications sent to: Patient’s Doctor
Prescription Medications/Products Covered:
Alphagan P .15%
Betagan .25%
Betagan .5% B.I.D.
Celluvisc
Lumigan .03% Q.D.
Refresh Liquigel
Refresh P.M.
Refresh Plus
Refresh Tears
Restasis .15%
TAZORAC CREAM .05%
TAZORAC CREAM .1%
TAZORAC GEL .05%
TAZORAC GEL .1%
Program Eligibility Requirements:
The objective of the Patient Assistance Program (PAP) is to provide assistance to patients who are without another form of drug coverage and cannot afford their medications. Patients must reside in the United States and be under the care of a U.S. based physician and not be eligible for drug coverage by any private or public assistance program such as Medicare or Medicaid. Annual household income limits do apply but each case is reviewed on an individual basis.
Additional Information and/or Requirements (known):
