Bayer Patient Assistance Program (PAP)

Bayer Patient Assistance Program (PAP)

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Bayer Pharmaceuticals Corporation

Bayer Patient Assistance Program (PAP)

Sponsor Organization
Bayer Pharmaceuticals Corporation

Prescription Medication Assistance Organization Contact
Bayer Patient Assistance Program (PAP)
PO Box 29209
Phoenix, AZ 85038-9209
Phone: (800) 998-9180

Medications sent to: Patientís Doctor

Prescription Medications/Products Covered:
Adalat CC
Avelox IV
Avelox tablets
Cipro HC Otic
Cipro I.V.
Cipro Oral Suspension
Domepaste Bandages

Program Eligibility Requirements:
Patient must be a U.S. resident. Physician must certify patient is not eligible for, or covered by, government-funded reimbursement or insurance program for medication; patient is not covered by private insurance; and patient's household income is below federal-poverty level guidelines.

Physician must indicate condition for which drug is to be prescribed and certify that drug will be used for indicated use only. Physician must agree to follow patient through therapy. All Application Forms are subject to a case-by-case evaluation by Bayer Corporation.

Additional Information and/or Requirements (known):
Patient/physician can qualify over the phone by calling (800) 998-9180. If all information needed is obtained over the phone, approval or denial is given immediately. If patient is approved, an Application Form is generated and sent to the physician's office for signatures.




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