Lilly Cares and Zyprexa PAP

Lilly Cares and Zyprexa PAP

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Eli Lilly and Sponsor Organization

Lilly Cares and Zyprexa PAP

Sponsor Organization
Eli Lilly and Company

Prescription Medication Assistance Organization Contact
Lilly Cares and Zyprexa PAP
Lilly Cares Program Administrator
PO Box 23099
Centreville, VA 20120
Phone: ( 800) 545-6962

Medications sent to: Patientís Doctor

Prescription Medications/Products Covered:
Glucagon Emergency Kit
Prozac Weekly
Quinidine Gluconate
Vancocin HCl Pulvules

Program Information And Resources:
Lilly Cares Application Form

Program Information And Resources:

Program Eligibility Requirements:
Patients must be U.S. residents. Eligibility is determined on a case-by-case basis in consultation with each prescribing physician. 

Eligibility is based on the patient's inability to pay and lack of third- party drug payment assistance, including insurance, Medicaid, government-subsidized clinics, and other government, community, or private programs. Inpatients and those who can obtain drug reimbursement from any source are not eligible. 

Requests for replacement drugs cannot be honored. Medications are provided directly to the physician for dispensing to the patient. Quantity of supply is dependent upon type of product being prescribed. All Lilly medications must be used as recommended in product labeling.

Additional Information and/or Requirements (known):
Forms to qualify a patient for the program will be provided to the physician. On this form, the physician is requested to provide prescription information, including signature and DEA number, and to confirm the patient's ineligibility for other forms of outpatient drug coverage. 

Additionally, the patient is requested to provide pertinent information and state financial need. Subsequent request for same patient requires another prescription and restatement of medical and financial need. Program guidelines may be subject to change.



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