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PAF Enrollment
Novartis is committed to providing access to our medications for those most in need through the Novartis Patient Assistance Foundation, Inc. (PAF). PAF provides assistance to patients experiencing financial hardship who have no third party insurance coverage for their medicines.
To be eligible for Novartis PAF, patients must:
- Be a U.S. resident
- Provide proof of income within program guidelines
- Not have private or public prescription coverage
Please be advised that access to the medicines distributed through the Novartis Patient Assistance Foundation, Inc. is free of charge to all eligible patients. A nominal co-pay for Novartis products using a pharmacy card will apply. Novartis is not affiliated with any individual or organization that may charge patients a fee(s) to assist them in completing applications for our program. These individuals or organizations are acting independently the Novartis Patient Assistance Foundation, Inc and its affiliates and do not have Novartis' consent.
Please be advised that access to the medicines distributed through the Novartis Patient Assistance Foundation, Inc. is free of charge to all eligible patients. A nominal co-pay for Novartis products using a pharmacy card will apply. Novartis is not affiliated with any individual or organization that may charge patients a fee(s) to assist them in completing applications for our program. These individuals or organizations are acting independently the Novartis Patient Assistance Foundation, Inc and its affiliates and do not have Novartis' consent.
Enrollment Process
Novartis Patient Assistance Foundation, Inc.
PO Box 66531
St. Louis, MO 63166-6556
1-800-277-2254
Download the PAP Enrollment Application
Enrolling in the Novartis Patient Assistance Foundation Program is quick and easy.
- You or your physician can call Novartis at 1-800-277-2254, selecting the appropriate phone prompts. You can request a faxed application by choosing the correct prompt and entering a fax number. Applications can be downloaded in a PDF format by following the links on the right hand side of this page.
- You will need to complete the upper portion of the application, and include your signature, the date and a copy of your most recent Federal Tax Return.
- Your physician should complete the lower portion of the enrollment application and attach a prescription for a three-month supply. Focalin® XR and Ritalin® LA are supplied through a pharmacy card.
- Qualifying individuals are eligible for up to one year of assistance, or until a prescription drug benefit becomes available to you. Upon approval, a 30 or 90-day supply of medication will be shipped directly to your physician. For Focalin® XR and Ritalin® LA, a pharmacy card will be issued.
- To obtain an additional 30 or 90-day supply of medication, a refill request form (included with each shipment) must be submitted along with a new prescription, or your physician can call 1-800-277-2254 to request a refill. For Focalin® XR and Ritalin® LA refills, you must obtain a prescription from your physician and take the prescription and your pharmacy card to a retail pharmacy for a refill.
NOTE: Patients who need assistance for multiple treatment areas must complete the enrollment process for each applicable product.
Enrollment Process
Novartis Patient Assistance Foundation, Inc.
PO Box 66531
St. Louis, MO 63166-6556
1-800-277-2254
Download the PAP Enrollment Application
To get started, you or your physician can call EPASSTM Prescription and Reimbursement Hotline at 1-888-903-7277
NOTE: Patients who need assistance for multiple treatment areas must complete the enrollment process for each applicable product.
Oncology Eligibility & Enrollment Process
Enrollment Process
Novartis Patient Assistance Program
PO Box 66559
St. Louis, MO 63166-6556
1-800-277-2254
Enrolling in the Novartis Oncology Patient Assistance Program (PAP) is quick and easy.
- To provide you with the best possible customer service, the first step in the enrollment process for Oncology medications is handled over the telephone. You or your physician must call; you will be asked a few qualifying questions to determine your eligibility for the program.
- For Femara® (letrozole tablets), Gleevec® (imatinib mesylate capsules), Sandostatin LAR® (octreotide acetate for injectable suspension), Tasigna® (nilotinib), or Zometa® (zoledronic acid for injection) requests. Please call 1-800-277-2254 and select the appropriate phone prompts.
- To get started with Exjade®, you or your physician can call EPASS™ Prescription and Reimbursement Hotline at 1-888-903-7277.
- For more information regarding Proleukin®, you or your physician can call the Proleukin® Reimbursement Hotline at 1-866-385-4729.
- If you qualify for the program, a PAP application will be mailed to you. Once received, you must complete the first three sections of the application, and include your signature, the date, a copy of your most recent Federal Tax Return, and a copy of your insurance card/prescription card, if applicable. Your physician must complete and sign the lower portion of the enrollment application.
- Download a SAMPLE Application to assist you in preparing for the questions that will be asked during your initial phone call.
- Qualifying individuals are eligible for up to one year of assistance, or until a prescription drug benefit becomes available to you. Upon approval, up to a year supply of medication will be shipped directly to you or your physician.
NOTE: Patients who need assistance for multiple treatment areas must complete the enrollment process for each applicable product.
Oncology Eligibility & Enrollment Process
Enrollment Process
Novartis Oncology Patient Assistance Program
PO Box 66559
St. Louis, MO 63166-6556
1-800-277-2254
Enrolling in the Novartis Oncology Patient Assistance Program (PAP) is quick and easy.
- To provide you with the best possible customer service, the first step in the enrollment process for Oncology medications is handled over the telephone. You or your physician must call; you will be asked a few qualifying questions to determine your eligibility for the program.
- For Femara® (letrozole tablets), Gleevec® (imatinib mesylate capsules), Sandostatin LAR® (octreotide acetate for injectable suspension), Tasigna® (nilotinib), or Zometa® (zoledronic acid for injection) requests. Please call 1-800-277-2254 and select the appropriate phone prompts.
- To get started with Exjade®, you or your physician can call EPASS™ Prescription and Reimbursement Hotline at 1-888-903-7277.
- For more information regarding Proleukin®, you or your physician can call the Proleukin® Reimbursement Hotline at 1-866-385-4729.
- If you qualify for the program, a PAP application will be mailed to you. Once received, you must complete the first three sections of the application, and include your signature, the date, a copy of your most recent Federal Tax Return, and a copy of your insurance card/prescription card, if applicable. Your physician must complete and sign the lower portion of the enrollment application.
- Download a SAMPLE Application to assist you in preparing for the questions that will be asked during your initial phone call.
- Qualifying individuals are eligible for up to one year of assistance, or until a prescription drug benefit becomes available to you. Upon approval, up to a year supply of medication will be shipped directly to you or your physician.
NOTE: Patients who need assistance for multiple treatment areas must complete the enrollment process for each applicable product.
Enrollment Process
For patients who cannot afford the cost of Reclast®treatment and lack insurance, the Reclast® Patient Assistance Program provides 1 free Reclast® treatment for qualified patients.
- Patient/Physician calls 1-800-833-0166
Enrollment Process
TOBI® Patient Assistance Program
PO Box 66978
St. Louis, MO 63166-6978
1-877-862-4423
Enrolling in the TOBI® PAP is quick and easy.
To get started, you or your physician can call the TOBI®Patient Assistance Program at 1-877-862-4423.
NOTE: Patients who need assistance for multiple treatment areas must complete the enrollment process for each applicable product.
Enrollment Process
For patients who cannot afford the cost of Visudyne®treatment and lack insurance, the Visudyne® Patient Assistance Program provides 2 free Visudyne®treatments for qualified patients.
- Physician calls 1-877-736-2778
Enrollment Process
Novartis Infectious Disease & Transplant Patient Assistance Program
PO Box 66531
St. Louis, MO 63166-6556
1-800-277-2254
Enrolling in the Novartis Infectious Disease & Transplant Patient Assistance Program (PAP) is quick and easy.
- Novartis requires all patients to participate in a brief phone screening to help us understand your needs. You or your physician can call Novartis at 1-800-277-2254, selecting the appropriate phone prompts.
- Following the phone screening, an application will be sent to you or your physician as requested.
- You will need to complete the upper portion of the application and include your signature, the date and a copy of your most recent Federal Tax Return. Your physician will need to complete the lower portion of the enrollment application and attach a prescription for a 90-day supply of the Novartis medication.
- To obtain an additional 90-day supply of the Novartis medication, a refill mailer (included with each shipment) must be submitted with a new prescription. Qualified individuals are eligible for up to one year of assistance as long as a new prescription is provided for each 90-day supply.
NOTE: Patients who need treatments from multiple treatment areas must complete enrollment processes in as many areas as applicable.
Enrollment Process
Clozaril® Patient Assistance Program
PO Box 66531
St. Louis, MO 63166-6556
1-800-277-2254
Enrolling in the Clozaril® Patient Assistance Program is quick and easy.
- Novartis requires all patients to participate in a brief phone screening to help us understand your needs. You or your physician can call Novartis at 1-800-277-2254, selecting the appropriate phone prompts.
- Following the phone screening, an application will be sent to you or your physician as requested.
- You will need to complete the upper portion of the application and include your signature, the date and a copy of your most recent Federal Tax Return. Your physician will need to complete and sign the lower portion of the enrollment application.
- Clozaril® (clozapine) is dispensed through a retail pharmacy card that is sent directly to the physician.
- Upon written notification of approval, qualified patients will pick up the approved pharmacy card from the physician, along with a valid prescription, and take both items to the pharmacy to receive the medication.
NOTE: Patients who need treatments from multiple treatment areas must complete enrollment processes in as many areas as applicable.
Clozaril® (entacapone tablets)
Type: Clozaril®
Supply: 30-days
Distribution:Pharmacy Card
learn more about Clozaril® ›
Comtan®
(entacapone tablets)
Used in the treatment of Parkinson's Disease.
Type: Mass Market Products Sponsored
Supply: 90-days
Distribution: Shipped to physician
learn more about Comtan® ›
Diovan® (valsartan hydrochloride)
Type: Mass Market Products Sponsored
Supply: 90-days
Distribution: Shipped to physician
learn more about Diovan® ›
Diovan HCT® (valsartan hydrochlorothiazide)
Type: Mass Market Products Sponsored
Supply: 90-days
Distribution: Shipped to physician
learn more about Diovan HCT® ›
Elidel® (pimecrolimus)
Type: Mass Market Products Sponsored
Supply: 30-days
Distribution: Shipped to physician
learn more about Elidel® ›
Enablex® (darifenacin)
Type: Mass Market Products Sponsored
Supply: 90-days
Distribution: Shipped to physician
learn more about Enablex® ›
Exelon® (rivastigmine tartrate)
Type: Mass Market Products Sponsored
Supply: 90-days
Distribution: Shipped to physician
learn more about Exelon® ›
Exelon® Patch (rivastigimine transdermal system)
Type: Mass Market Products Sponsored
Supply: 90-days
Distribution: Shipped to physician
Exforge® (amlodipine and valsartan)
Type: Mass Market Products Sponsored
Supply: 90-days
Distribution: Shipped to physician
Exjade® (deferasirox)
Type: Oncology Products Sponsored
Supply: 30-days
Distribution: Shipped to patient
learn more about Exjade® ›
Oncology Eligibility & Enrollment Process
Enrollment Process
Novartis Oncology Patient Assistance Program
PO Box 66559
St. Louis, MO 63166-6556
1-800-277-2254
Enrolling in the Novartis Oncology Patient Assistance Program (PAP) is quick and easy.
- To provide you with the best possible customer service, the first step in the enrollment process for Oncology medications is handled over the telephone. You or your physician must call; you will be asked a few qualifying questions to determine your eligibility for the program.
- For Femara® (letrozole tablets), Gleevec® (imatinib mesylate capsules), Sandostatin LAR® (octreotide acetate for injectable suspension), Tasigna® (nilotinib), or Zometa® (zoledronic acid for injection) requests. Please call 1-800-277-2254 and select the appropriate phone prompts.
- To get started with Exjade®, you or your physician can call EPASS™ Prescription and Reimbursement Hotline at 1-888-903-7277.
- For more information regarding Proleukin®, you or your physician can call the Proleukin® Reimbursement Hotline at 1-866-385-4729.
> Download an EPASS Application - If you qualify for the program, a PAP application will be mailed to you. Once received, you must complete the first three sections of the application, and include your signature, the date, a copy of your most recent Federal Tax Return, and a copy of your insurance card/prescription card, if applicable. Your physician must complete and sign the lower portion of the enrollment application.
- Download a SAMPLE Application to assist you in preparing for the questions that will be asked during your initial phone call.
- Qualifying individuals are eligible for up to one year of assistance, or until a prescription drug benefit becomes available to you. Upon approval, up to a year supply of medication will be shipped directly to you or your physician.
NOTE: Patients who need assistance for multiple treatment areas must complete the enrollment process for each applicable product.
Femara® (letrozole tablets)
Type: Oncology Products Sponsored
Supply: 90-days
Distribution: Shipped to patient
learn more about Femara® ›
Focalin® XR (dexmethylphenidate hydrochloride extended release capsules)
Type: Mass Market Products Sponsored
Supply: 30-days
Distribution: Pharmacy Card
Gleevec® (imatinib mesylate capsules)
Type: Oncology Products Sponsored
Supply: 30-days
Distribution: Shipped to patient
learn more about Gleevec® ›
Lamisil® Oral Granules (terbinafine hydrochloride)
Type: Mass Market Products Sponsored
Supply: 30-days
Distribution: Shipped to physician
Lescol® (fluvastatin sodium)
Type: Mass Market Products Sponsored
Supply: 90-days
Distribution: Shipped to physician
learn more about Lescol® ›
Lescol® XL (fluvastatin sodium extended release)
Type: Mass Market Products Sponsored
Supply: 90-days
Distribution: Shipped to physician
learn more about Lescol® XL ›
Miacalcin® Injection & Nasal Spray (calcitonin-salmon)
Type: Mass Market Products Sponsored
Supply: 30-days
Distribution: Shipped to physician
learn more about Miacalcin® Injection & Nasal Spray ›
Myfortic® (mycophenolic acid)
Type: Infectious Disease & Transplant Products Sponsored
Supply: 90-days
Distribution: Shipped to patient
Neoral® (cyclosporine soft gelatin capsule, USP)
Type: Infectious Disease & Transplant Products Sponsored
Supply: 90-days
Distribution: Shipped to patient
Reclast® (zolendronic acid)
Type: Reclast
Supply: 1 Bottle
Distribution: Shipped to physician
Ritalin® LA (methylphenidate HCl)
Type: Mass Market Products Sponsored
Supply: 30-days
Distribution: Pharmacy Card
learn more about ›
Sandimmune® (cyclosporine capsules, USP; cyclosporine oral solution, USP; cyclosporine injection, USP)
Type: Infectious Disease & Transplant Products Sponsored
Supply: 90-days
Distribution: Shipped to patient
Sandostatin LAR® Depot
Type: Oncology Products Sponsored
Supply: 30-days
Distribution: Shipped to patient
Stalevo® (carbidopa, levodopa and entacapone tablets)
Type: Mass Market Products Sponsored
Supply: 90-days
Distribution: Shipped to physician
learn more about Stalevo® ›
Starlix® (nateglinide)
Type: Mass Market Products Sponsored
Supply: 90-days
Distribution: Shipped to physician
learn more about Starlix® ›
Tasigna® (nilotinib)
Type: Oncology Products Sponsored by PAP
Supply: 30-days
Distribution: Shipped to patient
Tegretol-XR® (carbamazepine extended release)
Type: Mass Market Products Sponsored
Supply: 90-days
Distribution: Shipped to physician
learn more about Tegretol-XR® ›
Type: Mass Market Products Sponsored
Supply: 90-days
Distribution: Shipped to physician
learn more about Tekturna® ›
TOBI® (tobramycin inhalation solution USP)
Type: TOBI Patient Assistance Program
Supply: 30-days
Distribution: Shipped to patient
learn more about TOBI® ›
Tyzeka® (telbivudine)
Type: Infectious Disease & Transplant Products Sponsored
Supply: 90-days
Distribution: Shipped to patient
Visudyne® (verteporfin for injection)
Type: Visudyne
Supply: 1 vial
Distribution: Shipped to Physician
Voltaren Ophthalmic® (diclofenac sodium ophthalmic solution)
Type: Mass Market Products Sponsored
Supply: 180-days
Distribution: Shipped to Physician
learn more about Voltaren® ›
Zometa® (zoledronic acid for injection)
Type: Oncology Products Sponsored by PAP
Supply: 90-days
Distribution: Shipped to physician
learn more about Zometa® ›
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