Abbott/Ross Laboratories
555 13TH STREET NW, SUITE 7E
WASHINGTON, D.C. 20004-1109
1-800-922-3255
(202) 637-6889
FAX (202) 637-6690
Program: Survanta: Lifeline
Contact: Medical Technologies Hotlines
Requirements: The patient cannot be covered by public, private, or HMO coverage.
Access: Call the above telephone numbers for access instructions. If the patient is eligible for the program, s/he will receive a complete course of therapy, usually 1-4 vials which may be obtained at any one time.
Medications: Only Survanta is available. Clarithomycin (Biaxin) may be available pursuant to a Patient Assistance/Reimbursement Program. For more information on how to obtain Clarithomycin (Biaxin) the patients physician should call Abbott Laboratories at 1-800-688-9118.

Adria Laboratories, Inc.
P.O. BOX 16529
COLUMBUS, OH 43215-6529
(614) 764-8100
FAX (614) 764-8102
Program: Patient Assistance Program
Contact: No specific contact.
Requirements: The patient's physician must call 1-800-795-9759. The patient's physician must certify that the patient is unable to afford that cost of the drug and unable to obtain assistance elsewhere
Access: Contact the above telephone numbers for access instructions. A two month supply is available at any one time.
Medications: Rifabutin (Mycobutin), Adriamycin PFS, Adrucil, Folex. Idamycin, Neosar, Tarabine, and Vincasar.

Allergan Prescription Pharmaceuticals
2525 DUPONT DRIVE
IRVING, CA 92715-1599
1-800-347-4500 EXT. 6219
Contact: Judy McGee
Requirements: Physician's discretion
Access: Contact Judy McGee for access instructions. At any one time, up to six month supply.
Medications: All Allergan prescription products are available, including: Naphcon-A, Propine, FML, HMS, and Pilogan. Consult the latest edition of the Physician's Desk Reference (hereinafter "PDR") for a list of all products available from this company.

Amgen, Inc.
THOUSAND OAKS, CA
1-800-272-9376
Program: Patient Assistance
Contact: Michael Klein, Ph.D. (805) 447-3937
Requirements: Both insured and non-insured patients may apply.
Access: Phone the contact person or Amgen, Inc. at the above toll free number. Medications: G-CSF (Neupogen)

Astra Pharmaceuticals
WESTBOROUGH, MA
1-800-488-3247 OR
1-800-388-4148
Program: Foscavir Assistance and Information on Reimbursement (hereinafter "FAIR")
Contact: Sandra Stamos (508) 366-1100 ext. 2309
Requirements: FAIR will ship Foscavir to patients where the patient is without other means to secure Foscavir. Patient's annual income must be less than $27,500 for a one person household or less than $45,000 if the patient was dependents. Patient's with an annual income in excess of theses amount shall be considered on a case by case basis.
Access: Physician must contact FAIR, request an application, complete (including information regarding the patient's financial status) and return the same to Astra Pharmaceuticals. Continued participation in the program requires monthly renewal.
Medications: Foscavir (Foscarnet). For immune-suppressed individuals with Acyclovir-resistant mucocutaneous herpes simplex virus infections.

Burroughs Wellcome Company
3030 CORNWALLACE ROAD
RESEARCH TRIANGLE PARK, NC 27709
1-800-722-9294
Program: Patient Assistance Program
Contact: Jonas B. Daughterty, tel. (919) 248-4418, FAX (919) 248-0221
Requirements: Patients must have applied for Medicare, Medicaid, or SSI, and is not currently receiving assistance. The program also examines the following in determining eligibility:
1. Gross monthly income must be less than 200% of federal poverty guidelines/
2. All applications will be reviewed within established criteria on a case by case basis.
3. Patients must be residents of the United States.
4. All alternative funding sources must have been investigated.
5. All required information must be provided for consideration of eligibility.
6. Patients may be approved by exception if extreme circumstances exist.
Access: Physician must complete an application -- including a prescription for a supply for up to 90 days. All medications are sent directly to the physician. Re-applications accepted.
Medications: All Burroughs Welcome products are available through the program, including: AZT (Retrovir), Acyclovir (Zovirax), TMP/SMX (Septra), Septra DS, Atovaquone (Mepron, 566), Pyrimethamine (Daraprim), Lanoxin, Zyloprim, Imuran, and Wellcovorin. Consult the latest edition of the Physician's Desk Reference (hereinafter "PDR") for a list of all products available from this company.

Boehringer Ingelheim
P.O. BOX 368
RIDGEFIELD, CT 06877-0368
1-800-243-0127
Program: Formal Program
Contact: Sam Quy (203) 798-4131
Requirements: The determination of program eligibility will be made on a case by case basis. The patient must be on a fixed income and unable to afford medications.

Access: The program request written inquiries from the patient's physician.
Medications: All products are made available, including Persantine, Atrovent, Alupent, and Catapress.

Bristol-Myers Squibb Company
P.O. BOX 9445
MCLEAN, VA 22102-9445
1-800-736-0003
FAX (703) 760-0049
Program: Bristol-Myers Squibb Cardiovascular Access Program (AIDS & Cancer) and Bristol-Myers Squibb Videx Temporary Assistance Program.
Contact: Jonathan Weisenberg (212) 546-4343; call 1-800-788-0123 for the Bristol-Myers Squibb Videx Temporary Assistance Program.
Requirements: Patient must not be receiving Medicare, Medicaid, or be eligible for other third party reimbursement.
Access: The physician and patient must complete an application and attach the prescription. A 90 day supply will be sent to the physician's office, a second 90 day supply may be obtained if the patient's financial status has not changed. Re-qualification is required prior to receiving any further prescription shipments.
Medications: Anti-AIDS drug ddl (Videx). The following additional available products include: Duricef, Cefzil, Buspar, Desyrel, Estrace, Ovcon-35, Ovcon-50, Natalins, Natalins-RX, Vagistat-1, and Mycostatin. Sixteen anti-cancer drugs include Megestrol Acetate (Megace), for breast and endometrial cancers; Cytoxan, for malignant lymphomas, Hodgkin's disease and other cancers; Hydrea, for melanoma, myleocytic leukemia and ovarian cancer; Paraplatin, for ovarian cancer; Platinol, for testicular, ovarian, and bladder cancers; Vepesid, for testicular and small cell lung cancer; and Mutamycin, for cancers of the stomach and pancreas. Other cancer drugs include: BICNU, CEENU, Lysodren, Mycostatin Pastilles, Blenoxance, Lyophilized Cytoxan, Ifex, and Mesnex. Cardiovascular drugs include: Capoten, and ACE (angiotensin-converting enzyme) inhibitor used in the treatment of hypertension and heart failure; Monopril, an ACE inhibitor used to treat mild to moderate hypertension; Pravachol, an HMG-CoA reductase inhibitor used to control cholesterol; Corgard, a beta blocker used to control hypertension and angina pectoris; and Questran and Questran Light, which are cholesterol lowering agents. Other cardiovascular drugs include: Corpozide, Klotrix, K-Lyte, Traturetin, Pronestyl-SL, Rauzide, Saluron, Salutensin, Vasodilan, and Betapen-VK. d4T may be available for HIV infected individuals intolerant to or failing anti-retroviral therapy by calling 1-800-842-8036.
Statistics: Since 1989, ddl (Videx) has been made available without charge to over 23,000 patients with AIDS. In the past five years anti-cancer drugs were provided without charge to more than 14,000 patients.

Ciba-Geigy Pharmaceuticals
556 MORRIS AVENUE
SUMMIT, NJ 07901
(908) 277-5994
Program: Patient Support Program
Contact: Jackie Laguardia (D-2067) Medical Information Services
Requirements: The physician must certify that the patient is unable to afford the requested medication and has no third party insurance. Program may base eligibility on federal poverty guidelines. New prescription and application is required every three month in order to continue in the program.
Access: The physician must complete a prescription which includes the patient's name and a notation that the medication will be accepted without a child safety closure. The physician must send the prescription and application to the above contact person. A three month supply will be mailed to the physician's office.
Medications: All Ciba-Geigy products are available through the program. Consult the latest edition of the Physician's Desk Reference for a list of all products available from this company.

DuPont Pharmaceuticals Caribe, Inc.
P.O. BOX 80027
WILMINGTON, DE 19800-0027
(302) 992-5000
Program: Indigent Patient Program
Contact: Lynn Diffendorfer
Requirements: The patient must not be receiving any governmental assistance, with the exception of Medicare.
Access: The physician may call or write the Program and provide the following information: exact unit, and quantity with attached prescription.
Medications: Ethmozine, Coumadin, Moban, Sinemet, Symmetrel, and Trexan.

Eli Lilly and Company
LILLY CORPORATE CENTER
INDIANAPOLIS, IN 46285
(317) 276-2000
(317) 276-2950
FAX (317) 276-9288
Program: Not a formal program, case by case basis. Indigent Patient Program, Drop Code 1184.
Contact: Pam Budney
Requirements: Within the physician's discretion.
Access: The patient's physician should first call the above contact person and follow-up with a letter with the following notation clearly written on the prescription "prescription for indigent." The prescription should also include the physician's DEA number, State License number, and Social Security number. Send the letter to the attention of Pam Budney 1464.
Medications: Prozac, Vancocin, Oncovin, Velban, Dobutrex, and some antibiotics are available to indigent patients. Also available are the following products: Ceclor, Keflex, Dymelor, Axid, NPH Insulin, Regular Insulin, Lente Insulin, and Humulin Insulin.

Fujisawa Pharmaceuticals
3 PARKWAY NORTH
DEERFIELD, IL 60015
1-800-366-6323
Program: Nebupent Reimbursement Service
Contact: Phil Nowakowski (708) 317-0600
Requirements: Fujisawa will supply Nebupent, through community based organizations, free of charge to patients without other means of payment.
Access: Community based programs and not-for-profit health organizations must request Nebupent on behalf of an eligible patient.
Medications: Aerosolized Pentamidine (Nebupent).

Glaxo Pharmaceuticals and Glaxo Dermatology
5 MOORE DRIVE
P.O. BOX 13438
RESEARCH TRIANGLE PARK, NC 27709
1-800-334-0020
1-800-GLAXO-77
FAX (919) 248-7932
Program: Indigent Patient Program
Contact: Laura Newberry
Requirements: The patient must be ineligible for any third party reimbursement program. The physician must certify that the patient is indigent.
Access: The physician should write a letter and complete the application, mailing both to the above contact person with a prescription.
Medications: All Glaxo products are available through the program. Consult the latest edition of the Physician's Desk Reference for a list of all products available from this company, including Zantac, Ceftin, Ventolin, Beconase, Beconase-AQ, and Trandate.

G.D. Searle and Company
5200 OLD ORCHARD ROAD
P.O. BOX 5110
SKOKIE, IL 60077-5110
1-800-323-1603
Program: Indigent Patient Program
Contact: Beth Baron at the above toll free telephone number; or Michael Isaacson of Patients in Need Foundation, 1-800-542-2526, (708) 470-3831, FAX (708) 470-6633. For general program information, contact Laura Leber, (708) 470-6280, FAX (708) 470-6719.
Requirements: For a family of two there must be an annual income not exceeding $9,000, or less than $12,000 for a family of three.
Access: Complete the Searle application and upon acceptance a six month supply will be made available.
Medications: All Searle products are available through this program. Consult the latest edition of the Physician's Desk Reference for a list of all products available from this company, including Aldactazide, Aldactone, Calan, Calan-SR, Cytotec, Kerlone, Nitrodisc, Norpace, and Norpace-CR.

Genentech Incorporated
460 POINT SAN BRUNO BLVD.
SOUTH SAN FRANCISCO, CA 94080
1-800-879-4747 EXT. 1028
Program: Uninsured Patients Program, and Reimbursement Program
Contact: Cindy Connell
Requirements: The patient must not be receiving Medicare or Medicaid and have an annual income less than $25,000.
Access: A letter from the patient's physician is required.
Medications: Protropin, Actvase, Actimmune, and Interferon Gamma-1b. Note, for Activase, if the patient's gross family income is less than $25,000 the company will provide replacements.
Statistics: Since 1990 over $65 million in Protropin and Activase have been distributed. Approximately 10% of patients receiving Protropin are using one of the two above programs.

Hoescht-Roussel Pharmaceuticals, Inc.
SOMERVILLE, NJ 08816-1258
(908) 231-2000
Program: Formal Program, Prokine (Saragramostin) Program.
Contact: Linda Lauritano, or Jannalee Smithey for Prokine at 1-800-PROKINE.
Requirements: Both the social worker and physician must determine indigent status.
Access: A letter from the patient's physician with original prescription, strength, and quantity. A completed application must also be enclosed.
Medications: Altace, Diabeta, Lasix, Loprox, Topicort, Trental, and Prokine. Note, Prokine is subject to a separate program, see the above information.

Hoffman-La Roche, Inc.
1-800-443-6676 EXT. 2 OR 21
Contact: Oncoline Reimbursement Assistance Program at 1-800-443-6676; Cost Assistance Program at 1-800-227-7448; and the Indigent Patient Program at 1-800-526-6367.
Requirements: There are varying requirements for the different programs. Contact program for specific requirements. Access: The patient's physician must access the program.
Medications: Interferon Alfa-2A (Roferon-A), ddC (HIVID) and TMP/SMX (bactrim). For HIV infected individuals who are symptomatic and have failed or are intolerant of AZT, call 1-800-332-2144 (Open-Label Treatment Protocol).

ICI Pharma
PROFESSIONAL SERVICES DEPARTMENT
WILMINGTON, DE 19897
1-800-822-8215 EXT. 5216
(302) 886-2231
Contact: Yvonne Graham
Requirements: Not available. Must have a prescription for an ICI Pharma product.
Access: Write or call the above contact person for an application and more information.
Medications: Most ICI products are available through the program, including Nolvadex, Zestoretic, Buclanin, Kinesed, Sorbitrate, Tenormin, Tenoretic, and Zestril.

Immunex Corporation
1-800-321-4669 OR 1-800-334-6273.
(206) 587-0430
FAX (206) 343-8926
Contact: Michael Kleinberg, Director of Professional Services.
Requirements: Immunex patient criteria must be met requiring the patient's physician to certify that the patient requires the drug and that all the reimbursement option have been first examined.
Access: The product can be obtained at any one time, one cycle.
Medications: GM-CSF (Leukine), Leukine 250mcg, and Leukine 500mcg.

Janssen Pharmaceuticals, Inc.
1125 TRENTON-HARNOURTON ROAD
P.O. BOX 200, OFFICE A32000
TITUSVILLE, NJ 08560-0200
1-800-253-3682
Program: Patient Assistance Program for people with histoplasmosis.
Contact: Professional Services Department
Requirements: The physician determines that the patient is indigent and ineligible for health insurance. A Patient Assistance Program is available for patients with histoplasmosis. To find out more about this program call 1-800-544-2987.
Access: The physician may request free medication by either written or telephone request, accompanied by a signed and dated prescription and letter as to the patient's financial status.
Medications: Hismanal, Nizoral, Duragesic, Itraconazole (Sporanox capsules), Alfenta, Sufenta, and Sublimaze. Diclazuril may be available pursuant to the Compassionate Use Protocol for HIV infected individual with proven cryptosporidiosis by calling 1-800-521-AIDS.

Johnson and Johnson (Janssen Pharmaceuticals)
40 KINGSBRIDGE ROAD
PISCATAWAY, NJ 08854
(908) 524-9409
FAX (908) 524-9118
Contact: Ellen McDonald, Assistant Product Manager
Requirements: Patient must have an annual household income less than $25,000 and may not have prescription drug coverage. Note however, that Medicare and/or private insurance do not disqualify the patient from participating in the program.
Access: A two month supply may be obtained at any one time.
Medications: Ergamisol (Levamisole HCL).

Johnson and Johnson (Ortho Biotechnology)
1800 ROBERT FULTON DRIVE
RUSTON, VA 22091
1-800-447-3437 - FINANCIAL ASSISTANCE
1-800-441-1366 - COST SHARING PROGRAM
(908) 704-5232
FAX (908) 526-4997
Program: The Ortho Financial Assistance Program
Contact: Carol Webb, Executive Director, Hematopoietic products.
Requirements: Financial Assistance Program requires the patient have an annual household income less than $35,000 and no other prescription drug coverage. Cost Sharing Program is activated when Procrit expenditures exceed $8,500 a year, regardless of third party coverage.
Access: Product may be obtained at any one time, usually 4-8 weeks.
Medications: Procrit (Epoetin-alfa).

Knoll Pharmaceuticals
30 NORTH JEFFERSON ROAD
WHIPPANY, NJ 07981
1-800-526-0710
Program: Indigent Patient Program. Heart in Harmony Program.
Requirements: The physician and sales representative determine indigent status.
Access: The patient's physician can give certificates for 30 free tablets or the physician can fill out a request form with an attached prescription for additional product.
Medications: Rythmol, Isoptin, Zostrix, and Santyl.

Lederle Laboratories
DIVISION OF AMERICAN CYANAMID COMPANY
ONE CYANAMID PLAZA
WAYNE, NJ 07470
1-800-526-7870
(914) 732-5000 EXT. 2443
FAX (201) 831-4484
Contact: Romina Fremont or Jerry Johnson
Requirements: Physician must file with the company an indigent patient application.
Access: A letter from the patient's physician with application and prescription.
Medications: All Lederle products are available through the program. Consult the latest edition of the Physician's Desk Reference for a list of all products available from this company.

Lederle Laboratories
SOUTH ATLANTIC REGIONAL SALES OFFICE
115 PERIMETER CENTER PLACE, SUITE 415
ATLANTA, GA 30346
(404) 668-1110
Program: Indigent Patient Program
Contact: Debbie Vaughan
Requirements: The patient's physician must contact the sales representative.
Access: If the patient is approved for participation in the program and the prescription have been verified, allow 4-6 weeks for processing.
Medications: Most Lederle products are available through this program. Consult the latest edition of the Physician's Desk Reference for a list of all products available from this company.

Liposome Company
1-800-4-ABLC-RX
Program: Compassionate Use Protocol.
Contact: Marc J. Ostro at (609) 452-7060.
Requirements: The patient must have a life threatening fungal infection.
Access: None listed.
Medications: Amphotericin B Lipid Complex (ABLC).

Marion Merrell Dow Incorporated
900 WARD PARKWAY
P.O. BOX 8489
KANSAS CITY, MO 64114
1-800-362-7466
Program: Indigent Patient Program
Contact: Bill Lawrence at (816) 966-4250
Requirements: Based upon federal poverty guidelines.
Access: A letter from the patient's physician accompanied with an application. If the patient is accepted into the program, a 3 month supply of the product will be sent to the requesting physician.
Medications: Dow will not release the names of available medications. Some products which may be made available include Cardizem, Cardizem-CD, Cardizem-SR, Carafate, Pauabid, Suldane, Suldane-D, Nicorette, Rifadin, Quinamm, and Lorelco.

McNeil Pharmaceuticals
SPRING HOUSE, PA 19477
(215) 540-7803
Program: Informal Program
Contact: Laura Litzenberger
Requirements: The patient must be without public and private insurance.
Access: The physician must request the product and write the prescription.
Medications: Pancrease, Parafon Forte DSC, Haldol, Vascor, and Tolectin.

Merck-Sharp and Dohme
U.M. 2-12
WEST POINT, PA 19486
(215) 661-6369
(215) 540-8600
Program: Informal Program
Contact: Dr. Audrey Guist at (215) 540-8600.
Requirements: Case by Case basis.
Access: The program will only accept applications from the patient's physician who must identify the patient's financial status accompanied with a prescription which includes the physicians DEA number and state license number.
Medications: Most Merck-Sharp and Dohme products are available. Consult the latest edition of the Physician's Desk Reference for a list of all products available from this company, including Mevacor, Plendil, Pepcid, Prilosec, Prinivil, Timoptic, Timolol, Clinovil, Flexeril, Periactin, Noroxin, Cogentin, Indocin, Aldomet, Dolobid, Vosoretic, and Vasotec.

Miles Pharmaceuticals
400 MORAN AVENUE
WEST HAVEN, CT 06516
1-800-998-9180
(203) 937-2000
Program: Indigent Patient Program
Contact: Professional Services, Attn: Indigent Patient Program
Requirements: The patient must be below federal poverty guidelines and be without any form of insurance. Access: Case by Case basis.
Medications: All Miles products are available through the program. Consult the latest edition of the Physician's Desk Reference for a list of all products available from this company, including Ciprofloxacin (Cipro), Nimotop, and Tridesilon.

Ortho Pharmaceuticals
P.O. BOX 300
ROUTE 202 SOUTH
RARITAN, NJ 08869-0602
(908) 218-6466
Contact: Jerald Holleman
Requirements: Physician determines that the patient is indigent and ineligible for health insurance.
Access: Physician may request free medications by written or telephone request, accompanied by a signed and dated prescription and letter stating financial status and need of patient.
Medications: Floxin, Aci-jel, Ortho Dienestrol cream, Monistat Vaginal Suppositories, Protostat tablets, Sultrin Triple Sulfa Cream, Sultrin Triple Sulfa Vaginal Tablets, Terazol 3 Suppositories, Terazol 7 Cream, Spectazole Cream, Monistat-Derm Cream, Grifulvin Suppositories, Meclan Cream, Persa-gel, Persa-gel W, and Eyycette.

Ortho Biotech
1-800-447-3437
Program: Procrit Financial Assistance Program (based upon indigent status), Cost Sharing Program, and Reimbursement Assistance Program.
Contact: Call 1-800-553-3851 for information regarding the Reimbursement Assistance Program. The Cost Sharing Program may be contacted at 1-800-441-1366.
Requirements: The patient must be indigent in order to be eligible for the program.
Access: None listed.
Medications: Epoetin Alfa (EPO), and Procrit.
Note: Additional assistance may be available by contacting the Procrit Cost-Sharing Program (reimbursement after $8,500) at 1-800-441-1366; or the Procrit Line (verifies insurance coverage and assist with forms) at 1-800-553-2851.

Parke-Davis
201 TABOR ROAD
MORRIS PLAINS, NJ 07950
(201) 540-2000
Program: Informal Program
Contact: Park-Davis at the above telephone number.
Requirements: No formal criteria. The quantity of the product is determined by medical need.
Access: The patient's physician must make the request.
Medications: All products except controlled substances are made available, including Dilantin, Mandelamine, Accupril, Pyridium, Nitrostat Sublingual, Tabron, Ponstel, Procan, Anusol-HC, and Zarontin.

Pfizer Incorporated
235 EAST 42ND STREET
NEW YORK, NY 10017
1-800-869-9979
(212) 573-2323
(212) 573-3954
Program: Roerig Division, Diflucan (fluconazola) Patient Assistance Program
Contact: Daniel Coackley
Requirements: For Diflucan, the patient must not be eligible for State AIDS Drug Assistance Program. Patient must not have an annual income in excess of $25,000, or $40,000 if the patient has dependents.
Access: A letter from the patient's physician, including prescription dosage and quantity.
Medications: All products are made available, including Procardia (vasospastic angina), Feldene (arthritis), Diabinese (hyperglycemia), Glucotrol (Diabetic), Minipress (hypertension), a line of antibiotics, etc. Also available are Antivert, Marax, Cardura, Minizide, Navane, Sinequan, Zithromax, Procardia-XL, Vibramycin, Vistaril, and Zoloft. Through the Patient Assistance Program, Fluconazole (Diflucan) is made available -- call 1-800-869-9979. Azithromycin (Zithromax) is available pursuant to the Compassionate Use Protocol (for individuals with a definitive or presumptive diagnosis of toxoplasmosis by CAT scan and some favorable responce to treatment, call (203) 441-5701; For HIV infected individual with a proven cryptosporidiosis who have failed or are intolerant to conventional therapies, call (203) 441-6148; and for individuals with disseminated MAC who have failed or are intolerant to existing therapies, call (203) 441-5941).

Proctor and Gamble Pharmaceuticals
(FORMERLY NORWICH-EATON)
17 EATON AVENUE
NORWICH, NY 13815-1799
(607) 335-2079
(607) 335-2020 FOR COVERAGE AND REIMBURSEMENT
FAX 1-800-448-4878
Contact: R.M. Brandt
Requirements: The company relies upon the physician's appraisal of the patient's need. The company will also help the patient identify other sources of financial assistance to pay for medications.
Access: At least a one month supply may be obtained at any one time.
Medications: All Proctor and Gamble products are available through the program. Consult the latest edition of the Physician's Desk Reference for a list of all products available from this company, including Macrodantin and Dantrium.