Assistance+Programs+By+Drug+Class

= Assistance Programs by Drug Class =

====NOTE: Patient should seek out coverage through public drug programs prior to or in addition to physician contacting these manufacturer-sponsored programs. ====

* usually are on a case-by-case basis
====*** Physician initiates request and calls contact # at a particular manufacturer and then sends a written letter detailing financial need of the patient. **====

**1. Cardiovascular** Acute Coronary Syndrome Plavix® - contact Sanofi-Aventis

Dyslipidemia Crestor® - contact Astra-Zeneca Ezetrol® - contact Merck Frosst Lipidil EZ® - contact Fournier Lipitor® - contact Pfizer Niaspan FCT® - contact Sepracor

Hypertension ACEIs - Accupril® - contact Pfizer Altace HCT – contact Sanofi-Aventis Coversyl®; Coversyl Plus® - contact Servier Mavik® - contact Abbott Zestril® - contact Astra-Zeneca

ARBs - Atacand®; Atacand Plus® - contact Astra-Zeneca Avalide® - contact Bristol Myers Squibb Diovan® - contact Novartis Hyzaar® - contact Merck Frosst Micardis®; Micardis Plus® - contact Merck-Frosst Olmetec®; Olmetec Plus® - contact Merck-Frosst

Calcium Channel Blockers – Norvasc® - contact Pfizer or request Continuity of Care card through [|www.RxHelp.ca]

d) Prevention of Ischemic Stroke Pradax®  - contact Boeringer or request sample cards from [|www.RxHelp.ca]

**2. Chronic Pain** Tridural® - contact Sepracor’s local representative Lyrica® - contact Pfizer - not covered on compassionate program

Cymbalta - contact Eli Lilly

**3.Contraception** SOGC - Society of Obstetricians and Gynecologists of Canada Phone 1-800-561-2416 Web: @http://www.sogc.org/projects/ccap_e.asp

Compassionate Contraceptive Assistance Program
When a patient's financial hardship becomes a barrier in obtaining contraceptives, health-care professionals can turn to the Compassionate Contraceptive Assistance Program to receive free prescriptions. Administered by the Society of Obstetricians and Gynaecologists of Canada (SOGC), the program ensures that access to contraception is not denied due to a lack of funds.

A patient is eligible for compassionate supplies in the event that she is not covered by a private insurance plan or government assistance and requires more than a demonstration sample because she is unable to pay for her medication. There are no monthly or yearly limits on the number of requests submitted for these reasons. Physician can download Compassionate Contraceptive Assistance Program Request Form from website.

**3. [|Diabetes]** 3.1 Monitoring Supplies (All Ontario residents without any other coverage for supplies):

A Ministry of Health and Long-term Care funded program administered by the Canadian Diabetes Association 1-800-361-0796 Web: [|www.diabetes.ca/get-involved/programs-entry/ontario-monitoring-for-health-programs/] __ Note: __ For individuals who are visually impaired only. Letter from doctor required. || You can apply to the MFHP if: Check to see if your pharmacy participates in “Third Party Billing”. This means that you pay only 25% of the purchase price (the amount not covered by the MFHP) and the pharmacy is later reimbursed for the other 75% To receive a claim form and the claimant information package, please call 1-800-361-0796  begin_of_the_skype_highlighting <span class="skype_pnh_highlighting_inactive_common"><span class="skype_pnh_textarea_span"><span class="skype_pnh_text_span">1-800-361-0796  <span class="skype_pnh_mark">end_of_the_skype_highlighting. MFHP claim forms may also be available at your local pharmacy or diabetes education centre. Social assistance recipients, please see OW/ODSP program information ||
 * __ Ontario Monitoring for Health Program (MFHP) __**
 * ABOUT THE PROGRAM || ELIGIBILITY || ADDITIONAL INFORMATION ||
 * The MFHP covers:
 * 75% of the cost of blood glucose test strips and lancets, up to a maximum of $820.00 per year
 * 75% of the cost of a blood glucose meter (up to a maximum of $300.00), once every 5 years.
 * you __use insulin__ to manage your diabetes OR have gestational diabetes; **//and//**
 * you are an Ontario resident with a valid health card; **//and//**
 * you have no other coverage (in whole or in part) for the supplies being claimed || You must have your first claim form signed by a doctor to confirm that you use insulin or have gestational diabetes.
 * Note: ** The MFHP does not provide coverage for syringes or pen needles. Seniors 65+, please see //Syringes for Seniors// program information.

**__<span style="font-family: Arial,Helvetica,sans-serif;">Compassionate Program Through the Canadian Diabetes Association __** Phone: <span class="skype_pnh_print_container">1-800-226-8464 Web: diabetes.ca/meter 1 OneTouch® UltraMini® System Kit 300 OneTouch® Ultra® Blue Test Strips 300 OneTouch® Delica® Lancets Please Note: Quantities are limited If selected to receive a Compassionate Use Program blood glucose monitoring kit, you will be notified by the Canadian Diabetes Association, and your contact information (Name, Address and Telephone Number) will be forwarded to the OneTouch® Customer Service Team for fulfilment. Online application: [|Compassionate Program] ||
 * About the Program ||= Eligibility ||= ADDITIONAL INFORMATION ||
 * This limited offer allows Canadians living with diabetes to apply for a free diabetes monitoring kit consisting of a OneTouch® system with lancing device, test strips and lancets. Successful applicants will have their kits mailed to them. If you have additional questions, please call <span class="skype_pnh_print_container">1-800-BANTING <span class="skype_pnh_container"> <span class="skype_pnh_highlighting_inactive_common"><span class="skype_pnh_textarea_span"><span class="skype_pnh_text_span">1-800-BANTING   (226-8464), option 7. || Eligibility is based on medical and financial need as well as province/territory of residence. || Each Diabetes Testing Supply Kit consists of:

**__Manufacturers__**

 * Manufacturer || Website || Protocol for Accessing Compassionate Program (if available) ||
 * ** Abbott ** || [|www.abbott.ca] || NO COMPASSIONATE PROGRAM AVAILABLE ||
 * ** Bayer ** || [|www.bayer.ca/?q=en/node/61] || NO COMPASSIONATE PROGRAM AVAILABLE ||
 * ** Lifescan ** || [|www.lifescancanada.com] || NO COMPASSIONATE PROGRAM AVAILABLE ||
 * ** Roche ** || [|www.rochecanada.com] || NO COMPASSIONATE PROGRAM AVAILABLE ||

3.2 Syringes/Needles (Grant covering cost of syringes & needles for seniors only):

<span class="skype_pnh_print_container"><span class="skype_pnh_print_container">1-800-268-6021 <span class="skype_pnh_container"><span class="skype_pnh_mark"> begin_of_the_skype_highlighting <span class="skype_pnh_highlighting_inactive_common"><span class="skype_pnh_textarea_span"><span class="skype_pnh_text_span">1-800-268-6021  <span class="skype_pnh_mark">end_of_the_skype_highlighting   Web: [|www.health.gov.on.ca/english/public/pub/adp/diabetic/html] Download form: [|www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/GetFileAttach/014-1429-67~1/$File/1429-67E.pdf] [|www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/FormSearch?openform&ENV=WWE&SRCH=2] The program provides an annual grant of $170.00 || To apply, you must be: __ Lancets: __ The Monitoring ||
 * Syringes for Seniors Program – Ministry of Health and Long-Term Care, Assistive Devices Program **
 * or browse Services Ontario forms and enter “Syringes for Seniors” under search criterion at:
 * ABOUT THE PROGRAM || ELIGIBILITY || ADDITIONAL INFORMATION ||
 * The Syringes for Seniors program provides assistance for the purchase of syringes and pen needles for seniors (65 years and over) who use insulin on a daily basis.
 * an Ontario resident with a valid health card; **//and//**
 * 65 years or older; **//and//**
 * using insulin on a daily basis || Ask your pharmacist for a note confirming that you use insulin and send this along with your application.

3.3 Insulin Pumps & Supplies <span class="skype_pnh_print_container"><span class="skype_pnh_print_container">1-800-268-6021 <span class="skype_pnh_container"> <span class="skype_pnh_highlighting_inactive_common"><span class="skype_pnh_textarea_span"><span class="skype_pnh_text_span">1-800-268-6021    Web: [|www.health.gov.on.ca/english/public/pub/adp/insulin.html] The Program also provides a yearly grant of $2,400 for insulin pump supplies (paid quarterly in $600 installments). || A patient may apply to the Insulin Pump and Supplies Program if: // Diabetes team at Diabetes Education Centers will determine eligibility and assist in completing application. In Hamilton, approved sites are McMaster Diabetes Education Centre and St. Joseph’s Diabetes Education Centre only. // || Byetta - contact Eli Lilly for sample card ( 1 month supply of Byetta + 3 month extension through RxHelp) Diamicron MR® - contact Servier Janumet® - contact Merck-Frosst Onglyza® - contact Astra-Zenica Avandia®; Avandamet® - contact GlaxoSmithKline Inc.
 * __ Insulin Pump & Supplies Program – Ministry of Health & Long-Term Care, Assistive Devices Program (ADP) __**
 * ABOUT THE PROGRAM || ELIGIBILITY || ADDITIONAL I NFORMATION  ||
 * The [|Insulin Pump] and Supplies Program covers 100% of the price of an insulin pump; paid directly to the vendor once funding is approved. Vendor must be registered with the ADP.
 * patient has type 1 diabetes; **//and//**
 * patient is an Ontario resident with a valid health card; **//and//**
 * patient meets the established eligibility criteria || Eligibility criteria includes: not having success managing with multiple daily injections; ability to properly use an insulin pump; ongoing commitment to blood glucose monitoring; participation in a pump education class; etc.

Esophageal Reflux Nexium® - contact Servier?
 * 4. Gastrointentinal Disorders **


 * 5. Infectious Disorders **

Migraine - Maxalt® - contact Merck Frosst or have patient visit www.RxHelp.ca site for a patient assistance card. See RxHelp page.
 * 7. Neurologic Disorders **

Depression SSRIs – Cipralex ® - Contact Lundbeck SNRIs - Cymbalta® - contact Eli Lilly Pristiq® - contact Pfizer NDRIs – Wellbutrin XL® – contact Valeant
 * 8. Psychiatric Disorders **

Atypical Antipsychotics - Abilify® - contact Bristol Myers Squibb Seroquel XR® - contact Astra-Zenica Invega Consta® - contact

Risperdal Consta® - contact

Alzheimer’s Aricept® - contact Pfizer Exelon® patch – contact Novartis

ADHD Concerta® - contact Janssen


 * 9. Respiratory Disorders **

Inhaled corticosteroids Alvesco® - contact Nycomed

**10. Miscellaneous**
Diclectin® - contact Duchesnay Synvisc ® - - contact <span style="color: #1f497d; font-family: Arial,sans-serif; font-size: 16px;">Sanofi Biosurgery