Merck Patient Assistance Program

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MERCK

 

Merck Patient Assistance Program The Merck Patient Assistance Program is for patients who do not have prescription drug coverage and who without our assistance could not afford needed Merck medicines. This program is for patients who meet the following criteria:

This program is for patients who meet the following criteria:

  • The patient lives in the United States* and has a prescription for a medicine from Merck from a doctor licensed in the United States.
  • The patient has no prescription drug coverage.
  • The patient cannot afford to pay for medication.
  • The doctor has determined that a product by Merck may be appropriate for treating the patient.

This program is easy to use and convenient for you and your patients:

  • Product can be shipped directly to the patient’s home.
  • Prescriptions with refills are accepted.
  • Patients can initiate the prescription refill process directly.

View a Merck Patient Assistance Program Application With Instructions in PDF Format:

English
PDF icon [PDF: 667 KB, 3 pages]
Spanish
PDF icon [PDF: 203 KB, 2 pages]

To view a PDF in a browser window, click on the PDF icon or the link next to the icon for whichever item you wish to view. To save the PDF, right click on the icon and select “Save Target As…” You will be prompted to select a location to save the PDF to, and to rename the .pdf if you so desire.

Healthcare professionals and their office personnel can call 1-800-994-2111 toll free to obtain enrollment applications or request patient applications and brochures online.

*
The patient does not have to be a US citizen.
 

Selected Cautionary Information About FOSAMAX and FOSAMAX PLUS D
You should not use FOSAMAX or FOSAMAX PLUS D if you have certain disorders of the esophagus (the tube connecting the mouth with the stomach), are not able to stand or sit upright for 30 minutes, have severe kidney disease, low blood calcium, or are allergic to FOSAMAX or FOSAMAX PLUS D. Before use, talk to your doctor if you have or have had stomach or digestive problems or problems with swallowing. You should tell your doctor about all medicines you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements. In addition, for FOSAMAX PLUS D, you should talk to your doctor if you have conditions that may cause an overproduction of vitamin D (eg, sarcoidosis, leukemia, lymphoma).

Stop taking FOSAMAX or FOSAMAX PLUS D and call your doctor right away if you develop new or worsening heartburn, difficult or painful swallowing, or chest pain because these may be signs of serious upper digestive problems, which can include irritation, inflammation, or ulceration of the esophagus. (See the Patient Product Information for more details.) If you develop severe bone, joint, and/or muscle pain at any time, contact your doctor. Digestive side effects in studies were generally mild and included stomach pain, indigestion/heartburn, or nausea.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

20852628(1)-09/08-FOS