Virginia Alexandria Pfizer Prescription Assistance

Pfizer Prescription Assistance

P.O. Box 25457
Alexandria, VA - 22313
(800) 646-4455

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About Pfizer Prescription Assistance

Patient assistance program for the diabetes medications Diabenese (Chlorpropamide), Glucotrol (Glipizide), and Glucotrol XL (Glipizide). Eligibility: Any patient that a physician is treating as an indigent is eligible.

Patients must have incomes below $12,000 (single) or $15,000 (family). Must not be receiving or be eligible for third party or Medicaid reimbursements.

No copayment or cost sharing is required by the patient.

Other information: Physician must write a letter on their letterhead to Pfizer stating the patient meets income criteria and is uninsured for pharmaceuticals and enclose a prescription for the desired product.

The letter must be signed by the prescribing physician.

Products are shipped to the physician and it may take up to 4 weeks to receive the products.



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