Applying For The Pfizer Connection To Care Patient Assistance Program.
The drug manufacturer Pfizer has the Pfizer Connection to Care patient assistance program available to help out patients on their medications. If your doctor has prescribed one of the Pfizer medications listed below as part of your treatment, you might be eligible for the Pfizer Connection to Care program.
Accuretic Arthrotec Caduet Caverject Celebrex Celontin Chantix Cleocin HCI Cleocin Pediatric Cleocin Phosphate Cleocin T Cleocin Colestid Colestid Flavored Cortef Depo-Medrol Depo-Provera Depo-subQ Provera 104 Depo-Estradiol Detrol Detrol LA Dilantin Dilantin – 125 Duavee Effexor XR Estring Feldene Glyset Inspara Lincocin Lyrica Mycobutin Nardil Nicotrol Nitrostat Norpace Premarin Tablets Premarin Cream Premphase Prempro Pristiq Procardia Procardia XL Protonix Provera Quilivant Relpax Skelaxin Synaril Tessalon Tikosyn Toviaz Trecator Viagra Xalatan Zarontin.
The first step is to determine if you are eligible for the program. To qualify for Pfizer’s Connection to Care, an individual must be an American who falls within 200% of the Federal Poverty Level (FPL). Pfizer would prefer that the patient is uninsured, however they will accept patients who are insured but are facing a financial hardship that makes it difficult or impossible to pay for their medications. This includes patients in the Medicare Part D Donut Hole and patients with Veteran’s benefits.
If it looks like you qualify, it’s time to fill out the application and gather your proof of income. The application is about 3 pages long and requests the patient’s personal and financial information, the prescribing doctor’s information, and signatures from both doctor and patient. Be sure the application is filled out completely and accurately . The proof of income (POI) you provide must include the income of every adult living within the household. Pfizer accepts many different forms of proof including W-2s, last year’s tax forms, current paycheck stubs, and Social Security or Unemployment benefit statements, among others. If you are below 200% of the FPL this year but last year’s taxes will reflect a higher income, only send in current proof of income. Be sure that the household size listed on your application matches the number of people on your 1040. If you are receiving child support, it does not count toward your total income so there is no need to include it. Remember, only send of these financial documents; keep the originals for your records.
Once you have filled out the patient portion of the application, it’s time to get your doctor’s information and signature. Your doctor will need to provide their DEA number. If you and your prescribing doctor are in Florida, they will also need to include a form called a pedigree that allows them to receive repackaged drugs by mail. It’s important that you call your physician’s office to find out what their policy is for PAP paperwork. Some doctors require that you make an appointment but many of them will allow you to either drop off the forms or sit in the waiting room while they complete their portion.
When the application is filled out and copies of all of the financial forms have been gathered, make a copy of everything for your records. You can either fax or mail the whole kit to Pfizer’s Connection to Care program. Either way, your paperwork will take about 4 weeks to process so be sure that you have access to an alternate source of Cardura or Procardia during this period. If you are accepted into the program, Pfizer will mail the initial 90 day supply of medication to your doctor’s office. If you don’t have insurance, you are enrolled in Connection to Care for one year total. If you have insurance and applied with a financial hardship, you are enrolled until the end of the calendar year after which you can re-apply.
To order refills, have your doctor or advocate call the Connection to Care representatives and use the automated system – not unlike the automated system at your local pharmacy. Due to the lengthy processing times, it’s best to call every 75 days for refills to avoid lapses in medication.
At the end of the enrollment period, you may apply to Pfizer Connection to Care again if you still need assistance. Happily, there is no limit to the number of times you can re-apply to the program.
You can download an application at, or feel free to contact SCBN at or 1-888-331-1002 if you need assistance with managing your application and enrollment with Patient Assistance Programs.
16 Responses to “Applying For The Pfizer Connection To Care Patient Assistance Program”
Donald walls.
I am a member however I moved from Minnesota to Florida and Lost my contact information. Your help in getting reconnected would be greatly appreciated.
Melanie Galvan.
Sure Donald! You can call SCBN at (888)331-1002. Tell them that you are already a member and you would like to speak to a customer service representative. Let me know if you need further help ?
Rodger Snyder.
My enrollment expires 11/04/2014. I had my doctor reorder on 10/21/2014 my doctor said he had to send paperwork back to you. Is this for a yealy renewal.
Melanie Galvan.
Hey Rodger – We searched for you in our database and didn’t find you, so I don’t think you are one of our members. I think you are trying to reach the Pfizer patient assistance program. Pfizer has a few different patient assistance programs but these 2 phone numbers should connect you to the one you need:
855-742-7497 or 877-744-5675.
I hope this helps!
Helena Bell Black.
Why is the medication – ZOLOFT – no longer on your list? I am still unemployed – 62 yrs old so I can’t get Medicaid nor Medicare – and have no insurance. What can you provide for me to continue on the medication Zoloft or some other similar drug? Without it, I’m very depressed and would prefer being dead than go without it.
Melanie Galvan.
Helena – I totally understand your frustration. Unfortunately, patient assistance programs drop medications all the time. There are a lot of reasons – they came out with a new medication, someone else released a generic form of the medication, or that medication dropped in popularity – whatever the reason, the bottom line is that it isn’t available on patient assistance programs any longer. The good news is that you can still get the medication at a greatly reduced price through companies like Xubex and RX Outreach. Luckily, we do have articles on this blog that tell you how to work with these companies and they have the easiest, most laid back programs.
Check out those links. SCBN has worked with these companies for over a decade and they are very simple and reliable. If you need more help, you can contact me here. If you feel like you can’t manage your enrollment, you can call SCBN at 888-331-1002. I hope this helps!
Melanie Galvan.
Hey Barbara – This blog isn’t run by Pfizer Connection to Care but I can certainly send you a link to the Connection to Care Application:
SCBN is a prescription advocacy company and we help people navigate patient assistance programs.
Let me know if there’s anything else we can do to assist you ?
We were told to fill out on of your applications to help my husband with his med from your company. At first, your rep said we make too much. We both have serious health issues. Then one rep told my husband to fill out a hardship form & send letter. After following instrux’s & sending in forms from us and our physician, told form was insufficient. Not SO! Dr. had faxed it & form LOOKED different! So, then your rep said we did not send in ANOTHER COPY of my husband’s driver’s license with the second application! He was NOT told to do that AGAIN! So, we did it all over again. Took some time. LETTER STATED STILL REFUSED! The last couple of Pfizer people he spoke with upset him. Now, to make matters worse, we had to change Medicare advantage plan due to problems in area with one we had. in 2015 we MUST PAY EXTRA $150 PER MONTH FOR COVERAGE!! we NEVER asked to receive anything FREE! We only asked for help! Past two years my husband enters DONUT HOLE with LYRICA & goes from paying $45 copay to $207 COPAY in 2014!! He had to quit taking Lyrica. Tried two others & is suffering from BAD SIDE EFFECTS! I wish your drug, Lyrica, wasn’t best for him, but it WAS!! So, now HE HAS TO SUFFER WITH NEUROPATHY. which developed after 3 neck surgeries, which, by the way, caused complications which sent him finally to Mayo Clinic, MN, after being treated by more than a dozen drs in two states! He had to quit his job, under dr orders from several drs, and at request of company due to his being out so much every time he went thru more procedures to treat problems, including 3 times they tried to repair his vocal chord, damaged during 3rd surgery. There were 3 other major nerves damaged during that surgery. I had to finally withdraw ALL my savings and retirement funds to pay medical bills! Our medical bills alone are unreal! We know we are not alone. We just need SOME HELP to pay for his Lyrica a few months out of each year, when that DONUT HOLE hits!! But, your people refuse to even HELP my husband with his one med! He has always been hardworking and giving to others. Even now, with all his health problems, he helps his older siblings (6 of them) AND others with anything he can whenever they need something! Maybe your company will have a good year in 2015. Hopefully, you will help some people somewhere.
Melanie Galvan.
Kerri, I am so sorry to hear about your difficulty with the Pfizer patient assistance program. It sounds like you and your husband have had a really ghastly couple of years and you need assistance. Unfortunately, Pfizer doesn’t monitor this blog (we are connected to SCBN, a prescription advocacy company). If you would like to send this information to Pfizer, go to their “email us” link on this page: or contact their corporate office at:
235 East 42nd Street.
New York, NY 10017.
david clendaniel.
I need to reply for a new app.
Melanie Galvan.
Hey David – I’m sorry, I don’t understand your statement. Do you need a link to the application for your medication? Let me know!
Is the Pfizer connection to care have a new application?
Melanie Galvan.
Hey Lydia – Good question! Yes, the Pfizer patient assistance program has undergone some massive changes. They renamed their program RX Pathways and they split their medications into 3 groups: A, B, and C. Each has it’s own form. You can get the forms on the Pfizer RX Pathways website. Just go here: and then look at the very top of the page. In small letters, it says “Download an Application” and it has a drop-down box that will let you choose the correct group. If you don’t know what group your medication is in, look at the middle of the webpage and follow the instructions to find the assistance that’s right for you. I also have a more up-to-date article about Pfizer that you can find here:
I hope this helps! Let me know if there is anything else you need ?
My doctor has changed my dose of pristiq and having a hard time getting the form for him to fill out to get my refill. How can I get this form that was nevered faxed to him?
Melanie Galvan.
Hey Patricia – Oh man, I’m sorry you are going through that problem right now. Are you a current member with SCBN? I just want to verify that you re trying to reach SCBN and not the patient assistance program (Pfizer). Let me know!