Aciphex Patient Assistance Program

ECR Pharmaceuticals

Contact Information
PO Box 221857
Charlotte, NC 28222-1857
1-(800) 523-5870 (phone)
1-(888) 526-5168 (fax)
Physician requests should be directed to:
Aciphex Patient Assistance Program
P.O. Box 221857
Charlotte, NC 28222-1857
1-(800) 523-5870 (phone)
Eligibility:
Johnson & Johnson have developed the Aciphex® Patient Assistance Program for those U.S. residents who lack access to prescription drug coverage and meet specific financial criteria. Medicare LIS (Low Income Subsidy) eligible patients are not eligible to receive assistance through the Aciphex Patient Assistance Program. Patients receiving benefits under a Medicare Part D prescription drug plan are not eligible to receive assistance through the Patient Assistance Program, however program eligibility exceptions for Medicare Part D enrollees based on significant financial or medical need will be considered.
Other Information:
If necessary, patient may reapply after initial supply.
Product(s) covered by program:
  • Aciphex®