The Merck Patient Assistance Program

Merck and Co., Inc.

Contact Information
P.O. Box 690
Horsham, PA 19044-9979
1-(800) 727-5400 (phone)
Physician requests should be directed to:
1-(800) 994-2111 (phone)
How to Apply:
Select one of the links below to download the application or go to the program site for more information on how to apply. Once you fill out your application, send it to the address on the application. Do NOT send it to RxResource.
Eligibility:
The Merck Patient Assistance Program is a private and confidential program that provides medicines free of charge to eligible individuals who qualify. You may be eligible for the program if all three of the following conditions apply: 1.You are a U.S. Resident and have a prescription for a Merck medicine from a U.S. licensed physician 2.You do not have insurance or other coverage for your prescription medicine 3.You cannot afford to pay for your medicine. If you do not meet the income and prescription drug coverage criteria, your income is below a set upper limit, and there are special circumstances of financial and medical hardship that apply to your situation, you and your doctor can request that an exception be made for you. For more information, please contact the program using the information above.
Product(s) covered by program:
  • ASMANEX® TWISTHALER® 110 mcg
  • ASMANEX® TWISTHALER® 220mcg
  • Avelox® tablets
  • Clarinex tablets
  • CLARINEX® RediTabs®
  • Clarinex® syrup
  • CLARINEX-D® 24-HOUR EXTENDED RELIEF TABLETS
  • Cosopt Opthalmic Solution
  • Diprolene AF Cream
  • Diprolene lotion
  • Diprolene ointment
  • Elocon cream
  • Elocon ointment
  • Elocon® lotion
  • Foradil Aerolizer
  • Imdur tablets
  • JANUMET™ tablets
  • Januvia
  • Lotrisone Cream
  • Lotrisone lotion
  • Maxalt
  • Nasonex
  • Nitro-Dur Patches
  • Noroxin
  • Proventil HFA Inhaler
  • REMERON®
  • SAPHRIS®
  • Singulair tablets and chewable tablets
  • Stromectol tablets
  • Trusopt opthalmic Solution
  • Vytorin®
  • Zetia®