THE MERCK PATIENT ASSISTANCE PROGRAM FOR RENFLEXIS

The Merck Patient Assistance Program provides certain Merck medicines free of charge to eligible patients.
Who is the program for?
Patients who do not have insurance, or who cannot afford their prescribed Merck medicine even with prescription drug coverage, may be eligible for free product from the Merck Patient Assistance Program if they meet certain financial, medical, and/or insurance criteria.
For more information on the program’s eligibility requirements, please visit www.merckhelps.com.
Getting started is simple
  • Download and complete the appropriate sections of the enrollment form. If your patient is eligible and interested in co-pay assistance or the Merck Patient Assistance Program, please have the patient complete the appropriate sections on the form.
  • Fax signed, completed forms (whether downloaded, or completed electronically and then printed) to 800-376-2580.
  • A program representative will contact you and your health care provider’s office.
View Enrollment Form E-mail Enrollment Form Use Online Portal
 
Before prescribing RENFLEXIS, please read the accompanying Prescribing Information, including the Boxed Warning about serious infections and malignancies. The Medication Guide also is available.

 
Before prescribing RENFLEXIS, please read the accompanying Prescribing Information, including the Boxed Warning about serious infections and malignancies. The Medication Guide also is available.

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