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Name of Program
Knoll Indigent Patient Program

Physician Requests Should Be Directed To
Knoll Indigent Patient Program
Knoll Pharmaceutical Company
3000 Continental Drive, North
Mount Olive, NJ 07828-1234
Attn: Telemarketing

Product(s) Covered By Program
Mavik (trandolapril), Rythmol® (propafenone HCl), Synthroid® Tablets (levothyroxine sodium, USP), Tarka (trandolapril and verapamil)

Eligibility
Physicians must send a completed application form and prescription to Knoll Pharmaceutical. Applications can be obtained through the website www.rxhope.com or by calling (800) 240-3820. Applications can be submitted through the mail, via fax or through the RxHope website. Applications can be tracked through the RxHope website.

Other Program Information
Decisions are made on a case-by-case basis. Prescription is required for every request. Maximum of three-month supply on any one request.

Please see listing for Wyeth-Ayerst Laboratories.

Name of Program
Lilly Cares

Physician Requests Should Be Directed To
Lilly Cares Program Administrator
Lilly Cares
P.O. Box 23099
Centreville, VA 20120
(800) 545-6962

Product(s) Covered By Program
Most Lilly prescription products and insulins (except controlled substances) are covered by this program. Gemzar® is covered under a separate program.

Eligibility
Patients must be U.S. residents. Eligibility is determined on a case-by-case basis in consultation with each prescribing physician. Eligibility is based on the patient's inability to pay and lack of third- party drug payment assistance, including insurance, Medicaid, government-subsidized clinics, and other government, community, or private programs. Inpatients and those who can obtain drug reimbursement from any source are not eligible. Requests for replacement drugs cannot be honored. Medications are provided directly to the physician for dispensing to the patient. Quantity of supply is dependent upon type of product being prescribed. All Lilly medications must be used as recommended in product labeling.

Other Program Information
Forms to qualify a patient for the program will be provided to the physician. On this form, the physician is requested to provide prescription information, including signature and DEA number, and to confirm the patient's ineligibility for other forms of outpatient drug coverage. Additionally, the patient is requested to provide pertinent information and state financial need.

Subsequent request for same patient requires another prescription and restatement of medical and financial need. Program guidelines may be subject to change.

Name of Program
Gemzar^® Patient Assistance Program

Physician Requests Should Be Directed To
Gemzar^® Reimbursement Hotline
(888) 4-GEMZAR (888-443-6927)

Product(s) Covered By Program
Gemzar^® (gemcitabine hydrochloride)

Eligibility
Applications for the program are available by calling the toll-free Gemzar Hotline. Applicants determined to be eligible based on program income criteria will be approved on the basis of these additional criteria: no medical insurance, and ineligible for any programs with a drug benefit provision, including Medicaid, third-party insurance, Medicare, and all other programs have denied coverage for Gemzar in writing, and all appeals have been exhausted.

Name of Program
Financial Assistance Program for ABELCET^®

Physician Requests Should Be Directed To
Financial Assistance Program for ABELCET^®
The Liposome Company, Inc.
One Research Way
Princeton, NJ 08540-6619
(800) 335-5476

Product(s) Covered By Program
ABELCET^® (amphotericin B lipid complex injection)

Eligibility
Patients must be uninsured (not eligible to receive reimbursement through any other third-party drug reimbursement program, i.e., Medicaid, local or federal agency programs, Blue Cross/Blue Shield, private insurance programs and private foundations), and are unable to pay for the product out-of-pocket. Eligibility is determined by The Liposome Company based on medical and financial information provided on behalf of the patient by the hospital or physician.

Other Program Information
Patients must receive ABELCET® from a hospital, physician, or home health care company for a medically appropriate application. Providers may enroll a patient by calling (800) 335-5476 or by contacting a Liposome Area Sales Manager to obtain an application form. Application forms must be completed and signed by a physician to enroll a patient.

Name of Program
The Merck Patient Assistance Program

Physician Requests Should Be Directed To
The Merck Patient Assistance Program —
Health care professionals with prescribing privileges may call (800) 994-2111

Product(s) Covered By Program
Most Merck products. Requests for vaccines and injectables are not accepted, with the exception of requests for anti-cancer injectable products.

Eligibility
The Merck Patient Assistance Program is designed to provide temporary assistance to patients who have no access to any insurance coverage for prescription medications and are truly unable to afford prescription medications. The patient must have exhausted all options for prescription benefits and coverage including: private insurance, HMOs, Medicaid, Medicare, state pharmacy assistance programs, Veteran's Assistance, and any other social service agency support. Patients must also reside in the U.S. and have a U.S. treating physician. Completed applications are reviewed on a case-by-case basis.

Other Program Information
Each application must be completely filled out and signed by both the prescriber and the patient and be mailed with an original, signed, dated prescription with the prescriber's name, address, professional designation, and a DEA or state license number.

Completed applications are reviewed for eligibility on a case-by-case basis. Once eligibility has been verified, up to a three-month supply of the prescribed medication(s) is sent directly to the prescriber's office for distribution to the patient. Medications are labeled for the patient.

Name of Program
The Merck Patient Assistance Program for Aggrastat®
Reimbursement Support and Patient Assistance Services for Aggrastat®

Physician Requests Should Be Directed To
The Merck Patient Assistance Program for Aggrastat®
Health care professionals or patients may call (877) 810-0595

Product(s) Covered By Program
Aggrastat® (tirofiban HCI)

Eligibility
Financially disadvantaged patients may be eligible for assistance through the Merck Patient Assistance Program for Aggrastat. This program is designed to help cover the cost of Aggrastat for eligible patients who meet the following criteria: must demonstrate financial need, must not have coverage through an insurance provider, and must not be eligible for any third-party insurance or government-sponsored programs, including Medicare and Medicaid.

Alternative sources of coverage must be explored before applying to the Merck Patient Assistance Program for Aggrastat. Reimbursement is not guaranteed to all applicants.

Other Program Information
Hospital administrators can call the Merck Patient Assistance Program for Aggrastat at (877) 810-0595. Patient assistance experts will assist with the application process to determine eligibility. This program also offers reimbursement counseling for patients and providers to assist with any payor questions.

Health care professionals who participate in this program are under no obligation to prescribe Aggrastat or any other product manufactured by Merck & Co., Inc. The Merck Patient Assistance Program for Aggrastat may be discontinued or modified at any time, without notice.

Name Of Program
The SUPPORT™ Program for Crixivan®
Reimbursement Support and Patient Assistance Services for Crixivan®

Physician Requests Should Be Directed To
The SUPPORT™ Program for Crixivan®
Health care professionals or patients may call (800) 850-3430

Product(s) Covered By Program
Crixivan® (indinavir sulfate)

Eligibility
The SUPPORT™ program assists patients who are prescribed Crixivan® and are uncertain of their insurance coverage, in locating payment sources for Crixivan®. Free product is provided to those uninsured patients who qualify, and for whom no alternative source of coverage can be identified. Patients must also reside in the United States and have a U.S. treating physician. All applications are reviewed on a case-by-case basis. Product is shipped to the prescriber's office for distribution to the patient. Medicine is labeled for the patient.

Name of Program
Novartis Patient Assistance Program

Physician Requests Should Be Directed To
Novartis Pharmaceuticals
Patient Assistance Program
P.O. Box 52052
Phoenix, AZ 85072-9170
(800) 257-3273

Product(s) Covered By Program
Certain single source and/or life-sustaining products. Controlled substances are not included.

Eligibility
The Patient Assistance Program provides temporary assistance to patients who are experiencing financial hardship and who have no prescription drug insurance, until alternative sources of funding are obtained. Patients are required to complete an application along with their physicians and return it for evaluation.

Other Program Information
Patient applications are evaluated on a case-by-case basis.

Name Of Program
Remeron Indigent Patient Program

Physician Requests Should Be Directed To
Local Organon sales representative

Product(s) Covered By Program
Remeron® (mirtazapine)

Eligibility
Patients must be U.S. residents. Eligibility is determined on a case-by-case basis and is based on a patient's inability to pay and who are not eligible to receive these drugs through any other third-party drug reimbursement program, i.e., Medicaid, local or federal agency programs, Blue Cross/Blue Shield, private insurance programs and private foundations. Inpatients and those who can obtain drug reimbursement from other sources are not eligible.

Other Program Information
Forms to qualify a patient for the program will be provided to the physician. On this form, the physician is requested to provide prescription information, including their signature and DEA number and to confirm the patient's ineligibility for other forms of outpatient drug coverage. The patient is requested to provide the pertinent information and state financial need.

Name Of Program
"Gold Star" Fertility Assistance Program

Physician Requests Should Be Directed To
Local Organon sales representative

Product(s) Covered By Program
Follistim® (follitropin beta for injection), Follistim Antagon Kit

Eligibility
Patients must be U.S. residents. Eligibility is determined on a case-by-case basis and is based on a patient's inability to pay and who are not eligible to receive these drugs through any other third-party drug reimbursement program, i.e., Medicaid, local or federal agency programs, Blue Cross/Blue Shield, private insurance programs and private foundations. Inpatients and those who can obtain drug reimbursement from other sources are not eligible.

Other Program Information
Forms to qualify a patient for the program will be provided to the physician. On this form, the physician is requested to provide prescription information, including their signature and DEA number and to confirm the patient's ineligibility for other forms of outpatient drug coverage. The patient is requested to provide the pertinent information and state financial need.

Name of Program
Procritline ™

Physician Requests Should Be Directed To
Procritline ™
1250 Bayhill Drive, Suite 300
San Bruno, CA 94066
(800) 553-3851
(800) 683-7855 (fax)
(800) 987-5572 (fax)
Hours of operation: 9:00am — 8:00pm EST

Product(s) Covered By Program
PROCRIT^® (Epoetin alfa) for non-dialysis use, LEUSTATIN^® (cladribine) Injection

Eligibility
Program will ensure that PROCRIT^® and/or LEUSTATIN^® is made available to any persons who meet specific medical criteria and lack financial resources and third-party coverage necessary to obtain treatment. A reimbursement specialist determines eligibility.

Other Program Information
Patient eligibility application forms are available by accessing the 800 number (800-553-3851). This call can help determine if a patient is eligible to enroll in the program or is eligible for an alternative program if other sources of funding are identified.

Name of Program
Ortho Dermatological Patient Assistance Program

Physician Requests Should Be Directed To
Ortho Dermatological Patient Assistance Program
Ortho-McNeil Patient Assistance Program
P.O. Box 938
Somerville, NJ 08876
(800) 797-7737

Product(s) Covered By Program
Prescription products prescribed according to approved labeled indications and dosage regimens.

Eligibility
Patients should not have insurance coverage for prescription medication. Patients should not be eligible for other sources of drug coverage; they need to have applied to public sector programs and been denied. Patients' income falls below poverty level and retail purchase would cause hardship.

Other Program Information
Health care practitioner should request an application form. The completed form must be accompanied by a signed and dated prescription. Medication will be sent to the health care practitioner for dispensing to the patient.

Name Of Program
Ortho-McNeil Patient Assistance Program

Physician Requests Should Be Directed To
Ortho-McNeil Patient Assistance Program
P.O. Box 938
Somerville, NJ 08876
(800) 797-7737

Product(s) Covered By Program
Prescription products prescribed according to approved labeled indications and dosage regimens.

Eligibility
Patients should not have insurance coverage for prescription medication. Patients should not be eligible for other sources of drug coverage; they need to have applied to public sector programs and been denied. Patients' income falls below poverty level and retail purchase would cause hardship.

Other Program Information
Health care practitioner should request an application form. The completed form must be accompanied by a signed and dated prescription. Medication will be sent to the health care practitioner for dispensing to the patient.

Name Of Program
RxMAP Prescription Medication Assistance Program

Physician Requests Should Be Directed To
RxMAP
P.O. Box 29043
Phoenix, AZ 85038-9988
(800) 242-7014

Product(s) Covered By Program
Pletal® (cilstazol) Tablets

Eligibility
Based on federal poverty level and no prescription drug coverage

Other Program Information
All inquiries should go to RxMAP at (800) 242-7014

Please see listing for Pfizer Inc.

Name Of Program
Pfizer Prescription Assistance

Physician Requests Should Be Directed To
Pfizer Prescription Assistance
P.O. Box 230970
Centreville, VA 20120
(800) 646-4455

Product(s) Covered By Program
Most Pfizer outpatient products with chronic indications are covered by this program. Aricept®, Diflucan® and Zithro-max® are covered by separate programs.

Eligibility
Any patient that a physician is treating as indigent is eligible. Patients must have incomes below $12,000 (single) or $15,000 (family). Patients must not be receiving or be eligible for third-party or Medicaid reimbursements for medications. No copayment or cost-sharing is required by the patient.

Other Program Information
Specific forms are not required. The physician must write a letter on his or her letterhead to Pfizer stating that 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 for redistribution to the patient. Products are supplied to the physician in stock packages, usually 100 tablets or capsules. It may take up to four weeks to receive the product. Refills are obtained through physician resubmission of request. Pfizer reserves the right to limit enrollment of patients.

Name Of Program
Parke-Davis Patient Assistance Program

Physician Requests Should Be Directed To
The Parke-Davis Patient Assistance Program
P.O. Box 1058
Somerville, NJ 08876
(908) 725-1247

Product(s) Covered By Program
Accupril, Accuretic, Dilantin, Estrostep, FemHRT, Lipitor, Loestrin, Neurontin, and Zarontin

Eligibility
Patients must not be eligible for other sources of drug coverage and must be deemed financially eligible based on company guidelines and physician certification.

Other Program Information
Physicians should request an application form from their Parke-Davis Sales Representative. The completed form, accompanied by a signed and dated prescription, should be mailed to the address above. Up to a three-month supply will be delivered to the physician for dispensing to the patient.

Name Of Program
Sharing the Care

Requests Should Be Directed To
Sharing the Care
Pfizer Inc
235 E. 42nd Street
New York, NY 10017-5755
(800) 984-1500

Product(s) Covered By Program
Certain Pfizer single-source products

Eligibility
The program, a joint effort of Pfizer, the National Governors' Association, and the National Association of Community Health Centers, works solely through community, migrant, and homeless health centers that are funded under section 330(e), 330(g), or 330(h) of the Public Health Service Act and that have an in-house pharmacy. The program includes the participation of more than 350 health centers throughout the United States. To be eligible to participate in Sharing the Care, the patient must be registered at a participating health center, must not be covered by any private insurance or public assistance covering pharmaceuticals, must not be Medicaid-enrolled, and must have a family income that is equal to or below the federal poverty level. Pfizer reserves the right to limit enrollment of patients and health centers.

Other Program Information
Product is dispensed to patient at health center pharmacy.

Name Of Program
Diflucan^® and Zithromax^® Patient Assistance Program

Physician Requests Should Be Directed To
Diflucan^® and Zithromax^® Patient Assistance Program
(800) 869-9979

Product(s) Covered By Program
Diflucan^® (fluconazole) and Zithromax^® (azithromycin) for MAC prophylaxis

Eligibility
Patient must not have insurance or other third-party coverage, including Medicaid, and must not be eligible for a state's AIDS drug assistance program. Patient must have an income of less than $25,000 a year without dependents, or less than $40,000 a year with dependents.

Other Program Information
Physicians should call the Diflucan^® and Zithromax^® Patient Assistance Program and explain the patient's situation to the Patient Assistance Specialist. The specialist will then send a short qualifying form that requests insurance status, income information, and the amount of Diflucan^® or Zithromax^® the patient will require. The form must be completed, signed, a prescription attached, and returned to the Patient Assistance Program in the envelope provided.

The Program staff will determine whether the patient is eligible for free Diflucan^® or Zithromax^® on the same day the form is received. A letter will be sent notifying the physician of the patient's eligibility or ineligibility. It may take up to three weeks from the placement of the first call to the delivery of the product to physicians. Pfizer reserves the right to limit enrollment of patients.

Name of Program
Aricept® Patient Assistance Program
Please see listing for Eisai Inc.

Name Of Program
(A Participant in) the Arkansas Health Care Access Program

Physician Requests Should Be Directed To
Ms. Pat Keller
Program Director
Arkansas Health Care Access Foundation
P.O. Box 56248
Little Rock, AR 72215
(800) 950-8233, (501) 221-3033

Product(s) Covered By Program
Most Pfizer prescription products are covered

Eligibility
Must be an Arkansas resident to qualify. Eligible individuals are certified by the Arkansas Local County Department of Human Services as being Arkansas residents below the federal poverty guidelines, who do not have health insurance benefits and do not qualify for any government entitlement programs. No copayment or cost-sharing is required from the patient. Physician must waive his or her fee for the initial visit. This program does not apply to individuals during hospital inpatient stays.

Other Program Information
Physicians should contact the Arkansas Health Care Access Foundation for further information.

Name Of Program
(A Participant in) the Kentucky Health Care Access Program

Physician Requests Should Be Directed To
Mr. J. Scott Judy
Executive Vice President
Health Kentucky, Inc.
12700 Shelbyville Road
Louisville, KY 40243
(800) 633-8100, (502) 254-4214
(502) 254-5117 (fax)
healthky@pop.net (e-mail) Product(s) Covered By Program
Most Pfizer prescription products are covered

Eligibility
Must be a Kentucky resident to qualify. Eligible individuals are certified by the Kentucky Cabinet for Health Services as Kentuckians below the federal poverty standards who do not have health insurance benefits and do not qualify for any government entitlement programs. No copayment or cost-sharing is required from the patient. Physician must waive his or her fee. This program does not apply to individuals during hospital inpatient stays.

Other Program Information
Physicians should contact Health Kentucky, Inc. for further information.

Name Of Program
(A Participant in) Commun-I-Care

Physician Requests Should Be Directed To
Mr. Ken Trogdon
Director
Commun-I-Care
P.O. Box 12054
Columbia, SC 29211
(800) 763-0059, (803) 933-9183

Product(s) Covered By Program
Most Pfizer prescription products are covered

Eligibility
Eligible individuals must be South Carolina residents. Individuals are certified by Commun-I-Care as below the federal poverty line and not covered by any government entitlement programs. No copayment or cost-sharing is required from the patient. Physician must waive his or her fee.

Other Program Information
Physicians should contact Commun-I-Care for further information.