The Merck Access Program representatives can refer you to the Merck Patient Assistance Program for an eligibility determination for free product.
Who is the program for?
Patients who do not have insurance or whose insurance does not cover PREVYMIS may be eligible for free product from the Merck Patient Assistance Program if they meet certain financial and medical criteria.
For more information on the program’s eligibility requirements, please visit
Getting started is simple
1. Work with your health care provider to download and complete the enrollment form, OR complete the electronic patient enrollment form.
2. Submit the electronic patient enrollment form online, or print and fax the completed form to 866-866-4127.
3. A program representative will contact you and your health care provider's office.

For more information, contact The Merck Access Program at 855-404-5278 Mon–Fri, 8 AM to 8 PM (ET), to speak to a representative.