The Merck Access Program representatives can refer patients to the Merck Patient Assistance Program.

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

Getting started is simple

  1. Download and complete the appropriate sections of the enrollment form, OR use the electronic enrollment form.

  2. Submit electronically, or print and fax the completed form to 866-866-4127.

  3. A program representative will contact your patient and your office.