The Merck Patient Assistance Program is a private and confidential program that provides medicines free of charge to eligible individuals who qualify.

How to Apply

Please either download the application below (if available) or go to the program website for more information on how to apply. Once you fill out your application, send it to the address on the application. Remember not to send program applications to PPA.

Product(s) Covered by Program

  • A

    • ASMANEX® TWISTHALER® 110 mcg
    • ASMANEX® TWISTHALER® 220 mcg
  • B

    • BELOSOMRA® C-IV
  • C

    • CANCIDAS® for Injection
    • CRIXIVAN®
    • CUBICIN®
  • D

    • DIFICID® Tablets
    • DULERA®
  • E

    • EMEND®
  • G

    • GARDASIL®9
  • I

    • INTRON® A for Injection
    • INVANZ®
    • ISENTRESS®
  • J

    • Janumet XR
    • JANUMET® tablets
    • Januvia®
  • K

    • KEYTRUDA®
  • M

    • M-M-R II
    • Maxalt MLT®
    • Maxalt®
  • N

    • Nasonex®
    • NOXAFIL®
  • P

    • PNEUMOVAX® 23
    • PRIMAXIN® I.V.
  • R

    • Recombivax HB®
    • RENFLEXIS®
  • S

    • Singulair® OS Granules
    • Sivextro Tablets
    • Sylatron™
  • T

    • TEMODAR®
    • Trusopt® opthalmic Solution
  • V

    • VAQTA®
    • VARIVAX®
    • Vytorin®
  • Z

    • Zepatier
    • Zetia®
    • ZINPLAVA™
    • ZOLINZA®
    • ZOSTAVAX®