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Novartis Patient Assistance Foundation Program
SOURCE: 2008 Poverty Chart
| Family Size | 100% | 133% | 150% | 200% | 250% | 300% |
| 1 | $10,830 | $14,404 | $16,245 | $21,660 | $27,075 | $32,490 |
| 2 | $14,570 | $19,378 | $21,855 | $29,140 | $36,425 | $43,710 |
| 3 | $18,310 | $24,352 | $27,465 | $36,620 | $45,775 | $54,930 |
| 4 | $22,050 | $29,327 | $33,075 | $44,100 | $55,125 | $66,150 |
| 5 | $25,790 | $34,301 | $38,685 | $51,580 | $64,475 | $77,370 |
| 6 | $29,530 | $39,275 | $44,295 | $59,060 | $73,825 | $88,590 |
| 7 | $33,270 | $44,249 | $49,905 | $66,540 | $83,175 | $99,810 |
| 8 | $37,010 | $49,223 | $55,515 | $74,020 | $92,525 | $111,030 |
| For each additional family member | $3,740 | $4,974 | $5,610 | $7,480 | $9,350 | $11,220 |
What´s Next?
Fill out the program enrollment form located to your right. If you don’t see an enrollment form available please call Novartis Pharmaceuticals program directly. After filling out the enrollment form please bring the form to your doctor for proper signatures and procedures. Do not forget a self stamped envelope for them to mail in your application to the program.
Other Tips
- If you have any questions please call the Novartis Pharmaceuticals program directly
- Fill out as much of the information on the enrollment form as possible. The more information you have pre-filled the easier the progrm is to enroll in
- Write down the refill dates for your program and set a reminder here on PatientAssistance.com so that you don’t run out of medication.
- Do not write messy on your forms as this will delay any response
- Call and write thank you notes to Novartis Pharmaceuticals program. Without their help millions of people will be without medication.
- PAP Links:
- Website:
- Address:
- Phone:
- Fax:
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List of Medications
Comtan Tablets 200mg (entacapone), Diovan Tablets 40mg, 80mg, 160mg, 320mg (valsartan), Diovan HCT Tablets 12.5mg/160mg (valsartan/hydrochlorothiazide), Diovan HCT Tablets 80mg, 12.5mg (valsartan/hydrochlorothiazide), Elidel Cream 1% (pimecrolimus Topical), Enablex Tablets 7.5mg, 15mg (darifenacin), Exelon Capsules 1.5mg, 3mg, 4.5mg, 6mg (rivastigmine), Exelon Patch 4.6mg, 9.5mg (rivastigmine), Exforge Tablets 5/160mg, 5/320mg, 10/160mg, 10/320mg (amlodipine/valsartan), Focalin XR Tablets 5mg, 10mg, 20mg (dexmethyiphenidate), Lamisil Oral Granules 125mg/packet, 187.5mg/packet (terbinafine Hydrochloride), Lescol Capsules 20mg, 40mg (fluvastatin), Lescol XL Tablets 80mg (fluvastatin), Miacalcin Nasal Spray 200iu/dose (calcitonin), Ritalin LA 10mg (methylphenidate), Ritalin LA Capsules 20mg, 30mg, 40mg (methylphenidate), Stalevo Tablets 50mg, 100mg, 150mg (carbidopa/levodopa/entacapone), Starlix Tablets 50mg, 120mg (nateglinide), Tegretol XR Tablets 200mg (carbamazepine), Tekturna Tablets 150mg, 300mg (aliskiren), Tekturna HCT Tablets 150/12.5mg, 150/25mg, 300/12.5mg, 300/25mg (aliskiren/hydrochlorothiazide)
Forms and other information are Copyright © Novartis Patient Assistance Foundation Program
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