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Estimated patient savings $600,000,000.00
Mallinckrodt Patient Assistance Program


Mallinckrodt Incorporated is an equipment supply company responsible for respiratory machines, chemical supplies, imaging supplies and pharmaceutical supplies. Now a division of Tyco Healthcare International, Mallinckrodt is the only legal manufacturer of cocaine in the United States, and is one of the few importers of opium from India. Since federal regulations do not allow for the import of drugs manufactured from cocaine, such as Esterom, Mallinckrodt is the only legal supplier of drugs such as these in the United States.


Mallinckrodt Patient Assistance Program is a patient assistance program provided by Mallinckrodt which offers the medications listed to the right at a discount to those who are eligible for the program. The prescription lasts for month for twelve months, at which point the patient must complete there-application process. Eligibility is based off of the following requirements:

- You must not be covered by private or public health insurance.

- You must meet an undisclosed income guideline

- You are responsible for a $20 co-pay.

- Those eligible for Medicare Part D, however are not currently enrolled may be eligible, and should apply.

The medication must be sent to the physicians office.

Those eligible for Medicare Part D but not enrolled may still be eligible.

SOURCE: 2008 Poverty Chart
Family Size
Each Additional Family Member

What´s Next?

Fill out the program enrollment form located to your right. If you don't see an enrollment form available please call Mallinckrodt 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 Mallinckrodt 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 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 AAI Pharma Inc. program. Without their help millions of people will be without medication.

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