Aldara (imiquimod)

Program name: Graceway Pharmaceuticals Patient Assistance Program

Program address: PO Box 8202 Somerville, NJ 08876

Phone number: 866-628-6498, opt 2

Fax number: 866-838-5820

Forms: gracew0170.pdf

Eligibility guidelines
and notes: The patient can have no public or private prescription insurance and

Application process: Anyone with the patient's and the doctor's information can call.

Application requirements: The doctor must fill out a section, sign the application and attach a prescription for 90 days.

Program details: Up to a 90-day supply is sent to the doctor's office.

Last updated: 8/7/2008

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