Daiichi Sankyo

LINK: http://dsi.com/patient-assistance-programs

You must be a legal resident of the United States.

You cannot have any private or government prescription coverage such as Medicaid, Medicare, HMO, or PPO.

If you have Medicare, you cannot be enrolled in Medicare Part D.

Income Guidelines:

Household Size Annual Income
1 $22,980
2 $31,020
3 $39,060
4 $47,100
5 $55,140

Medications covered by the patient assistance program:

AZOR® (amlodipine/olmesartan medoxomil)
BENICAR® (olmesartan medoxomil)
BENICAR HCT® (olmesartan medoxomil/hydrocholorothiazide)
EVOXAC® (cevimeline HCI)
TRIBENZOR® (olmesartan medoxomil/amlodipine/hydrocholorothiazide)
WELCHOL® (colesevelam HCL)

Phone: (706) 208 9700   Mail: info@pcpmail.org