LIPITOR Co-Pay Card – LIPITOR.com
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Request a LIPITOR Co-Pay Card.

LIPITOR Money-Saving Offers and Information

The LIPITOR Co-Pay Card can instantly reduce the amount of your co-pay required by your insurance coverage or your out-of-pocket expense. If your co-pay is less than $35, you can receive $10 off—or the price of your co-pay, whichever is less—every time you fill your LIPITOR prescription, up to 12 times per year. If your co-pay is $35 or greater, you can receive $15 off every time you fill your LIPITOR prescription, up to 12 times per year. Simply activate the card, then present it to your pharmacist along with your LIPITOR prescription. Keep your card to use every time you fill your LIPITOR prescription during the offer period.

Please answer the following questions to request your co-pay card.

*Required information

*First Name:
     
*Last Name:
     
*Address Line 1:
     
Address Line 2:
     
*City:
     
*State:
     
*Zip Code:
     
E-mail:
     
*When is your date of birth?
     /    (mm/yyyy)  

*Do you purchase your prescription medication through Medicare, Medicaid, or a similar federal or state prescription drug program?

Yes No

*If you live in Massachusetts, do you have any insurance coverage for your prescription medication?



  Yes, I live in Massachusetts and have insurance coverage for
my prescription

  No, I do not live in Massachusetts—or do not have insurance
coverage in Massachusetts



Are you currently taking a prescription medication for high cholesterol?

Have you taken a prescription medication for high cholesterol in the past year?

Which prescription medication are you currently taking?

How long have you been taking LIPITOR®?

Would you like extra help achieving your cholesterol goals?

Join LIPITOR's My HeartWise™ patient support program. Get information to help you meet your short-term and long-term cholesterol management goals. My HeartWise™ also offers useful tips and tools for developing good habits around total heart health.

Check this box to join the My HeartWiseTM patient support program, and get tips, tools, and valuable offers for LIPITOR.
Along with the material you asked us to send, Pfizer may want to contact you from time to time about special offers and updates on LIPITOR and related health issues. Check here if you would like this information.
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Co-Pay Card Terms and Conditions

Offer not valid for prescriptions eligible to be reimbursed, in whole or in part, by Medicare, Medicaid, any other federal or state program (including SPAPs) or by private plans or other health or pharmacy benefit programs which reimburse you for the entire cost of your prescription drugs. You must deduct the value of this offer from any reimbursement requests submitted to your insurance plan either by you or on your behalf. Offer void in Massachusetts for residents whose prescriptions are covered in whole or in part by third party insurance or where otherwise prohibited by law. This card is not health insurance. Depending on co-pay, reimbursement will be either up to $10 or $15 with each refill. Offer good only in USA. Co-pay card limited to one per person during offering period and is not transferable. Offer limited to one use per month up to 12 times per patient year. Offer expires 12/31/08. Pfizer reserves the right to terminate this offer at any time without notice. You understand and agree to comply with these Offer Terms.