LIPITOR® (atorvastatin calcium) | Lipitor For You

You May Be Eligible for the Advantages of the LIPITOR FOR YOU Program:

Access to name-brand LIPITOR (atorvastatin calcium) tablets for as low as a $4 co-pay per month with the LIPITOR $4 Co-Pay Card.* Terms and conditions apply
You can continue to manage your cholesterol and your co-pay for branded LIPITOR may be less than half the average co-pay of a generic statin.^† You may save up to $75 per month
Support materials to help you reach your heart-heath goals

For your convenience, the LIPITOR $4 Co-Pay Card can be used at just about any pharmacy from coast to coast. More than 98% of retail pharmacies participate.

Begin by answering the questions below. Once registered, use your LIPITOR $4 Co-Pay Card to continue to get one or more month's supply (30 tablets or more) of LIPITOR filled.

If you would prefer to register by phone, please call 1-866-3-LIPITOR (1-866-354-7486).

**Required information

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

Yes No

**Do you live in Massachusetts and/or have insurance coverage for prescriptions in Massachusetts?

Yes No

**I am 18 years of age or older

Please complete the form below to receive your LIPITOR $4 Co-Pay Card. Your name and address are required to mail your card.

**First Name

M.I.

**Last Name

**Address Line 1

Address Line 2

**City

**State

**ZIP Code

E-mail Address

In the future, we may be able to send product information and messages containing helpful tips and tools to your mobile phone. Standard text messaging rates would apply. Would you like to share your mobile phone number with us?

Yes, please send product information and co-pay reminders to my mobile phone.

Mobile Phone Number

Pfizer understands your personal and health information is private. The information you provide will only be used by Pfizer and parties acting on its behalf to send you the materials you requested and other helpful information and updates on LIPITOR (atorvastatin calcium) tablets and/or high cholesterol as well as related treatments, products, offers and services.

By checking this box, I also agree that Pfizer or companies acting on its behalf may send me materials about other health conditions, use my information to develop or improve products and services, or contact me in the future about health-related topics.

^†IMS PlanTrak Co-pay^TM data, 1/1/2012-10/31/2012.

Questions About the LIPITOR FOR YOU Program

Browse the FAQs for answers. Or call 1-877-343-1239 to speak with a live representative. Learn More

LIPITOR (atorvastatin calcium) tablets are not for everyone, including anyone who has previously had an allergic reaction to LIPITOR (atorvastatin calcium) tablets. It is not for those with liver problems. And it is not for women who are nursing, pregnant or may become pregnant.

If you take LIPITOR (atorvastatin calcium) tablets, tell your doctor if you feel any new muscle pain or weakness. This could be a sign of rare but serious muscle side effects. Tell your doctor about all your medical conditions and all medications you take. This may help avoid serious drug interactions. Your doctor should do blood tests to check your liver function before starting LIPITOR (atorvastatin calcium) tablets and during your treatment if you have symptoms of liver problems. Tell your doctor if you have diabetes. Elevated blood sugar levels have been reported with statins, including LIPITOR (atorvastatin calcium) tablets.

Common side effects are diarrhea, upset stomach, muscle and joint pain, and changes in some blood tests.

INDICATION

LIPITOR (atorvastatin calcium) tablets are a prescription medicine that is used along with a low-fat diet. It lowers the LDL ("bad") cholesterol and triglycerides in your blood. It can raise your HDL ("good") cholesterol as well. LIPITOR can lower the risk for heart attack, stroke, certain types of heart surgery, and chest pain in patients who have heart disease or risk factors for heart disease such as age, smoking, high blood pressure, low HDL, or family history of early heart disease.

LIPITOR can lower the risk for heart attack or stroke in patients with diabetes and risk factors such as diabetic eye or kidney problems, smoking, or high blood pressure.

IMPORTANT SAFETY INFORMATION

Common side effects are diarrhea, upset stomach, muscle and joint pain, and changes in some blood tests.

You are encouraged to report negative side effects of prescription drugs to the FDA.
Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

*LIPITOR $4 Co-Pay Card TERMS AND CONDITIONS
By using the LIPITOR $4 Co-Pay Card (the "Card"), you acknowledge that you currently meet the eligibility criteria and will comply with the terms & conditions described below:

This Card is not valid for prescriptions that are eligible to be reimbursed, in whole or in part, by Medicaid, Medicare or other federal or state healthcare programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico [formerly known as "La Reforma de Salud"]).

The Card is not valid for prescriptions that are eligible to be reimbursed by private insurance plans or other health or pharmacy benefit programs which reimburse you for the entire cost of your prescription drugs.

To qualify for this offer, your out-of-pocket expense must be greater than $4 per prescription. If your out-of-pocket expenses for a 1-month supply (30 tablets) are $79 or less, you will pay $4 for a 1-month supply. If your out-of-pocket expenses for a 1-month supply (30 tablets) exceed $79, you qualify for up to $75 in savings for a 1-month supply. In either case, you can only qualify for up to $1,000 of savings per calendar year. After maximum of $1,000, you will pay usual monthly out-of-pocket costs.

You must deduct the value received under this program from any reimbursement request submitted to your insurance plan, either directly by you or on your behalf.

The Card is not valid for Massachusetts residents whose prescriptions are covered in whole or in part by third-party insurance, or where otherwise prohibited by law.

This Card cannot be combined with any other rebate/coupon, free trial or similar offer for the specified prescription.

The Card will be accepted only at participating pharmacies.

This Card is not health insurance.

Offer good only in the U.S. and Puerto Rico.

The Card is limited to 1 per person during this offering period and is not transferable. Offer limited to 1 use per month.

Pfizer reserves the right to rescind, revoke or amend the program without notice at any time.

Card and Program expires 12/29/2014.

No membership fees.

For reimbursement when using a non-participating pharmacy/mail order: Pay for LIPITOR prescription and mail copy of original pharmacy receipt (cash register receipt NOT valid) with product name, date and amount circled to:

LIPITOR Co-Pay Card
6501 Weston Parkway, Suite 370
Cary, NC 27513
Be sure to include a copy of the front of your Co-Pay Card, your name and mailing address.

Need help paying for your Pfizer medicines?
Pfizer Helpful Answers® may be able to help, regardless of your insurance situation.
Learn how at www.PHAHelps.com

Pfizer

The health information contained herein is provided for educational purposes only and is not intended to replace discussions with a healthcare provider. All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patient.

The product information provided in this site is intended only for residents of the United States. The products discussed herein may have different product labeling in different countries.

LEP486505-01/LEP00059B10