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Drug Assistance Programs for the Uninsured
Differin (adapalene)
Company:
Galderma Laboratories
Program name:
Galderma Laboratories Patient Assistance Program
Program address:
122 S. Michigan Ave. Suite 100 Chicago, IL 60603
Phone number:
866-730-5074
Fax number:
312-935-3599
Forms:
galder0077.pdf
Eligibility guidelines
and notes:
The patient cannot have prescription insurance, be ineligible for any federal or state programs and
Application process:
Anyone can write the company to request an application.
Application requirements:
The doctor must fill out a section and sign the application.
Program details:
The patient is sent a pharmacy card that is valid for one month.
Last updated:
7/14/2008
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