Sanofi Patient Connection™ is a program designed to help the uninsured and people in need better afford their prescription medicines, subject to financial restrictions.

How to Apply

Please either download the application below (if available) or go to the program website for more information on how to apply. Once you fill out your application, send it to the address on the application. Remember not to send program applications to PPA.

Product(s) Covered by Program

  • A

    • Adacel® (tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine absorbed)
    • Adlyxin™ (lixisenatide) injection
    • Apidra® (insulin glulisine [rDNA origin] injection
  • C

    • Clolar® (clofarabine) Injection
  • E

    • Elitek® (rasburicase)
  • I

    • Imovax® Rabies Vaccine [Human Diploid Cell]
  • J

    • Jevtana® (cabazitaxel) Injection
  • L

    • Lantus® (insulin glargine [rDNA origin] injection)
    • Leukine® (sargramostim)
    • Lovenox® (enoxaparin sodium injection)
  • M

    • Menactra® Meningococcal (Groups A, C, Y and W-135) Polysaccharide Diphtheria Toxoid Conjugate Vaccine
    • Menomune® (Meningococcal Polysaccharide Vaccines Groups A, C, Y and W-135 combined)
    • Mozobil® (plerixafor injection)
    • Multaq® (dronedarone) Tablets
  • P

    • Priftin® (rifapentine) Tablets
  • S

    • SOLIQUA™ 100/33 (insulin glargine & lixisenatide injection) 100 Units/mL and 33 mcg/mL
    • SYNVISC ONE® HYLAN G-F 20
    • SYNVISC® HYLAN G-F 20
  • T

    • Tenivac® (tetanus and diphtheria toxoids adsorbed)
    • Thymoglobulin® [Anti-thymocyte Globulin (Rabbit)]
    • Toujeo® (insulin glargine [rDNA origin] injection, 300 units/mL)
  • Z

    • Zaltrap® (ziv-aflibercept)