The purpose of the Valeant PAP is to help those eligible patients who are prescribed certain Valeant Pharmaceuticals products obtain those products although financial circumstances or insurance status may otherwise interfere with the ability to do so. How the Valeant PAP Works - You and your prescriber must complete the Valeant PAP application and submit it with a signed original prescription. There is no cost to apply. - We will review and confirm the information in your application and respond within two business days. - If approved, you are eligible to receive your Valeant prescription product(s) at no cost to you for up to one year. - You may be able to reapply to the program annually if you continue to meet eligibility requirements and have a valid prescription.

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

    • Ancobon
    • Android
    • AquaMephyton
  • C

    • Carac®
  • D

    • Demser
    • Diastat® Acudial™ 10mg
  • E

    • Edecrin
    • Elidel®
  • L

    • Lacrisert
    • Lodosyn tablet
  • M

    • Migranal®
    • Mysoline
  • O

    • Oxsoralen-Ultra® Capsules, 10mg
  • P

    • Prostigmin®
  • T

    • Targretin®
    • Tasmar
    • Timoptic - XE Opthalmic Gel Forming solution
    • Tretinoin (Atralin)
  • Z

    • Zelapar®
    • Zovirax®