Detrol LA

Pfizer Patient Assistance Program Patient Guide: How to Get Detrol LA at Low or No Cost

About This Program

The Pfizer Patient Assistance Program is a joint program of Pfizer Inc. and the Pfizer Patient Assistance Foundation that helps eligible patients receive Detrol LA (tolterodine tartrate) for free or at reduced cost. This program has provided over 2.8 million prescriptions to patients, with 44,000 patients receiving over 351,000 Pfizer prescriptions for free in 2024.[5]

About Detrol LA

Detrol LA is a prescription medication used to treat overactive bladder symptoms. The Pfizer Patient Assistance Program covers this medication for eligible patients who cannot afford their prescription costs.[4]

Who Qualifies for This Program?

To be eligible for the Pfizer Patient Assistance Program for Detrol LA, you must meet the following requirements:

• Have a valid prescription written by a healthcare provider licensed in the United States, Puerto Rico, or US Virgin Islands[8]
• Be treated in an outpatient setting by a licensed healthcare provider[8]
• Live in the United States, Puerto Rico, or US Virgin Islands[8]
• Meet income requirements based on your household size and financial situation[8]
• Not have commercial insurance (patients with employer-based or Federal Employer Plan insurance are not eligible)[8]
• Demonstrate financial need by certifying that you cannot afford your medication[7]

Income Eligibility

While specific income thresholds are not publicly listed, the program uses an income-based eligibility system. You will need to provide proof of your household income to determine if you qualify. The program evaluates your financial situation to determine assistance eligibility.[8]

Insurance Requirements

Important: Patients with commercial insurance (insurance through an employer or Federal Employer Plan) are not eligible for this program.[8] However, if you have Medicare Part D, you may still qualify. If you are enrolled in Medicare Part D and approved for the program, Pfizer will notify your Medicare Part D plan of your participation.[2]

How to Apply: Step-by-Step

Step 1: Gather Required Documents

Before starting your application, collect the following:[3]

• A completed and signed enrollment form
• Your original prescription from your healthcare provider
• Proof of income (choose one):
  • Pages 1 and 2 of your previous year's federal tax return (Form 1040 or 1040EZ)
  • W-2 forms
  • Two recent paycheck stubs
  • Social Security, pension, or railroad retirement statements

Step 2: Complete the Enrollment Form

You can apply through multiple methods:[1]

• Online Application: Visit www.PfizerRxPathways.com and use the Program Finder. Enter the name of your prescribed medicine (Detrol LA) and follow the onscreen instructions. For certain Pfizer medicines, you can complete the application online through Pfizer PAP Connect.[1]
• Manual Application: If you cannot participate online, a fully manual process is available.[1]

Your healthcare provider can also help you complete the application.[1]

Step 3: Submit Your Application

If applying by mail or fax, send your completed application to:[3]

Pfizer Patient Assistance Program P.O. Box 66585 St. Louis, MO 63166-6585 Fax: 866-470-1748

Include:

• Completed and signed enrollment form
• Original prescription
• Proof of income documentation

Do not send patient medical records or other unnecessary documentation.[3]

Step 4: Await Approval Notification

You will be notified of your enrollment status within 2 to 3 weeks of submitting your application.[1][3] If approved, you will receive a letter with your enrollment term and instructions on how you will receive your medication through the program.[3]

What Happens After Approval?

Once approved, Pfizer will provide your Detrol LA medication at no charge. The medication will be provided only to you as the eligible and enrolled patient.[2] Pfizer may contact you directly to confirm receipt of medications.[7]

What If Your Application Is Denied?

If your application is denied, you have options:

• Contact a Medicine Access Counselor: Call the toll-free number 1-844-989-PATH (7284) to speak with a Pfizer Medicine Access Counselor who can explain the denial and discuss your options.[8]
• Reapply: You can reapply for the program if your circumstances change. Check the "reapplying" box on the enrollment form if you are submitting a new application.[2]
• Explore Alternatives: Ask your healthcare provider about other patient assistance programs, generic alternatives, or other cost-reduction options.

Important Reminders

• The information you provide on your application is subject to random audits and verification.[7]
• You must comply with your state's practitioner dispensing laws.[2]
• Eligibility rules are subject to change at any time.[8]
• This program is for patients without commercial insurance coverage.

Need Help?

For questions about your eligibility or the application process, contact a Pfizer Medicine Access Counselor:

Phone: 1-844-989-PATH (7284) Website: www.PfizerRxPathways.com

Disclaimer

This guide provides general information about the Pfizer Patient Assistance Program for Detrol LA. Program eligibility, requirements, and benefits are subject to change. Always verify current program details by visiting www.PfizerRxPathways.com or calling 1-844-989-PATH (7284). This information is not a guarantee of program enrollment or medication provision. Consult with your healthcare provider and the program directly for personalized guidance.