PIFELTRO

Indicated For

HIV-1 infection

About This Medication

# Merck Patient Assistance Program Patient Guide: How to Get PIFELTRO (doravirine) at Low or No Cost PIFELTRO (doravirine) is a prescription medication used to treat HIV-1 infection in adults and children weighing at least 35 kg, as part of a complete antiretroviral regimen. The **Merck Patient Assistance Program** offers **PIFELTRO at no cost** to eligible patients who meet income and other requirements, helping uninsured or financially strained individuals access this important HIV treatment.[1][3] ## About PIFELTRO (doravirine) **PIFELTRO** is a non-nucleoside reverse transcriptase inhibitor (NNRTI) tablet taken once daily with a meal. It works by blocking the HIV virus from multiplying in the body, helping to control the infection and reduce viral load. Always take it exactly as prescribed by your healthcare provider (HCP), and never change your dose without consulting them. Common side effects may include headache, nausea, diarrhea, and trouble sleeping, but discuss any concerns with your doctor.[3] This guide explains how to qualify for free **PIFELTRO** through Merck's program, step-by-step application instructions, and what to do if you're denied. It's designed for patients like you—clear, straightforward, and actionable. ## Who Qualifies for the Program? The **Merck Patient Assistance Program** is primarily for **uninsured U.S. residents** (including territories) with a valid prescription for **PIFELTRO**. You must live in the U.S. or a U.S. territory—no citizenship required. Key factors include: - **Income limits**: Your household income must not exceed specific thresholds based on family size. - **Financial need**: Even some insured patients qualify if they attest to hardship and can't afford the medication. - **Prescription**: From a licensed U.S. healthcare provider.[1][2][4] ### Income Eligibility Breakdown Eligibility is based on annual household income. Here's a clear table: | Household Size | Maximum Annual Income | |----------------|-----------------------| | 1 (Individual) | $62,600 | | 2 (Couple) | $84,600 | | 4 | $128,600 | *Notes*: Income limits adjust yearly; check merckhelps.com for updates. Add about $22,000–$25,000 per additional family member (exact figures vary). Provide proof like tax returns if requested during audits.[1][4][5] ## Insurance Requirements - **Primarily uninsured**: The program targets those without prescription coverage.[1] - **Insured patients welcome with hardship**: If you have insurance (including **Medicare Part D**), you may still qualify if: - You can't afford copays or out-of-pocket costs. - Your income meets limits. - You attest to financial/medical hardship.[1][2] No participation in alternative funding programs that require PAP application. Merck may verify insurance status.[2] ## Step-by-Step Application Process Applying is free and straightforward. Follow these **4 steps**:[4][6] 1. **Check eligibility**: Visit merckhelps.com or call **1-800-727-5400** (Mon–Fri, 8 AM–8 PM ET) to confirm you qualify.[1][6] 2. **Get the enrollment form**: - Download from merckhelps.com. - Call **1-800-727-5400** to request by mail. - Your HCP may have one.[1][3][6] 3. **Complete the form**: - **You (patient)**: Fill Section 1 (personal info, income, address). Sign and date Sections 2 & 3. - Include **proof of income** (e.g., last year's tax return, pay stubs, or benefit letter)—one document usually suffices, but check form cover.[4] - **Your HCP**: Completes Section 4 (prescription for PIFELTRO, up to 90-day supply) and Section 5. Signs/dates.[1][2][4] - One form covers up to **3 Merck meds**; max **3 refills** per enrollment.[1] 4. **Submit**: - **Mail original** (no copies): Merck Patient Assistance Program, PO Box 690, Horsham, PA 19044-9979.[1][4] - Fax options may exist; confirm by phone.[8] - If email provided, you'll get receipt confirmation.[8] **Tip**: Use the checklist on merckhelps.com to avoid errors. All sections must be complete![4][8] ## Timeline and Delivery - **Processing**: Typically **2-3 business days** if complete and eligible; up to **2 weeks** otherwise. Urgent? Call **1-800-727-5400**.[4][6][7] - **Approval notice**: Via mail or email. - **Delivery**: **Mailed free to your home** (or doctor's office if specified in Section 1). Up to 90-day supply + 3 refills.[1][4] - **Duration**: Enrollment valid **up to 12 months** or calendar year; **reauthorization required** afterward with new form.[1][5] ## Refills and Reauthorization - Request refills via phone or new form if needed.[1] - After 12 months: Submit new application.[1][5] ## Alternatives if Denied - **Appeal**: Call **1-800-727-5400** to discuss reasons (e.g., income too high, incomplete form). Provide missing docs.[6] - **Other options**: - Merck's copay programs (if insured). - Patient Access Network (PAN) Foundation or HealthWell Foundation for HIV meds. - State ADAP programs for HIV. - Generic alternatives (discuss with HCP).[5] - **RxAssist.org** or Needymeds.org for more PAPs. ## Important Disclaimer This guide is for informational purposes based on publicly available program details as of latest updates. Eligibility, income limits, and processes can change—**always verify with Merck at 1-800-727-5400 or merckhelps.com**. Not medical advice; consult your HCP for treatment. Merck may audit applications or limit enrollment. Free meds depend on program funds.

Program information last verified: March 30, 2026