Clozapine Prescription Assistance Programs

Clozapine: Apply for prescription assistance below

If you are eligible, the programs below can help you afford clozapine. Review the information to see if you qualify. The applications are available in Adobe PDF format and should be mailed directly to the provider of the patient assistance program.

If you have any questions, please call the telephone number for the program (not or go to the program website.

Looking for a different medication?

Mylan Clozapine Patient Assistance Program (MCPAP)

(Program 1 of 1 — Scroll down to see them all )

Provided by: Mylan Pharmaceuticals, Inc.
781 Chestnut Ridge Road Morgantown, WV 26505
TEL: 800-796-9526
FAX: 877-427-7290
Languages Spoken:
English, Spanish
Program Website
  • None (clozapine)
Eligibility Requirements
  • Insurance Status Must have no prescription coverage
  • Those with Part D Elibible? No
  • Income At or below 400% of FPL
  • Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
  • U.S. Residency Required? The patient must be a US citizen or legal resident.
  • Obtaining Call
  • Receiving Faxed, emailed or mailed
  • Returning The completed application can be faxed, mailed or emailed back.
  • Doctor's Action Complete section, sign, attach required documents
  • Applicant's Action Complete section, sign, attach required documents
  • Decision Communicated Patient notified in writing
  • Decision Timeframe Within 2 weeks
  • Amount/Supply Up to 90 day supply
  • Sent To Pharmacy
  • Delivery Time Contact Program for Details
  • Refill Proces Automatically sent out
  • Limit Not specified
  • Re-application New application every 6 months
Additional Information
There are two steps and two sets of paperwork for this program. The first step is to register the patient, which is required for any patient taking Clozapine, regardless of insurance or financial situations. Call 800-843-9915 to register. This is a two-page form that the patient, physician and pharmacist must fill out.
Updated July 9, 2019

If you, your patient or loved one does not qualify for this program or other prescription savings programs, then please search for prices here.

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