This program is available for patients with financial difficulties. Physicians apply for this program on behalf of their patients. Eligibility is determined on a case-by-case basis through a formal review process at Lumicera Health Services. Upon approval, a FREE three month supply of Pertzye® will be sent to the patient. Patient is eligible for three 90-day refills. Patients must re-enroll for the assistance program once per year.

Click here or click the form to download a PDF of the Uninsured Patient Assistance Program^SM form.