Horizon Pharma Patient Assistance Program

How to Apply

One Phone Call Will Get You Started


Call 1-888-958-5502
or click to access the Patient
Assistance Program Application

for your application
program details
Monday-Friday, 8:00 AM
to 5:00 PM, Central Standard Time

Provide the
patient information

on your application form

Submit the completed application
by mail or fax

to the address provided*

*Your application must be signed by both you and your physician. Prescriptions will be sent to your home address, pending approval of your application. Please see eligibility requirements.

Making It Easier to Get Your Medicine

At Horizon Pharma, the maker of VIMOVO, we believe that it is important for patients like you to be able to get the medicine your doctor has prescribed. However, we understand it can be difficult to pay if you are uninsured or underinsured.

If you are unable to afford a Horizon Pharma product that has been prescribed to you, the Horizon Pharma Patient Assistance Program can help.

For more information about the Horizon Pharma Patient Assistance Program, please call 1-888-958-5502 or click to access the Patient Assistance Program Application.

Eligibility Requirements for the Horizon Pharma Patient Assistance Program

  • You must be a US resident with a valid Social Security number
  • You are currently uninsured or underinsured as defined by the program
  • Your annual household income should be at or below 300% of the current Federal Poverty Level