Helping Patients Access Quality Brands

Sun Pharma Copay Program

Welcome to the Sun Pharma Copay Program activation site. Please provide the following information to activate your copay card and begin saving.

Card ID
First Name* Last Name*
Address - Line 1 Address - Line 2
City State Zip Code*
Date of Birth* Patient's 10‑Digit Phone Number*
E-mail Address Preferred Method of Contact:
Are you enrolled in any government, state of federally funded medical or prescription benefit program, including but not limited to Medicare, Medicaid, Medigap, VA, DOD, and Tricare?*

Do you have commercial insurance coverage?*

You understand that the personal information you provide and information pertaining to the use of your copay card at the pharmacy will be shared with Sun Pharma, and its third party partners. Sun Pharma and companies providing services to Sun Pharma will not sell or rent your personally identifiable information, as described in the Privacy Policy, which you can view by visiting*

You agree to be contacted at the phone number, address or email provided to receive information about products, services and promotional offers from Sun Pharma. You understand that you have the ability to opt-out of these by calling 855‑820‑9077.*

*Field is required.

You are encouraged to report negative side effects of prescription drugs to the FDA.
Visit, or call 1‐800‐FDA‐1088.

© 2020 Sun Pharmaceutical Industries, Inc. All rights reserved.
All trademarks are property of their respective owners.
PM-US-HLG-0076 07/2020