You are now leaving the Lilly Medical website

The link you clicked on will take you to a site maintained by a third party, which is solely responsible for its content. Lilly USA, LLC does not control, influence, or endorse this site, and the opinions, claims, or comments expressed on this site should not be attributed to Lilly USA, LLC. Lilly USA, LLC is not responsible for the privacy policy of any third-party websites. We encourage you to read the privacy policy of every website you visit.
Click "Continue" to proceed or "Return" to return to Lilly Medical

Contact Us
Dossier Inquiry Form

US Dossier Inquiry Form

This form is for requesting Lilly AMCP Dossiers for US Healthcare Professionals and individuals who are actively working in a capacity where healthcare, formulary, and/or benefit design are a part of their role.

Please complete the required fields below. Your request will be triaged appropriately and a response will be provided to you in a timely manner.

For any other questions or to report an Adverse Event or Product Complaint, please contact 1-800-LILLYRX (1-800-545-5979).

Fields with (*) are mandatory

First Name *

Last Name *

Organization *

Department/Role *

Email *

Phone *

Product *

CONFIRMATION OF APPROPRIATE USE

Lilly's AMCP Dossiers are intended for those individuals who are actively working in a capacity where health care, formulary, and/or benefit designs are part of their role. This could include-but is not limited to-P&T committee members, clinical pharmacists reponsible for reviewing medications or managing formularies, and individuals who work with health plans to develop, implement, or advise on various benefit designs.
Lilly's AMCP Dossiers ARE NOT intended for physicians, pharmacists or patients seeking prescribing information.
Lilly's AMCP Dossiers ARE NOT intended for use by individuals representing or employed by pharmaceutical, biotechnology, medical device manufacturers, or other industries not directly involved in health benefit design and provision. Such individuals are not eligible to recieve Lilly's AMCP Dossiers.

I affirm that I am an appropriate user of Lilly's AMCP Dossier, as noted above.

For more information about Lilly's privacy practice, please view the Privacy Statement.

DO NOT USE THIS FORM TO REQUEST PRODUCT SAMPLES, EDUCATION MATERIALS, OR MEDICAL INFORMATION.

Copyright
Terms of Use
Privacy Statement
Consumer Health Privacy Notice
Accessibility Statement
Sitemap

Select a country

This site is intended for US Healthcare Professionals only.

Product names listed above are trademarks or registered trademarks owned by or licensed to Eli Lilly and Company, its subsidiaries, or affiliates

Your Privacy Choices

Cookie Settings