To request free of charge medicine under the specific terms and conditions within the ‘free of charge licenced medicine supply trust agreement’ please download the free of charge supply request form.
Ibrance free of charge supply is now closed to new patients. However, the request form can be used to order re-supply of medicine for patients already registered for the programme.

Please ensure all relevant fields are completed, then sign and return via email to [email protected] or alternatively fax to (+44) 01304 646 737.

Ibrance^® SmPC
Ibrance^® Prescribing Information 

PP-IBR-GBR-2299. March 2020