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xeljanz patient assistance application

by Earl Schneider Published 2 years ago Updated 1 year ago
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What is the coverage for Xeljanz?

XELJANZ is covered for 99% of commercially-insured, moderate to severe rheumatoid arthritis patients with a prescription. †‡ * The Pfizer Patient Assistance Program is a joint program of Pfizer Inc. and the Pfizer Patient Assistance Foundation™.

How do I apply for the xelsource Patient Assistance Program?

XELSOURCE Patient Assistance Program Application 1 PATIENT APPLICATION PFIZER PATIENT ASSISTANCE PROGRAM* Phone 1-844-935-5269 | Fax 1-866-297-3471 | 2730 S. Edmonds Lane, Suite 300, Lewisville TX 75067

How do I contact Xeljanz?

Phone 1-844-XELJANZ (1-844-935-5269) • Fax 1-866-297-3471 • 2730 S. Edmonds Lane, Suite 300, Lewisville, TX 75067 Patient Declaration– By signing below, I affirm that my answers and my proof-of-income documents are complete, true, and accurate to the best of my knowledge.

What is the Xeljanz+you support program?

The XELJANZ+YOU Support Program provides tools and information to help you take an active role in your treatment with XELJANZ/XELJANZ XR and better manage your disease. You’ll also receive a welcome kit in the mail. By completing this registration, you’ll also receive resources in the mail to help you understand how RA may be impacting you.

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How much is a 30 day supply of XELJANZ?

The cost for Xeljanz XR oral tablet, extended release 11 mg is around $5,487 for a supply of 30 tablets, depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans.

What is Pfizer patient assistance program?

Pfizer Patient Assistance Program Provides free Pfizer medicines to eligible patients through their doctor's office or at home.

How much does XELJANZ cost per month?

Xeljanz cost without insurance will vary depending on where you buy it. As a guide, Xeljanz oral solution (1 mg/mL) usually costs $4,350 for 240 milliliters. With NiceRx you will pay a flat monthly fee of $49, regardless of the retail price of your medication.

What is Xelsource?

Psoriatic Arthritis. • XELJANZ/XELJANZ XR (tofacitinib) is indicated for the treatment of adult patients with active psoriatic arthritis who have had an inadequate response or intolerance to methotrexate or other disease-modifying antirheumatic drugs (DMARDs).

How do you qualify for free eliquis?

You may be eligible for the Free 30-Day Trial Offer for ELIQUIS® (apixaban) if:You have not previously filled a prescription for ELIQUIS;You have a valid 30-day prescription for ELIQUIS;You are being treated with ELIQUIS for an FDA-approved indication that an HCP has planned for more than 35 days of treatment;More items...

How long does it take to be covered by Pfizer?

You may not be fully protected against COVID-19 until 7 to 14 days after your second dose. Some people who are severely immunocompromised are recommended to have a third dose as part of their primary course. Pfizer can be used for this third dose.

How long can you stay on Xeljanz?

Ulcerative Colitis Xeljanz 10 mg twice daily for at least eight weeks; then 5 mg twice daily. A higher dose of 10 mg twice daily can be continued for a total of 16 weeks, depending on response.

What can I take instead of Xeljanz?

There are currently no generic alternatives to Xeljanz in the United States. Fortunately, Natco Pharma, an Indian pharmaceutical company, launched a generic Xeljanz (tofacitinib) called Jaknat 5 mg recently, which can help you save up to 90%.

Is Xeljanz a high risk medication?

Initial safety trial results find increased risk of serious heart-related problems and cancer with arthritis and ulcerative colitis medicine Xeljanz, Xeljanz XR (tofacitinib) The FDA has issued new information about Xeljanz, Xeljanz XR (tofacitinib) and other Janus kinase (JAK) inhibitors.

Does tofacitinib cause hair loss?

Official answer. Hair loss is not a side effect of Xeljanz (tofacitinib citrate), according to the results of clinical trials used to gain approval of the drug. During clinical development, hair loss was not reported as an adverse effect.

What are side effects of Xeljanz?

Common side effects may include:skin rash, shingles;increased blood pressure;abnormal blood tests;fever;headache;nausea, vomiting, diarrhea; or.cold symptoms such as stuffy nose, sneezing, sore throat.

Is Xeljanz a biologic?

Xeljanz and Xeljanz XR (generic name: tofacitinib) are classified as a Janus kinase (JAK) inhibitor and Disease-Modifying Anti-Rheumatic Drug (DMARD). Xeljanz is not considered a true biologic, as it is made with traditional drug manufacturing techniques, but has side effects similar to the biologics.

What is Pfizer connect?

The Pfizer Patient Assistance Program provides certain medicines for free to eligible financially needy insured and uninsured patients.

What is Pfizer enCompass?

Pfizer enCompass offers various services to patients including reimbursement support for insured patients; co-pay assistance for eligible commercially insured patients who cannot afford their co-pays, co-insurances, or deductibles; and a free medicine patient assistance program for eligible uninsured or underinsured ...

Does Pfizer donate money?

Pfizer and the Pfizer Foundation provide coordinated support for disaster and humanitarian relief and recovery efforts around the world. This includes cash grants and product donations to organizations leading relief efforts, as well as employee donation matching and volunteer efforts.

What is Pfizer Oncology together?

Welcome to Pfizer Oncology Together, a program that offers you personalized support. We'll help you find resources for financial assistance and other day-to-day challenges you may be facing. Because when it comes to support, we're in this together.

What are the most common adverse reactions to Xeljanz?

The most commonly reported adverse reactions during the first 3 months in controlled clinical trials with XELJANZ 5 mg twice daily and placebo, respectively, (occurring in greater than or equal to 2% of patients treated with XELJANZ with or without DMARDs) were upper respiratory tract infections (4.5%, 3.3%), headache (4.3%, 2.1%), diarrhea (4.0%, 2.3%), and nasopharyngitis (3.8%, 2.8%).

What does XELJANZ XR look like?

When you take XELJANZ XR, you may see something in your stool that looks like a tablet. This is the empty shell from the tablet after the medicine has been absorbed by your body.

Can XELJANZ XR be administered with strictures?

Caution should be used when administering XELJANZ XR to patients with pre-existing severe gastrointestinal narrowing. There have been rare reports of obstructive symptoms in patients with known strictures in association with the in gestion of other drugs utilizing a non-deformable extended release formulation.

Does XELJANZ inhibit gastrointestinal perforation?

Gastrointestinal perforations have been reported in XELJANZ clinical trials, although the role of JAK inhibition is not known. XELJANZ/XELJANZ XR should be used with caution in patients who may be at increased risk for gastrointestinal perforation (e.g., patients with a history of diverticulitis).

Can Xeljanz cause TB?

XELJANZ/XELJANZ XR may cause serious side effects, including:Serious infections. XELJANZ/XELJANZ XR can lower the ability of your immune system to fight infections. Some people can have serious infections while taking XELJANZ/XELJANZ XR, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Your healthcare provider should test you for TB before starting and during XELJANZ/XELJANZ XR treatment, and monitor you closely for signs and symptoms of TB infection during treatment. You should not start taking XELJANZ/XELJANZ XR if you have any kind of infection unless your healthcare provider tells you it is okay.

Is tofacitinib safe for pregnant women?

There are no adequate and well-controlled studies in pregnant women and the estimated background risks of major birth defects and miscarriage for the indicated population is unknown. Based on animal studies, tofacitinib has the potential to affect a developing fetus. Women of reproductive potential should be advised to use effective contraception.

What is Xeljanz used for?

XELJANZ (tofacitinib) is the first and only pill of its kind (JAK inhibitor) that treats adults with moderate to severe rheumatoid arthritis, active psoriatic arthritis, and moderate to severe ulcerative colitis. Getting Started With XELJANZ. I'm Ready To Talk.

How does Xeljanz work?

How XELJANZ Works. XELJANZ is a Janus kinase (JAK) inhibitor that helps disrupt JAK pathways from inside the cells, which are believed to play a role in inflammation. Watch to learn more about the science of XELJANZ and how JAK inhibitors are thought to work. Video Player is loading. Play Video.

When was Xeljanz approved?

XELJANZ has been prescribed for more than 8 years, since initial approval in 2012, for adults with moderate to severe rheumatoid arthritis. XELJANZ was approved to treat adults with active psoriatic arthritis in 2017 and adults with moderate to severe ulcerative colitis in 2018.

What is XELJANZ support?

The XELJANZ+YOU Support Program provides tools and information to help you take an active role in your treatment with XELJANZ/XELJANZ XR and better manage your disease. You’ll also receive a welcome kit in the mail.

What to tell your healthcare provider before taking Xeljanz?

Before you use XELJANZ, tell your healthcare provider if you: Are being treated for an infection, have an infection that won’t go away or keeps coming back, or think you have symptoms of an infection.

What are the side effects of Xeljanz?

Shortness of breath. Weight loss. Diarrhea or stomach pain. Feeling very tired. Increased risk of death in people 50 years of age and older with rheumatoid arthritis who have at least 1 heart disease (cardiovascular) risk factor and who are taking a higher than recommended dose of XELJANZ/XELJANZ XR.

Does Xeljanz cause cancer?

Cancer. XELJANZ may increase your risk of certain cancers by changing the way your immune system works. Lymphoma and other cancers, including skin cancers, can happen. Tell your healthcare provider if you have ever had any type of cancer.

Does Xeljanz affect pregnancy?

XELJANZ may affect the ability of females to get pregnant. It is not known if this will change after stopping XELJANZ. It is not known if XELJANZ will harm an unborn baby.

Can Xeljanz cause tears?

Tell your healthcare provider if you have had diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines. Some people taking XELJANZ can get tears in their stomach or intestine.

Is Xeljanz XR a high risk drug?

Higher dose. People taking the higher dose of XELJANZ (10 mg twice daily) or XELJANZ XR (22 mg one time each day) have a higher risk of serious infections, shingles, or skin cancers. Immune System Problem.

What is Xeljanz used for?

XELJANZ® (tofacitinib citrate) is indicated for the treatment of adult patients with moderately to severely active rheumatoid arthritis who have had an inadequate response or intolerance to methotrexate. It may be used as monotherapy or in combination with methotrexate or other nonbiologic disease-modifying antirheumatic drugs (DMARDs).

What are the most common adverse reactions to Xeljanz?

The most commonly reported adverse reactions during the first 3 months in controlled clinical trials with XELJANZ 5 mg twice daily and placebo, respectively, (occurring in greater than or equal to 2% of patients treated with XELJANZ with or without DMARDs) were upper respiratory tract infections (4.5%, 3.3%), headache (4.3%, 2.1%), diarrhea (4.0%, 2.3%), and nasopharyngitis (3.8%, 2.8%).

What is an attached authorization?

The attached Authorization, when signed by your patient, documents the patient’s permission for you to share certain medical and personal information with Pfizer in connection with Pfizer’s patient assistance programs. This Authorization is strictly for your records and should not be returned with your patient’s application.

What infections are associated with Xeljanz?

The most common serious infections reported with XELJANZ included pneumonia, cellulitis, herpes zoster, and urinary tract infection . Avoid use of XELJANZ in patients with an active, serious infection, including localized infections. Consider the risks and benefits of treatment before initiating XELJANZ in patients:

Can Xeljanz cause TB?

Serious infections. XELJANZ can lower the ability of your immune system to fight infections. Some people have serious infections while taking XELJANZ, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Your healthcare provider should test you for TB before starting XELJANZ, and monitor you closely for signs and symptoms of TB infection during treatment. You should not start taking XELJANZ if you have any kind of infection unless your healthcare provider tells you it is okay.Before starting XELJANZ, tell your healthcare provider if you:

What is XELSOURCE support?

Use XELSOURCE support programs to help your eligible patients receive their XELJANZ treatment after a prescribing decision is made.

What setting of care must a patient be treated in?

Patient must be treated in the outpatient setting of care.

Is the offer valid for cash paying patients?

Patient must have private insurance. Offer is not valid for cash-paying patients.

Does interim care require purchase?

Interim Care Rx offer does not require, nor will be made contingent on, purchase requirements of any kind.

How to contact XELSOURCE?

Commercial patients prescribed XELJANZ or XELJANZ XR should call XELSOURCE at 1-844-935-5269 to determine if they qualify for a Co-Pay Savings Card. Terms and conditions can be accessed here.

How to speak with someone at XELSOURCE?

To speak with someone at XELSOURCE about your insurance coverage and medication costs for XELJANZ or XELJANZ XR , call 1-844-935-5269 and say “Representative.”. XELJANZ is covered for 98% of commercially-insured, moderate to severe rheumatoid arthritis patients with a prescription. †‡.

How to receive XSAVINGS?

Elect to receive one via text message by texting “XPROGRAM” to 50336 and enrolling in the XSAVINGS Co-Pay Program for XELJANZ. †

Can you save on Xeljanz?

Savings may be just a phone call away. If you have a financial hardship and you’ve been prescribed XELJANZ or XELJANZ XR, call XELSOURCE to learn how you may be able to save on your XELJANZ prescription. See below for details. Terms and conditions/eligibility requirements apply.

Can you get XELJANZ if you don't have insurance?

If turned down, we will evaluate you for the Pfizer Patient Assistance Program. If you are eligible, we will provide you XELJANZ or XELJANZ XR at no cost to you. See limits, terms, and conditions.

Can XELSOURCE change your health insurance?

Health plans can change—so can your health insurance and prescription benefits. Once your new plan begins, XELSOURCE can help review your plan information, verify your coverage if needed, and assist with the Prior Authorization (PA) process.

Can you switch from Xeljanz to XR?

When switching from XELJANZ to once-daily XELJANZ XR, additional approvals may not be required. For more information, check with your insurance provider.

What is the phone number for Xeljanz?

If you have questions, concerns, or comments, please call our XELJANZ Information Center toll-free at 1-844-935-5269 Monday through Friday, 8:00 AM–8:00 PM ET.

What is Xeljanz oral solution used for?

XELJANZ/XELJANZ Oral Solution is used to treat patients 2 years of age and older with active polyarticular juvenile arthritis.

What are the risks of Xeljanz?

Feeling very tired. Increased risk of death in people 50 years of age and older with rheumatoid arthritis who have at least 1 heart disease (cardiovascular) risk factor and who are taking a higher than recommended dose of XELJANZ/XELJANZ XR.

Does Xeljanz cause cancer?

Cancer. XELJANZ may increase your risk of certain cancers by changing the way your immune system works. Lymphoma and other cancers, including skin cancers, can happen. Tell your healthcare provider if you have ever had any type of cancer.

Can Xeljanz cause tears?

Tell your healthcare provider if you have had diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines. Some people taking XELJANZ can get tears in their stomach or intestine.

Can you take Xeljanz if you have an infection?

XELJANZ can lower the ability of your immune system to fight infections. Do not start taking XELJANZ if you have any kind of infection unless your healthcare provider tells you it is okay. Serious Infections have happened in people taking XELJANZ.

Can you breastfeed while taking Xeljanz?

You and your healthcare provider should decide if you will take XELJANZ or breastfeed. You should not do both.

What are the most common adverse reactions to Xeljanz?

The most common serious adverse reactions were serious infections. The most commonly reported adverse reactions during the first 3 months in controlled clinical trials in patients with rheumatoid arthritis (RA) with XELJANZ 5 mg twice daily and placebo, respectively, (occurring in greater than or equal to 2% of patients treated with XELJANZ with or without DMARDs) were upper respiratory tract infection, nasopharyngitis, diarrhea, headache, and hypertension. The safety profile observed in patients with active psoriatic arthritis treated with XELJANZ was consistent with the safety profile observed in RA patients.

What are the side effects of Xeljanz?

Your healthcare provider may do blood tests before you start treatment with XELJANZ/XELJANZ XR and while you are using XELJANZ/XELJANZ XR. Tell your healthcare provider if you have any of the following symptoms of a possible hepatitis B or C infection: feel very tired, little or no appetite, clay-colored bowel movements, chills, muscle aches, skin rash, skin or eyes look yellow, vomiting, fevers, stomach discomfort, or dark urine.Common side effects of XELJANZ/XELJANZ XR in rheumatoid arthritis and psoriatic arthritis patients include upper respiratory tract infections (common cold, sinus infections), headache, diarrhea, nasal congestion, sore throat, and runny nose (nasopharyngitis), and high blood pressure (hypertension).

What is XELJANZ XR?

XELJANZ/XELJANZ XR (tofacitinib) is indicated for the treatment of adult patients with active psoriatic arthritis who have had an inadequate response or intolerance to methotrexate or other disease-modifying antirheumatic drugs (DMARDs).

Can you take Xeljanz twice daily?

Use of XELJANZ/XELJANZ XR in patients with severe hepatic impairment is not recommended.For patients with moderate hepatic impairment or with moderate or severe renal impairment taking XELJANZ 5 mg twice daily, reduce to XELJANZ 5 mg once daily.For UC patients with moderate hepatic impairment or with moderate or severe renal impairment taking XELJANZ 10 mg twice daily, reduce to XELJANZ 5 mg twice daily.

Can XELJANZ XR be administered with strictures?

Caution should be used when administering XELJANZ XR to patients with pre-existing severe gastrointestinal narrowing. There have been rare reports of obstructive symptoms in patients with known strictures in association with the in gestion of other drugs utilizing a non-deformable extended release formulation.

Can XELJANZ cause death?

Patients treated with XELJANZ/XELJANZ XR are at increased risk for developing serious infections that may lead to hospitalization or death. Most patients who developed these infections were taking concomitant immunosuppressants, such as methotrexate or corticosteroids.

Is Xeljanz XR safe for pregnancy?

Available data with XELJANZ/XELJANZ XR use in pregnant women are insufficient to establish a drug associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes. There are risks to the mother and the fetus associated with rheumatoid arthritis and UC in pregnancy. In animal studies, tofacitinib at 6.3 times the maximum recommended dose of 10 mg twice daily demonstrated adverse embryo-fetal findings. The relevance of these findings to women of childbearing potential is uncertain. Consider pregnancy planning and prevention for females of reproductive potential.

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