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xeljanz patient assistance application 2020

by Cristal Berge 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.

How often can you take Xeljanz XR?

Use of XELJANZ/XELJANZ XR in patients with severe hepatic impairment is not recommended. The recommended dose in patients with moderate hepatic impairment or with moderate or severe renal impairment is XELJANZ 5 mg once daily.

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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 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 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.

How much does XELJANZ cost per year?

Xeljanz costs around $6,156.08 but luckily you can reduce the price of Xeljanz to $4,416.01 for 1, 60 Tablets Tablet by using our SingleCare coupons. Talk to your pharmacist about using SingleCare free coupons at checkout.

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 drug class is Xeljanz?

It belongs to a class of drugs called Janus kinase inhibitors. These drugs help to decrease inflammation in your body. Xeljanz comes as a tablet and solution that's taken by mouth. You'll take it either once or twice a day, depending on the form of the drug your doctor prescribes.

When will there be a generic Xeljanz?

The United States and Japan will most likely be the first major markets with a Xeljanz generic, in 2026. A generic in the EU5 will follow as early as 2027, although additional market protections could occur if Xeljanz launches in a new indication where it brings significant clinical benefit over existing therapies.

Does Xeljanz cause hair growth?

Researchers found that more than 50 percent of 66 patients treated with the drug Xeljanz (tofacitinib citrate) saw hair regrowth in three months.

What is the success rate of Xeljanz?

After eight weeks, 18.5% of the patients with ulcerative colitis receiving Xeljanz, 10 mg twice a day, achieved remission. This was in comparison to a remission rate of 8.2% in those who received the placebo.

Can you drink alcohol with Xeljanz?

by Drugs.com Although the manufacturer of Xeljanz, Pfizer, does not warn of an interaction between alcohol and Xeljanz, you should not drink excessive amounts of alcohol while you are taking Xeljanz because both are metabolized by the liver and can cause liver damage.

How much is a bottle of Xeljanz?

It works on the immune system. It belongs to a group of medicines called JAK inhibitors. The lowest GoodRx price for the most common version of Xeljanz XR is around $5,063.68, 34% off the average retail price of $7,749.12. Compare kinase inhibitors.

What is the generic name for Xeljanz?

Generic Name: tofacitinib Tofacitinib is used to treat certain types of arthritis (such as psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis, polyarticular course juvenile idiopathic arthritis-pcJIA).

How much does a bottle of Xeljanz cost?

The cost for Xeljanz oral solution (1 mg/mL) is around $4,391 for a supply of 240 milliliters, depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans.

What is the safest drug for rheumatoid arthritis?

Methotrexate is widely regarded as one of the safest of all arthritis drugs, though it carries some potential downsides. Gastrointestinal symptoms such as nausea and vomiting are its most frequent side effects.

What is the generic name for Xeljanz?

Generic Name: tofacitinib Tofacitinib is used to treat certain types of arthritis (such as psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis, polyarticular course juvenile idiopathic arthritis-pcJIA).

Does Xeljanz cause weight loss?

No, Xeljanz and Xeljanz XR don't lead to weight gain or weight loss. But serious side effects of these drugs or your condition itself may cause unexplained weight loss. For example, weight loss can be seen with diarrhea, serious infection, and cancer.

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 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.

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 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.

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:

When was Xeljanz approved?from xeljanz.com

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 used for?from rxhope.com

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 to speak with someone at XELSOURCE?from xeljanz.com

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 contact XELSOURCE?from xeljanz.com

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.

What is XELSOURCE support?from xeljanz.pfizerpro.com

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

What is an attached authorization?from rxhope.com

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 are the most common adverse reactions to Xeljanz?from pfizerpro.com

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 Pfizer Patient Assistance Program?from pfizerrxpathways.com

Pfizer Patient Assistance Program. Provides free Pfizer medicines to eligible patients through their doctor’s office or at home. To qualify, patients must: Have a valid prescription for the Pfizer medicine for which they are seeking assistance. Have no prescription coverage, or not enough coverage, to pay for their Pfizer medicine.

How to contact Pfizer Rxpathways?from pfizerrxpathways.com

For more information about Pfizer RxPathways, please visit www.PfizerRxPathways.com. Patients can also call the toll-free phone number 1-844-989-PATH (7284) to consult with a Pfizer Medicine Access Counselor.

How many Pfizer medicines are free?from pfizerrxpathways.com

The Pfizer Patient Assistance Program provides more than 60 Pfizer medicines for free to eligible patients through their doctor’s office, or in some cases, through home delivery.

How to be evaluated for Pfizer?from pfizerrxpathways.com

To be evaluated for assistance, patients and their healthcare providers must submit a completed enrollment form. Patients must also provide proof of income, such as a W2 form, a paycheck stub, or prior year’s tax return. In some cases, patients prescribed certain Pfizer medicines may first be required to seek alternate forms of assistance before they can be considered for free medicine through the Pfizer Patient Assistance Program.

What is RX Outreach?from pfizerrxpathways.com

Rx Outreach – A nonprofit charitable organization that provides eligible patients with access to more than 500 medications at an affordable cost. To learn more, go to www.rxoutreach.org

Is Pfizer still available to uninsured patients?from pfizerrxpathways.com

Pfizer medicines that have lost their patent exclusivity and have reasonably priced, multisource generic alternatives (costing $30 or less for a 30-day supply) are no longer offered for free through Pfizer’s Patient Assistance Program. They are , however, still being made available to uninsured patients through the Pfizer Savings Program.

Does Pfizer have a copay?from pfizerrxpathways.com

Pfizer provides access to co-pay and savings cards to help eligible patients save on a variety of brand-name medicines, regardless of their income.

How to contact Pfizer Rxpathways?from pfizerrxpathways.com

For more information about Pfizer RxPathways, please visit www.PfizerRxPathways.com. Patients can also call the toll-free phone number 1-844-989-PATH (7284) to consult with a Pfizer Medicine Access Counselor.

What is RX Outreach?from pfizerrxpathways.com

Rx Outreach – A nonprofit charitable organization that provides eligible patients with access to more than 500 medications at an affordable cost. To learn more, go to www.rxoutreach.org

How many Pfizer medicines are free?from pfizerrxpathways.com

The Pfizer Patient Assistance Program provides more than 60 Pfizer medicines for free to eligible patients through their doctor’s office, or in some cases, through home delivery.

How to be evaluated for Pfizer?from pfizerrxpathways.com

To be evaluated for assistance, patients and their healthcare providers must submit a completed enrollment form. Patients must also provide proof of income, such as a W2 form, a paycheck stub, or prior year’s tax return. In some cases, patients prescribed certain Pfizer medicines may first be required to seek alternate forms of assistance before they can be considered for free medicine through the Pfizer Patient Assistance Program.

Is Pfizer still available to uninsured patients?from pfizerrxpathways.com

Pfizer medicines that have lost their patent exclusivity and have reasonably priced, multisource generic alternatives (costing $30 or less for a 30-day supply) are no longer offered for free through Pfizer’s Patient Assistance Program. They are , however, still being made available to uninsured patients through the Pfizer Savings Program.

Does Pfizer have a copay?from pfizerrxpathways.com

Pfizer provides access to co-pay and savings cards to help eligible patients save on a variety of brand-name medicines, regardless of their income.

Does Pfizer have a support program?from pfizerrxpathways.com

Some Pfizer medicines have support programs designed just for their patients. Select a medicine to learn more.

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.

What is the phone number for Xeljanz?

To speak to someone at XELSOURCE about your insurance coverage and medication costs for XELJANZ or XELJANZ XR, Monday through Friday, 8:00 AM - 8:00 PM ET, call 1-844-935-5269 and say “Representative.”.

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 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.

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