How do I apply for the Xeljanz Patient Assistance Program?
XELSOURCE Patient Assistance Program Application 1 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 Xeljanz used to treat?
IndicationsRheumatoid Arthritis XELJANZ®/XELJANZ® XR (tofacitinib) is indicated for the treatment of adult patients with moderately to severely active rheumatoid arthritis (RA) who have had an inadequate response or intolerance to one or more TNF blockers.
When should anti-TB therapy be considered prior to administration of Xeljanz XR?
Consider anti-TB therapy prior to administration of XELJANZ/XELJANZ XR in patients with a past history of latent or active TB in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent TB but who have risk factors for TB infection.
Is Interim Care Rx available for Xeljanz patients?
Contact XELSOURCE for details. Interim Care Rx is not health insurance and is available for eligible, commercially insured patients only. Offer is only available to patients who have been diagnosed with an FDA-approved indication for XELJANZ.
How to speak with someone at XELSOURCE?
How to contact XELSOURCE?
What is the phone number for Xeljanz?
Can you switch from Xeljanz to XR?
Can you save on Xeljanz?
How to receive XSAVINGS?
Can you get XELJANZ if you don't have insurance?
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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....Oral Tablet, Extended Release.QuantityPer unitPrice30$182.90$5,486.86
What is the cost of XELJANZ 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 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 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.
How long can you stay on Xeljanz?
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.
Can you take Xeljanz long term?
Additionally, Xeljanz is used in certain children with juvenile idiopathic arthritis. If Xeljanz or Xeljanz XR works for you, your doctor may recommend the medication as a long-term treatment option.
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.
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 there a substitute for Xeljanz?
There are currently no generic alternatives to Xeljanz.
What drug is similar to Xeljanz?
Xeljanz, Humira, and Enbrel are all similarly effective options for treating rheumatoid arthritis when methotrexate isn't working well enough on its own.
Is Xeljanz cheaper than Humira?
The report also made an indirect comparison between Xeljanz and Humira indicating that “a price much higher than [Humira] may not be justified.” It estimated a $36,000 net price for Xeljanz.
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 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%.
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.
Xeljanz Prices, Coupons, Copay & Patient Assistance - Drugs.com
Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include IBM Watson Micromedex (updated 1 Sep 2022), Cerner Multum™ (updated 21 Sep 2022), ASHP (updated 12 Sep 2022 ...
Co-Pay Savings Card | XELJANZ® (tofacitinib) | Safety Info
On Friday, December 3, 2021, the U.S. Food and Drug Administration (FDA) updated the XELJANZ full prescribing information. Pfizer issued a media statement announcing that the U.S. full prescribing information for XELJANZ ® (tofacitinib) has been updated based on the U.S. FDA’s completed review of the ORAL Surveillance trial, a post-marketing required safety study.
Does Medicare Cover Xeljanz? | Medicare Prescription Drug Coverage
Does Medicare cover Xeljanz? Yes! 69% of Medicare Advantage plans and Medicare Part D plans cover Xeljanz. 1 Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD).Most Medicare Advantage beneficiaries (88 percent) are enrolled in MA-PDs. 2Medicare prescription drugs plans each have their own formulary, or drug list, that ...
PATIENT ASSISTANCE APPLICATION FOR XELJANZ® (tofacitinib ... - RxHope
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. I understand that: • Completing this application form does not guarantee that I will qualify
Xeljanz Medicare Coverage and Co-Pay Details - GoodRx
Xeljanz (Tofacitinib) is an expensive drug that works on the immune system. This medicine is used to treat rheumatoid arthritis and psoriatic arthritis.It is also used to treat ulcerative colitis.This drug is more popular than comparable drugs.
XELSOURCE Patient Assistance Program Application - Pfizer pro
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
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 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 help with kidney transplant rejection?
Immune System Problem. Some people who have taken XELJANZ with certain other medicines to prevent kidney transplant rejection have had a problem with certain white blood cells growing out of control (Epstein Barr Virus–associated post-transplant lymphoproliferative disorder).
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.
What are the risks of getting TB?
Have diabetes, chronic lung disease, HIV, or a weak immune system. People with these conditions have a higher chance for infections.
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.
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 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.
Can you claim reimbursement for a prescription?
No claim for reimbursement or credit for any costs associated with the medicine (s) may be submitted to any prescription insurance provider or payer, including Medicare Part D plans.
Can you use a Medicare card in Puerto Rico?
Patients are not eligible to use the Card if they are enrolled in a state- or federally funded insurance program, including but not limited to Medicare, Medicaid, TRICARE, Veterans Affairs health care, a state prescription drug assistance program, or the Government Health Insurance Plan available in Puerto Rico (formerly known as “La Reforma de Salud”).
Is Pfizer a health insurance?
The Pfizer Patient Assistance Program is not health insurance and is available for eligible uninsured/underinsured patients only.
Can Pfizer revoke a program?
Pfizer reserves the right to rescind, revoke, or amend the program without notice.
Is a prescription card valid for insurance?
This Card is not valid when the entire cost of your prescription drug is eligible to be reimbursed by your private insurance plan or other private health or pharmacy benefit programs.
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.
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.
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.
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 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 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:
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).
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 Xeljanz oral solution?
XELJANZ/XELJANZ Oral Solution is indicated for the treatment of active polyarticular course juvenile idiopathic arthritis (pcJIA) in patients 2 years of age and older.
What infections can Xeljanz cause?
The most common serious infections reported with XELJANZ included pneumonia, cellulitis, herpes zoster, urinary tract infection, diverticulitis, and appendicitis. Avoid use of XELJANZ in patients with an active, serious infection, including localized infections, or with chronic or recurrent infection.
What are the adverse reactions to Xeljanz?
Adverse reactions reported in ≥5% of patients treated with either 5 mg or 10 mg twice daily of XELJANZ and ≥1% greater than reported in patients receiving placebo in either the induction or maintenance clinical trials for UC were: nasopharyngitis, elevated cholesterol levels, headache, upper respiratory tract infection, increased blood creatine phosphokinase, rash, diarrhea, and herpes zoster.
How often should you monitor hemoglobin levels after Xeljanz?
Monitor hemoglobin at baseline and after 4-8 weeks of treatment and every 3 months thereafter.
Can Xeljanz be used for hepatic impairment?
Use of XELJANZ in patients with severe hepatic impairment is not recommended.
Does Xeljanz cause liver enzyme elevation?
Liver Enzyme Elevations: Treatment with XELJANZ was associated with an increased incidence of liver enzyme elevation compared to placebo. Most of these abnormalities occurred in studies with background DMARD (primarily methotrexate) therapy. If drug-induced liver injury is suspected, the administration of XELJANZ should be interrupted until this diagnosis has been excluded. Routine monitoring of liver tests and prompt investigation of the causes of liver enzyme elevations is recommended to identify potential cases of drug-induced liver injury.
Does Xeljanz have gastrointestinal perforations?
Gastrointestinal perforations have been reported in XELJANZ clinical trials, although the role of JAK inhibition is not known . In these studies, many patients with rheumatoid arthritis were receiving background therapy with Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). There was no discernable difference in frequency of gastrointestinal perforation between the placebo and the XELJANZ arms in clinical trials of patients with UC, and many of them were receiving background corticosteroids. XELJANZ should be used with caution in patients who may be at increased risk for gastrointestinal perforation (e.g., patients with a history of diverticulitis or taking NSAIDs).
Is Prescription Hope A Xeljanz Discount Coupon Card, Generic, Or Insurance Product?
Prescription Hope is not a Xeljanz coupon card or insurance policy. This is also not a Xeljanz Generic. Prescription Hope is a complimentary program that works alongside any coverage you may currently have.When you obtain your medications from Prescription Hope, your total will never cost more than $50.00 per month for each medication. If we cannot help you obtain a prescription medication, we will never charge a fee for that medication.
Can Prescription Hope Help Me Obtain My Other Medications?
As a national advocacy program, Prescription Hope works directly with over 180 U.S. based pharmaceutical manufacturers patient assistance programs to obtain over 1,500 FDA-approved prescription medications, including the top-100 prescribed medications in America. Visit our website to see our full list of medications and fill out an application to get started.
What is Xeljanz used for?
Xeljanz is a medication that works on the immune system and is used to treat moderately to severely active rheumatoid arthritis. Xeljanz can also be used to treat active psoriatic arthritis and moderate to severe ulcerative colitis.Important Safety Information & Side Effects
What is prescription hope?
Prescription Hope is a service-based company that offers access to FREE brand-name medication through patient assistance programs.Prescription Hope charges a service fee of $50 a month for each medication accessed through patient assistance programs to manage medication orders and refills.There are no other costs, fees, deductibles, or copays associated with the Prescription Hope service.Prescription Hope is not an insurance product, coupon card, discount program, or pharmacy.Prescription Hope is a service that helps you manage patient assistance programs. We do not manufacture, store, or ship medications.Our medication list includes the top-100 prescribed medications offered by U.S. based pharmaceutical manufacturers. Create your account to fill out a free enrollment form today!
How long does it take for a prescription to arrive?
Once your application is approved, the first shipment of prescription medication typically arrives within four to six weeks.
How much does prescription hope cost?
Prescription Hope works with thousands of Americans every month, obtaining prescription medications on their behalf for the set price of $50.00 per month per medication.The income guidelines to qualify for Prescription Hope are as follows; An individual earning up to or around $30,000 per year.
How do you know if you have a blood clot?
If you begin having signs of a blood clot, then tell your doctor right away. These signs may consist of chest pain, swelling of leg or arm, problems breathing, and discoloration of the leg or arm. Blood clots in the lungs, veins of legs, and arteries have happened more often in patients that have rheumatoid arthritis and are 50 years of age or older.
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 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.
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.”.
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.
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.
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 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.
