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xelsource patient assistance application 2020 pdf

by Jordyn Dietrich Published 2 years ago Updated 1 year ago
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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 the Pfizer Patient Assistance Program?

The Pfizer Patient Assistance Program is a joint program of Pfizer Inc. and the Pfizer Patient Assistance Foundation Inc. The Pfizer Patient Assistance Foundation is a separate legal entity from Pfizer Inc., with distinct legal restrictions.

How do I enroll patients in xelsource HCP?

​​​​​​Contact your Pfizer Representative to be put in touch with your FRM See how the XELSOURCE HCP Portal streamlines the enrollment processFind out more about XELSOURCEForms and resources to help eligible patients access their prescribed medicationXELSOURCE Prescription and Enrollment Form Complete, print, and fax to enroll patients in XELSOURCE.

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.

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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).

What is Pfizer patient assistance program?

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

How do I get Rinvoq?

Just give us a call at 1.800. 2RINVOQ (1.800. 274.6867). Eligibility: Available to patients with commercial prescription insurance coverage for RINVOQ™ (upadacitinib) who meet eligibility criteria.

What is patient Assistance Program Canada?

PAPs offer trained staff members who help patients investigate their available coverage options. With access to a private infusion clinic, private drug plans may cover the drug but may require the patient to pay co-insurance.

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...

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 ...

Is Rinvoq an expensive drug?

The list price, also known as the Wholesale Acquisition Cost (WAC), for a 30-day supply of RINVOQ, is $5,671.26 as of January 2022. The WAC may not reflect the price paid by patients. Call 1-800-2RINVOQ (1-800-274-6867) to find out how much RINVOQ will cost for you.

When will there be a generic for Rinvoq?

Rinvoq will be eligible for patent challenges on August 16, 2023. This date may extended up to six months if a pediatric exclusivity extension is applied to the drug's patents. By analyzing the patents and regulatory protections it appears that the earliest date for generic entry will be October 17, 2036.

Is there a generic for Rinvoq?

No. There is currently no therapeutically equivalent version of Rinvoq available in the United States. Note: Fraudulent online pharmacies may attempt to sell an illegal generic version of Rinvoq. These medications may be counterfeit and potentially unsafe.

How does a patient support program work?

A patient assistance or support programs (PAPs or PSPs) exist to get you timely access to medication and to help you stay on track of your therapy. Being diagnosed with a complex disease or condition may come with unexpected financial burden and a need to better understand treatment options and next steps.

How do I get free prescriptions in Canada?

Under the Canada Health Act, prescription drugs administered in Canadian hospitals are provided at no cost to the patient. Outside of the hospital setting, provincial and territorial governments are responsible for the administration of their own publicly-funded drug plans.

What is patient assist?

Pharmaceutical manufacturers may sponsor patient assistance programs (PAPs) that provide financial assistance or drug free product (through in-kind product donations) to low income individuals to augment any existing prescription drug coverage.

What is Pfizer Oncology together?

Pfizer Oncology Together is a personalized patient support program that offers resources for patients prescribed Pfizer Oncology medicines. We provide access and reimbursement support, as well as help identifying financial assistance options, so patients can get their prescribed Pfizer Oncology medicines.

Does Viatris have a patient assistance program?

The Viatris Patient Assistance Program provides certain medicines for free to patients with demonstrated financial need. Viatris is committed to helping patients get the treatments they need, when and where they need them.

Does Chantix have a patient assistance program?

Uninsured, low income patients may be able to get Chantix for free with the Pfizer Patient Assistance Program (PAP). How much can I save? Your prescription may be free if you qualify.

Does Pfizer make metoprolol?

metoprolol tartrate injection, USP - VIAL | Pfizer Medical Information - US.

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 combine a prescription card with a savings card?

The Card cannot be combined with any other savings, free trial, or similar offer for the specified prescription.

Does interim care require purchase?

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

Is the offer valid for cash paying patients?

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

Is Pfizer a health insurance?

The Pfizer Patient Assistance Program is not health insurance and is available for eligible uninsured/underinsured patients only.

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