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.
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.
How do I apply for the Pfizer Patient Assistance Program?
PATIENT APPLICATION Phone 1-844-XELJANZ (1-844-935-5269) • Fax 1-866-297-3471 • 2730 S. Edmonds Lane, Suite 300, Lewisville, TX 75067 Please complete the form where applicable and return via mail or fax. Pages 1 and 3 must be returned to XELSOURCE. Check here if reapplying for the Pfizer Patient Assistance Program.
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?
Pfizer Patient Assistance Program Provides free Pfizer medicines to eligible patients through their doctor's office or at home.
Does Organon have a patient assistance program?
The Organon Co-pay Assistance Program offers assistance to eligible, privately insured patients who need help affording their medication. For product-specific information, please visit your medication website.
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 connect?
The Pfizer Patient Assistance Program provides certain medicines for free to eligible financially needy insured and uninsured patients.
How can I get a free inhaler?
Prescription assistance programs (PAPs) are designed to provide inhalers and other asthma drugs free of charge or at a highly discounted price to lower-income individuals and families. Copay assistance programs (CAPs) cover a portion of drug copay costs for people with health insurance.
How do I get help from Jardiance?
For more information and to find out if you're eligible for support, visit the program website or call 866-279-8990. If you have Medicare and you're having trouble paying for Jardiance, you may qualify for an assistance program. For details, visit this website or call 800-556-8317.
What is harmony by Organon?
The HARMONY BY ORGANON Patient Support Program provides support services, including coordination with private payers (for patients taking Renflexis, Brenzys or Hadlima) and infusion centres (for patients taking Renflexis).
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 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 ...
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.
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.
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.
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.
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).
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).
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.
