Patient-Helpdesk.com

xelsource patient assistance form

by Mr. Morton Terry IV Published 2 years ago Updated 1 year ago
image

How do I send a prescription to xelsource?

Prescription & Enrollment Formto XELSOURCE at 1-866-297-3471 EHR Complete a Prescription & Enrollment Form through your Electronic Health Record (EHR)* and send to XELSOURCE A link to enroll patients appears in the EHR during the e-prescribing process.

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 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.

How do I send a prescription to sonexus health pharmacy?

Send to: Sonexus Health Pharmacy Services, 2730 S. Edmonds Lane #400, Lewisville, TX 75067 (NCPDP: 5910206; NPI: 1447680210) Fax Fax a completed Prescription & Enrollment Formto XELSOURCE at 1-866-297-3471 EHR Complete a Prescription & Enrollment Form through your Electronic Health Record (EHR)* and send to XELSOURCE

image

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.

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 does XELJANZ treat?

XELJANZ (tofacitinib) is the first approved pill of its kind (JAK inhibitor) that treats adults with moderate to severe rheumatoid arthritis, active psoriatic arthritis, active ankylosing spondylitis, and moderate to severe ulcerative colitis.

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.

Is Rinvoq an expensive drug?

About Rinvoq It is also used to treat ulcerative colitis. It works on the immune system. It belongs to a group of medications called JAK inhibitors. The lowest GoodRx price for the most common version of Rinvoq is around $5,520.10, 43% off the average retail price of $9,739.01.

Does Rinvoq cause weight gain?

Is weight gain a side effect of Rinvoq? It's possible for weight gain to occur with Rinvoq. This wasn't reported in clinical trials of people with rheumatoid arthritis (RA) or psoriatic arthritis. However, it was a rare side effect in people with atopic dermatitis, which is also known as eczema.

When will Rinvoq be generic?

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.

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.

Who should not take Xeljanz?

chronic kidney disease stage 4 (severe) chronic kidney disease stage 5 (failure) kidney disease with likely reduction in kidney function. an increased risk of developing an uncommon viral infection called an opportunistic infection.

Can you stop Xeljanz cold turkey?

You should not stop taking Xeljanz without consulting your doctor. Stopping treatment with Xeljanz may cause the symptoms of your condition to return. However, some patients are able to stop Xeljanz without their symptoms flaring up, according to the results of research conducted in patients with rheumatoid arthritis.

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.

Is Pfizer a health insurance?

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

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.

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.

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.

image
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z 1 2 3 4 5 6 7 8 9