Co-pay, access, and patient support

Co-pay assistance
Pfizer Oncology Together Co-Pay Savings Program
Eligible, commercially insured patients may pay as little as $0 per month for BOSULIF. Limits, terms, and conditions apply.
For more information, visit PfizerOncologyTogether.com/HCP or direct your patients to PfizerOncologyTogether.com/Patient
Terms and Conditions
By using this co-pay card, you acknowledge that you currently meet the eligibility criteria and will comply with the Terms and Conditions described below:
Patients are not eligible to use this card if they are enrolled in a state or federally funded insurance program, including but not limited to Medicare, Medicaid, TRICARE, Veteran 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”).
Patient must have private insurance. Offer is not valid for cash-paying patients.
With this card, eligible patients will pay a $0 co-pay per eligible monthly prescription, subject to a maximum amount of $25,000 per calendar year. The amount of any benefit is the difference between your co-pay and $0. After the annual maximum of $25,000 is reached, you will be responsible for the remaining monthly out-of-pocket costs. This card may not be redeemed more than once per 30 days.
This co-pay 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.
You must deduct the value of this co-pay card from any reimbursement request submitted to your insurance plan, either directly by you or on your behalf.
You are responsible for reporting use of the co-pay card to any private insurer, health plan, or other third party who pays for or reimburses any part of the prescription filled using the co-pay card, as may be required. You should not use the co-pay card if your insurer or health plan prohibits use of manufacturer co-pay cards.
• This co-pay card is not valid where prohibited by law.
• Card cannot be combined with any other savings, free trial, or similar offer for the specified prescription.
Card will be accepted only at participating pharmacies.
This card is not health insurance.
Offer good only in the U.S. and Puerto Rico.
Card is limited to 1 per person during this offering period and is not transferable.
No other purchase is necessary.
Data related to your redemption of the co-pay card may be collected, analyzed, and shared with Pfizer for market research and other purposes related to assessing Pfizer’s programs. Data shared with Pfizer will be aggregated and de-identified; it will be combined with data related to other co-pay card redemptions and will not identify you.
Pfizer reserves the right to rescind, revoke, or amend this offer without notice.
Offer expires 12/31/2022.
If your pharmacy does not participate, you may be able to submit a request for a rebate in connection with this offer. Mail a copy of the patient’s pharmacy receipt indicating patient name, name of medication purchased, price paid, and date purchased, along with a copy of the patient’s Pfizer Oncology Together Co-Pay Savings Card, to:
Pfizer Oncology Together Co-Pay Savings Program
2250 Perimeter Park Drive, Suite 300
Morrisville, NC 27560
Ph+=Philadelphia chromosome–positive.
Free trial offer
BOSULIF voucher program
1-month (30-day) free trial offer for patients initiating therapy
Patients who are new to therapy with BOSULIF may be eligible for a free 30-day trial offer. Terms and Conditions apply; see below.
For more information on the voucher program and to obtain a 30-day free trial offer, please contact Pfizer Oncology Together at or your local Pfizer Oncology representative.
 
Terms and Conditions for Trial Voucher Program
By enrolling in the 30-day trial program for BOSULIF, you acknowledge that you currently meet the eligibility criteria and will comply with the terms and conditions described below:
1. Voucher is valid for a 30-day supply of BOSULIF.
2. Only new patients may use this voucher. By redeeming this voucher, you certify that you are not currently using BOSULIF.
3. An original voucher and a valid prescription must be presented to the pharmacy.
4. The voucher will be accepted only at participating pharmacies.
5. You must not submit any claim for reimbursement for product dispensed pursuant to this voucher to any third party payor, including Medicare, Medicaid, or any other federal or state health care program. You cannot apply the value of the free product received through this voucher toward any government insurance benefit out-of-pocket spending calculations, such as Medicare Part D True Out-of-Pocket Costs (TrOOP).
6. You must be 18 years of age or older to redeem this voucher.
7. This voucher is not valid where prohibited by law.
8. This voucher cannot be combined with any other savings, free trial or similar offer for the specified prescription.
9. This free trial voucher is not health insurance.
10. Offer good only in the U.S. and Puerto Rico.
11. No purchase is necessary.
12. Patients have no obligation to continue to use BOSULIF.
13. Pfizer reserves the right to rescind, revoke or amend this offer without notice.
14. This voucher expires 12/31/2021.
For more information, call 1-877-744-5675, contact Pfizer Inc. at 235 East 42nd Street, New York, NY 10017, or visit PfizerOncologyTogether.com.
Pfizer Oncology Together
Making your patients' support needs a priority. Together.
At Pfizer Oncology TogetherTM, patient support is at the core of everything we do. We've gathered resources and developed tools to help patients and their loved ones throughout BOSULIF treatment. From helping to identify financial assistance options to connecting patients to resources for emotional support, your patient's needs are our priority.
PATIENT FINANCIAL ASSISTANCE
Pfizer Oncology Together can help patients understand their insurance benefits and connect them with financial assistance resources, regardless of their insurance coverage. Eligible, commercially insured patients may pay as little as $0 per month for BOSULIF. Limits, terms, and conditions apply.* We can also help identify resources for patients with Medicare, Medicaid, other government insurance, or for those who don't have health insurance.
PERSONALIZED PATIENT SUPPORT
When patients need support for their day-to-day challenges, we can provide them with a dedicated Care Champion who has social work experience. Our Care Champions are here to listen to patients and connect them to resources that may help with certain emotional, educational, and practical needs.
*Patients are not eligible to use this card if they are enrolled in a state or fedrally funded insurance programs, 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. Patients may receive up to $25,000 in savings per product annually. The offer will be accepted only at participating pharmacies. This offer is not health insurance. No membership fees apply. Pfizer reserves the right to rescind, revoke, or amend this offer without notice. For full terms and conditions, please see PfizerOncologyTogether.com/terms. For any questions, please call 1-877-744-5675, visit PfizerOncologyTogether.com/terms or write: Pfizer Oncology Together Co-Pay Savings Program, 2250 Perimeter Park Drive, Suite 300, Morrisville, NC 27560.
Some services are provided through third-party organizations that operate independently and are not controlled by Pfizer. Availability of services and eligibility requirements are determined solely by these organizations.
Reference
1.
BOSULIF Prescribing Information. New York, NY: Pfizer Inc.