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.
Ask a Pfizer Oncology representative for more details, or download here.
Terms and Conditions for Trial Voucher Program
The trial voucher is not a prescription for BOSULIF beyond 1 month and there is no obligation to continue BOSULIF. To continue a patient on therapy, a separate prescription must be written to be filled at a participating specialty pharmacy. Patients may be offered enrollment in the trial voucher program exclusively through their healthcare provider.
This offer is valid once per patient for a 1-month (30-day) 400-mg, 500-mg, or 100-mg supply through 3/31/2020.
By enrolling in the 30-day trial program for BOSULIF® (bosutinib), you acknowledge that you currently meet the eligibility criteria and will comply with the terms and conditions described below.
The patient, or healthcare provider on the patient’s behalf, must provide a valid prescription to the BOSULIF 30-day free trial offer.
The program is valid for one 30-day trial. Trial cannot exceed 30 days.
The patient, or the healthcare provider on the patient’s behalf, must not submit any claim for reimbursement for product dispensed pursuant to this program to any third party payor, including Medicare, Medicaid, or any other federal or state health care program. The patient must not apply the value of the free product received through this program toward any government insurance benefit out-of-pocket spending calculations, such as Medicare Part D True Out-of-Pocket Costs (TrOOP).
Patients who have already begun therapy with BOSULIF are not eligible to participate in the program.
Patients must be at least eighteen (18) years of age to be eligible to participate in the program.
Only 1 program enrollment per person per lifetime.
Massachusetts residents whose prescriptions are covered in whole or in part by third party insurance are not eligible for this program.
Program not available where prohibited by law.
This free trial is not health insurance.
This program cannot be combined with any other savings, free trial, or similar offer for the specified prescription.
Offer good only in the United States and Puerto Rico.
Pfizer reserves the right to rescind, revoke, or amend this free trial program without notice.
This free trial program expires 03/31/2020.
Ph+=Philadelphia chromosome–positive.
Reference
1.
BOSULIF Prescribing Information. New York, NY: Pfizer Inc.