Access and Support for ELELYSO Patients

Pfizer Gaucher Personal Support (GPS)
The Pfizer Gaucher Personal Support (GPS) program can help address some of the financial and insurance benefit concerns of patients taking ELELYSO, and can provide them infusion support.

The GPS program offers patients, as well as their parents and caregivers, several support options.


Pfizer GPS Case Manager
  • A GPS Case Manager is the primary contact to help coordinate ELELYSO support offerings for patients, parents, and caregivers
  • The GPS team is available by phone to assist your patients
Call Pfizer Gaucher Personal Support (GPS) at 1-855-ELELYSO (1-855-353-5976)

Financial Assistance & Access Support for Your Patients
  • $0 out-of-pocket costs for ELELYSO for eligible commercially insured patients*
  • Help with insurance benefits verification and understanding prior authorization requirements
  • Provide information regarding insurance coverage appeals process
  • Provide support to patients experiencing an insurance change

Pfizer Patient Assistance Program
  • ELELYSO may be available at no cost to qualified uninsured or underinsured patients
*ELELYSO $0 Co-Pay Program Terms and Conditions apply.
The Pfizer Patient Assistance Program is a joint program of Pfizer Inc. and the Pfizer Patient Assistance Foundation™. The Pfizer Patient Assistance Foundation is a separate legal entity from Pfizer Inc. with distinct legal restrictions.

Eligible patients must meet financial qualifications and also be diagnosed with the FDA-approved indication. They must be US residents who are treated by US physicians and must complete the Patient Assistance Program Application and Patient Authorization Form.
 

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. The value of this Co-pay Card is limited to a maximum of $15,000 per calendar year.
  • 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 private 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 for Massachusetts residents whose prescriptions are covered in whole or in part by third party insurance.
  • This co-pay card is not valid where prohibited by law.
  • Co-pay card cannot be combined with any other savings, free trial or similar offer for the specified prescription.
  • Co-pay card will be accepted only at participating pharmacies.
  • If your pharmacy does not participate, you may be able to submit a request for a rebate in connection with this offer.
  • This co-pay card is not health insurance.
  • The co-pay program is available only through the Gaucher Personal Support program. For any questions, please call Gaucher Personal Support at 1-855-ELELYSO (1-855-353-5976).
  • Offer good only in the U.S. and Puerto Rico.
  • Co-pay card is limited to 1 per person during this offering period and is not transferable.
  • No other purchase is necessary.
  • No membership fee.  
  • 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 12/31/2019.  

For more information, visit our website www.elelyso.com, call 1-855-353-5976, or contact us at 2730 S. Edmonds Lane, Suite 300, Lewisville, TX 75067.