Patient Cost and Assistance Programs

OPTIONS TO HELP ELIGIBLE PATIENTS WITH ACCESS TO XELJANZ®/XELJANZ® XR (tofacitinib) AFTER A PRESCRIBING DECISION HAS BEEN MADE
Commercial Insurance
  • Co-Pay Savings Program*—Eligible patients may be able to reduce out-of-pocket costs, with a maximum benefit of $15,000 per calendar year
  • Additional Co-pay Savings for Qualified Commercially Insured Patients—Eligible, underinsured patients may receive additional co-pay support up to $10,000 annually
Additional offers for eligible, commercially insured patients by request
  • Interim Care Rx—Up to 6 months of free XELJANZ XR or XELJANZ shipped to eligible patients during a delay in prior authorization or appeal
  • Appeals Support§—Up to 2 clinical appeal letters prepared by a Registered Nurse
Government-Funded Insurance
  • Locating alternative funding sources
    For those patients who need help with their medication cost-sharing requirements, Pfizer will refer patients who appear to be eligible to Medicare Extra Help
  • Pfizer Patient Assistance Program
    Free XELJANZ XR or XELJANZ shipped directly to eligible, underinsured patients
No Insurance Coverage
  • Locating alternative funding sources
    For those patients who need help with their medication cost-sharing requirements, Pfizer will refer patients who appear to be eligible to Medicare Extra Help
  • Pfizer Patient Assistance Program
    Eligible patients may receive XELJANZ XR or XELJANZ at no charge
*Administered by TrialCard. Availability subject to patient eligibility requirements and/or applicable limits, terms, and conditions. See Terms & Conditions.
Availability subject to patient eligibility requirements and/or applicable limits, terms, and conditions. Up to a maximum of $10,000 per calendar year.
The free product for this program is for certain commercially insured patients only. Not available to residents in the states of MA, IA, MN, MO, OH, or RI. See Terms & Conditions.
§If permitted by the patient's commercial insurance carrier. Patient must opt-in on the Prescription & Enrollment Form for XELSOURCE to prepare the appeal on their behalf; provider's office has the option to opt out of this service. Not available to patients in MA, MI, MN, MO, OH, and RI.
Free medicines from Pfizer are provided through the Pfizer Patient Assistance FoundationTM. The Pfizer Patient Assistance Foundation is a separate legal entity from Pfizer Inc, with distinct legal restrictions.



 


JAK=Janus kinase; RA=rheumatoid arthritis; Rx=prescription.